Researchers believe that a hot flash represents a temporary shift in blood flow, in response to fluctuations in hormone levels. Hot flashes can also be brought on by diet (especially one high in refined carbohydrates), alcohol, and stress. Avoiding these triggers may help reduce the frequency of hot flashes.
Night sweats are hot flashes that occur during sleep, sometimes resulting in a sweat so heavy that it soaks clothing and sheets. Because night sweats interrupt sleep patterns, they can contribute to fatigue and insomnia, and increased irritability and tension, all of which are also frequently reported symptoms during menopause.
The lining of the vagina is very sensitive to changes in estrogen hormone levels. Estrogens encourage blood flow to the genital area and keep the walls of the vagina supple and elastic, and also help protect it against bacterial infection.
As levels of the estrogen hormones begin to decline, some women experience vaginal dryness, itching, or swelling, and/or pain during sexual intercourse. Leaking small amounts of urine while sneezing or coughing, or when engaged in strenuous physical activity may also occur. Due to changes in vaginal secretions, there is an increased risk of developing vaginal and urinary tract infections.
After menopause, vaginal and genital tissues become thinner, drier, and less elastic. Vaginal atrophy can also begin to occur.
During perimenopause, menstrual bleeding may stop for several months and then return, or it may increase or decrease in duration, intensity, and flow. Over time, cycles typically get farther and farther apart, until menstruation finally ceases. Some women suddenly stop menstruating without any irregularities at all.
Abnormal bleeding, including very heavy blood loss, thick clots, periods that last two or more days longer than normal, or bleeding between menses, may also indicate an underlying condition. Therefore, it is wise to track these symptoms carefully and discuss them with your healthcare practitioner whenever they occur.
Irregular bleeding or vaginal changes can make women less interested in sex. However, with appropriate treatment, many women feel an increase in their sex drive during and after menopause. Having more privacy after children “leave the nest” and not having to worry as much about pregnancy may rejuvenate the sex drive for some women.
Dr. Sheldon Cherry notes that “the need for intimate relationships exists throughout life, especially during the middle and later years.” He also suggests that “continued sexual activity is important for the maintenance of vaginal health,” although pregnancy is still possible
Other Symptoms Related to Menopause
Emotional problems and minor psychological complaints are more frequent among menopausal women, but there may be reasonable explanations for this. Menopause is just one aspect of any number of mid-life crises that may be occurring, such as the death of a spouse or parent, empty nest syndrome, or career changes.
Other symptoms typically reported by women going through menopause may be related to but not necessarily caused by menopause. For example, insomnia, irritability, headaches, fatigue, and mood swings are all non-specific symptoms that can occur at all ages, in both men and women. These symptoms are often a result of hormonal imbalances brought on by a variety of other health conditions or life stresses.
At menopause our bodies become dependent on our adrenal glands for sex hormone production. If we are already dealing with chronic or long-term stresses, adrenal function will be compromised, further compounding the inter-relationships among various health conditions, hormone balance and symptoms.
Nevertheless, the following symptoms are often attributed to women going through menopause:
- Sleep disturbances, which may be related to hot flashes and night sweats.
- Depression, often brought on by other circumstances or changes. The incidence is much lower among post-menopausal women.
- Increased moodiness, irritability and anxiety, related to fluctuations in hormone levels. Some women say that they just don’t feel like themselves.
- Impaired concentration and memory can be a result of sleep disturbances and/or hormonal fluctuations.
- Headaches are more common among women than men, in general, primarily due to hormonal fluctuations. Migraines have been associated with PMS, but those cyclical symptoms can still occur during menopause.
- Heart palpitations, which are rapid or irregular heartbeats, may be related to stress, hot flashes or other hormonal fluctuations.
- Skin changes may become more noticeable, partially as a result of declining levels of the estrogen hormones. As we age, our skin becomes drier, thinner and less elastic. The skin aging process can be accelerated by sun exposure and smoking.
- Hair loss, which can also be brought on by stress and other hormone imbalances.
- Increased risk of osteoporosis tends to accompany menopause. The majority of cases of osteoporosis are found in post-menopausal women.
- Dental changes, such as tooth loss, is especially common among post-menopausal women. Tooth loss could also be related to osteoporosis, whereby bone loss in the jaw alters the tooth sockets.
- Increased risk of cardiovascular disease also occurs as women approach menopause. As women age, their risk of high blood pressure, abnormal heart rhythm, heart attack, stroke and coronary artery disease increases.
How Long Do Menopausal Symptoms Last?
How long symptoms last and how they affect your daily life will depend on a number of factors. Your menopausal experience will be influenced by your diet, your relationships with family and friends, your career and/or life satisfaction, and your heredity, among other things. Whatever else is going on in your life at the time, as well as your physical and emotional health, will affect your ability to deal with the transition.
With all of this in mind, Dr. Northrup explains that typical “symptoms of perimenopause (in a natural transition) last anywhere from five to ten years, with a gradual crescendo in the beginning, a peak as one approaches mid-transition, and a gradual decrescendo towards the end, as the body learns to live in harmony with its new hormonal and emotional milieu.”
It is important to remember that some of these symptoms represent a natural process, not a disease, and therefore are usually temporary. “The reassurance that comes from this knowledge will go a long way toward relieving the anxiety some women experience as they approach this stage of life” says Dr. Cherry.
In any case, if symptoms are so severe that they interfere with your daily life, consult with your healthcare practitioner. Many of these symptoms can be reduced or eliminated with treatment.