18 signs of the menopause that you might have missed

Here Miss Tania Adib, Consultant Gynaecologist at The Lister Hospital, part of HCA Healthcare UK, runs us through 18 symptoms of the menopause which women might not be aware of. 

1. Cold flushes

Whilst it’s likely you will have heard of hot flushes in relation to the menopause, have you noticed that you have experienced cold flushes too? They often occur after a hot flush or spontaneously. Like hot flushes, cold flushes can be caused due to a change in the brain’s ability to control your body temperature. It can also be made worse by wearing damp clothes from sweating. 

2. Tingling in extremities

During the menopause you might experience tingling in your hands, feet, arms and legs. This symptom is the result of hormone fluctuations affecting the central nervous system and usually lasts for a few minutes at a time.

3. Fatigue

You might have also realised that you’re feeling more tired than usual – this could be as a result of a lack of sleep due to night sweats, or because of hormonal fluctuations.

4. Decreased libido

Menopause might have also decreased your libido or desire for sex. This can be due to you having lower levels of testosterone and oestrogen, which can make physical arousal more difficult.

It can also be triggered by other symptoms of the menopause, such as mood changes, or as a side-effect of medication.

5. Thinning hair

Hormonal fluctuations during the menopause can cause your hair follicles to shrink – meaning hair grows slower and sheds easier.

6. Burning mouth

This is a lesser-known symptom of the menopause – you might experience a burning, tenderness, tingling, heat or numbing in the mouth – which again is a result of hormonal changes. 

7. Missed periods

During the menopause, your periods are likely to be irregular and it’s normal to miss a few periods.

However, it’s important to note that menopausal symptoms can still occur whilst your periods are regular (this stage is referred to as the perimenopause).

8. Dizziness or vertigo

You might experience dizzy spells during the perimenopause and menopause.

This is because the hormonal changes which take place affect the production of insulin, which can make it difficult for your body to maintain blood sugar stability. 

9. Anxiety

Anxiety might affect you intermittently as your hormone levels fluctuate and can sometimes worsen at night.

10. Vaginal dryness

Female sex hormones ensure that there is a good circulation of blood flow around the vagina, so a lack of these hormones can impact natural lubrication and cause dryness.

This can be uncomfortable and make penetrative sex difficult. 

11. Changes in spatial awareness

During the menopause, changes in the perception of depth of vision can occur, which can affect your awareness of surroundings. Your concentration can sometimes dip during this time, and your eyes can become drier. This can lead to clumsiness or being more accident prone. 

12. Low mood and depression

When you go through the menopause it can bring about significant changes that can have an impact on your mood and mental health. Lack of sleep due to menopausal symptoms can also contribute to low mood.

13. Feeling that something is crawling on your skin

This might sound like an unusual symptom, but you may have felt some level of skin itchiness, or even the feeling that something is crawling on your skin.

This could occur because oestrogen is closely related to collagen production and skin hydration, so a decline in this hormone during the menopause can lead to increased itchiness and dryness of the skin.

14. Tinnitus

The menopause can cause your hearing to alter slightly, or for you to start experiencing tinnitus (ringing in your ears).

There are oestrogen receptors in the ear cells and it’s thought that a change in production of oestrogen can impact your ear function.

15. Brittle nails

During or after the menopause, your body might not produce enough keratin – the substance that nails need to stay strong. This can lead to brittle, weak nails that crack or break easily. 

16. Changes in taste

You may find that some foods taste differently or that your sense of taste becomes stronger. Fluctuation in oestrogen levels might also cause a metallic taste in your mouth.

17. Breast tenderness

Your breasts might feel more sore or tender than usual as oestrogen and progesterone levels change.

This symptom tends to ease as the menopause progresses.

18. Change in body odour

Hot flushes and night sweats can result in an increase or change in body odour during the menopause. If the menopause is also making you feel more stressed or anxious than normal, this can also make you sweat more. 

How to manage the menopause

With so many changes happening in your body, the menopause can feel overwhelming for many women, but help and support is available. With so many potential symptoms, it important to rule out other conditions and your GP or gynaecologist will be able to point you in the right direction, identify if you are in menopause or perimenopause and discuss the best way to manage your symptoms.

One treatment for menopausal symptoms is hormone replacement therapy (HRT). This can ease some of the symptoms which the menopause can cause and rebalance the body’s oestrogen levels – which is good as long-term deprivation of oestrogen to the body can have a significant health impact.

If you’re considering using HRT, it is important to discuss the risks and benefits with your GP or gynaecologist. If you decide to go ahead with HRT, the type and dose, as well as the recommended period of time to take it, will be tailored to your particular circumstances. HRT is not suitable for everyone and there are other options.

Non-hormonal medication such as antidepressants can also be prescribed to relieve low mood and hot flushes. However, antidepressants often have side effects, so again talking this through with your GP or specialist is essential.

Paying close attention to diet, nutrition and exercise can also be helpful in dealing with menopausal symptoms, for example following a Mediterranean diet which involves good-quality protein, lots of fruit and vegetables and a reduction on carbohydrates has been proven to beneficial.

Learn more about the care we offer for women going through the menopause