Unexpected signs of menopause: what you need to know

Is it (peri)menopause? Surprising clues your body might be giving you

Menopause, defined as a point in time 12 months after a woman’s last period, is one of the only “conditions” that every woman who lives long enough will experience. Many women will experience bothersome, yet preventable, symptoms in the months and years leading up to menopause—a period referred to as “the menopausal transition” or perimenopause. In fact, approximately 85% of women report experiencing symptoms.

Unfortunately, menopausal symptoms remain underdiagnosed and undertreated due to several factors: lacking education among providers, controversy surrounding the most common treatment (HRT), and gender bias in the healthcare system. Additionally, menopause presents a wide range of symptoms that vary between patients, making it challenging to diagnose and treat consistently.

In this post, we discuss some of the lesser known symptoms of menopause, as described in Dr. Mary Claire Haver’s best-selling book The New Menopause.

The usual suspects: commonly discussed menopause symptoms

When we think of menopause, we usually think of the following well-known symptoms:

• Hot flashes: Sudden feelings of intense heat, often accompanied by sweating and reddening of the skin, usually in the upper body. Hot flashes can occur anytime but are most common during the day.

• Night sweats: Episodes of excessive sweating that occur during sleep, often drenching pajamas and sheets

• Genitourinary symptoms: Vaginal dryness, pain during sexual intercourse (dyspareunia), and incontinence (involuntary leakage of urine)

• Difficulty sleeping & insomnia: Trouble falling or staying asleep, or waking up too early

• Changes in the regularity and flow of the menstrual cycle: Cycles may be longer or shorter than usual, and flow may become lighter or heavier, before menstruation ceases altogether

• Loss of bone density: A decrease in bone mass weakens the bones and increases the risk of fractures, diagnosed by DEXA scan

The hidden side of menopause: symptoms you didn’t see coming

However, beyond these common symptoms, there is a wide array of lesser known symptoms that might be entirely due to your body producing less estrogen, progesterone, and testosterone.

Skin, hair, and nails

• Acne

• Body odor

• Brittle nails

• Dry skin

• Eczema

• Itchy skin

• Thinning hair on head

• Wrinkles

• Unwanted hair growth

Cognitive & mental health

• Brain fog

  • Difficulty concentrating

  • Memory challenges and forgetfulness

  • Slow thinking

• Irritability

• Frequent mood swings

• Anxiety

• Depression

Musculoskeletal

• Arthralgia (joint pain or stiffness)

• Arthritis

• Muscle aches

• Sarcopenia (loss of muscle mass)

• Frozen shoulder

  • Stiffness in the shoulder joint

  • Pain in the shoulder joint

  • Limited range of motion in the shoulder joint

• Osteoporosis

Gastrointestinal

• Acid reflux & gastroesophageal reflux disease (GERD)

  • Heartburn

  • Regurgitation of food or sour liquid

  • Difficulty swallowing

  • Chronic cough

• Bloating

• Irritable bowel syndrome (IBS)

  • Cramping

  • Belly pain

  • Gas

  • Diarrhea

Metabolic

• Non-alcoholic fatty liver disease (NAFLD)

• High cholesterol

• High triglycerides

• Insulin resistance

• Weight gain

• Kidney stones

• Body composition changes

Sexual & reproductive health

• Decreased libido (desire for sex)

• Genitourinary syndrome of menopause (GSM)

  • Vaginal dryness

  • Vaginal irritation

  • Vaginal itching

  • Pain during intercourse (dyspareunia)

  • Urinary incontinence

  • Frequent urinary tract infections (UTI)

Neurological & sensory

• Dizziness or vertigo

• Headaches

• Migraines

  • Throbbing pain, usually on one side of the head

  • Nausea or vomiting

  • Sensitivity to light, sound, or smells

  • Visual disturbances (aura), such as flashing lights or blind spots

  • Dizziness or vertigo

• Tinnitus (perception of sound in the ears or head when no external sound is present)

• Tingling extremities

• Electric shock sensations

• Crawling skin sensation

Cardiovascular & respiratory

• Heart palpitations (sensation of a rapid, fluttering, pounding, or irregular heartbeat)

• Asthma

• Sleep apnea

Oral & dental

• Dry mouth (xerostomia)

• Gum disease (gingivitis or periodontitis)

• Burning sensation in mouth or tongue

• TMJ (jaw pain)

• Tooth sensitivity

• Bone loss in the jaw

• Loose teeth

Miscellaneous

• Alcohol tolerance changes

• Breast tenderness

• Dry or itchy eyes

• Itchy ears

• Fatigue

• Chronic fatigue syndrome

• Fibromyalgia

• Triggering or exacerbation of autoimmune conditions

  • Rheumatoid arthritis (RA)

  • Lupus (Systemic Lupus Erythematosus)

  • Sjögren's syndrome

  • Hashimoto’s thyroiditis

  • Multiple sclerosis (MS)

The bright side

As you can see, menopause is significantly more complex and multifaceted than popular culture leads us to believe.

If you’re experiencing any of these symptoms, the good news is that many are very treatable and avoidable. Treatments such as Hormone Therapy (HT)—also known as Hormone Replacement Therapy (HRT), Menopausal Therapy (MT), and Menopauale Hormone Therapy (MHT)—can not only address troublesome symptoms but also reduce your risk of chronic disease and extend lifespan.

If you’re ready to take control, Otto Health can help you find the perfect clinician to manage your symptoms and ensure the next decades of your life are full of health and vitality.