The 48 signs of menopause: what they are and how to find support

Awareness of the signs

Despite there being 48 symptoms of menopause according to GenM, most women can name just 3-5 of these signs.

With that in mind, GenM are working to improve awareness of the signs of menopause, combined with the MTick certification to highlight products that may help support with these symptoms.  

At Pharmacy2U, we believe that women should feel prepared, educated, and empowered about the signs of menopause, which is why we’ve put together this comprehensive guide to the symptoms of menopause. 

The 48 signs of menopause

This guide is an A-Z of the signs of menopause, grouped into categories. For each sign, we’ve included a brief description of what it is and how it might affect you. For more information about each sign, browse the detailed GenM guide. 

Vasomotor menopause signs 

Body odour 

Menopause may affect the hypothalamus, the part of the brain which regulates the body’s temperature. This may contribute to the body overproducing sweat, which in turn can cause body odour. Night sweats, hot flushes, and anxiety can also contribute to this. 

Feeling cold  

Reduced levels of oestrogen may also affect the hypothalamus, which regulates body temperature, leading to feeling cold. Cold flashes are the reverse of hot flushes and can occur more often at night. 

Hot flushes 

One of the more commonly known menopause symptoms, hot flushes affect 75% of menopausal women, but the exact cause is unclear. Hot flushes create feelings of intense heat in the face, neck, and chest and they usually last around four minutes. 

Night sweats 

An estimated 75% of perimenopausal and menopausal women are affected by night sweats, the nocturnal version of hot flushes. These episodes can disrupt sleep and are thought to be linked to changes in the body’s temperature regulation system, which may lead to increased sweating. 

Cognitive and emotional menopause signs 

Anxiety 

A aquarter of women in perimenopause or menopause suffer from anxiety according to the GenM study, which may present itself as feelings of worry, panic, nervousness, or anxiousness. This may in part be caused by fluctuations in oestrogen levels. 

Brain fog 

Brain fog is struggling to think clearly, remember things, or take in new information. It is thought to be associated with hormonal changes which may affect cognitive function and can be really frustrating. 

Depression 

Menopause-related depression can manifest as low mood, fatigue, loss of interest in everyday life, and feelings of worthlessness. These symptoms are thought to be associated with hormonal changes, although other factors can also contribute. 

Irritability 

Around 70% of women list increased irritability as their main emotional symptom of menopause, especially earlier in the process. Like many symptoms, this may be associated with hormonal changes, including fluctuating oestrogen levels, although other factors can also contribute. 

Lack of motivation 

A lack of motivation could be associated with fluctuating levels of oestrogen and progesterone, as well as changes in other hormones involved in energy regulation. This may occur alongside other symptoms such as low mood and brain fog. 

Loss of concentration 

Loss of concentration is a common symptom that often comes on at the start of perimenopause. It’s believed that hormonal fluctuations may influence the brain’s neurotransmitters and function, which can contribute to difficulty concentrating. 

Loss of confidence and self-esteem 

Reduced self-esteem and confidence may be experienced during menopause and can be associated with other symptoms including cognitive and emotional issues, appearance changes, and physical symptoms. All these factors combined can contribute to women feeling low on confidence. 

Mood swings 

Fluctuating hormone levels during perimenopause and menopause may be associated with mood changes in some people. These hormonal changes can affect emotional wellbeing and may contribute to irritability or low mood. 

Panic disorders 

Some people may experience anxiety during menopause which may be associated with fluctuations in oestrogen and progesterone. Overwhelming or untreated anxiety in menopause in some cases may lead to panic attacks. 

Short-term memory issues 

Forgetfulness and short-term memory loss are commonly reported in perimenopausal women, with the GenM study showing 60% of women reporting that their memory isn’t as good as it used to be. 

Energy and sleep menopause signs 

Fatigue 

Fatigue is a feeling of extreme exhaustion or a lack of energy, which may affect some women in menopause regardless of how much sleep they get. 

Sleep issues and insomnia 

Insomnia and disturbed sleep may affect some women throughout perimenopause and menopause. As with many symptoms, this it thought to be a result of dropping oestrogen levels, which may help the body process serotonin. 

Skin, hair, and nails menopause signs 

Acne 

Fluctuating hormones may contribute to changes in skin oil production. This can sometimes lead to blocked pores and outbreaks of acne, which are often seen in the lower cheeks and jawline. It’s estimated that 25% of women in their 40s and 15% of women in their 50s are affected. 

Altered skin 

Some women may experience unusual skin sensations during menopause, such as pinching, shocking, or random pain. These symptoms are thought to be associated with changes in hormone levels, which may influence how sensory signals are perceived. 

Changes in skin texture 

Reduced levels of collagen may contribute to changes in skin texture such as skin feeling thin, brittle, and loose. According to the GenM study, during the first five years of menopause, women’s skin loses an average of around 30% of its collagen. 

Itchy, crawly skin 

An itchy, crawly, or tickly feeling on the skin is called pruritus, and some people report experiencing this during perimenopause. It may be associated with oestrogen and collagen levels changing and can sometimes lead to skin becoming dry or thin, causing this itching sensation, often on the neck, chest, or back. 

Nail changes 

Nails might become to feel dry, flaky, and flimsy during perimenopause and menopause. These changes may be associated with hormonal fluctuations as well as dehydration. 

Thinning hair 

Some people may notice changes in their hair during perimenopause and menopause such as thin, brittle, or dry hair, which is often compounded by hair growing more slowly and shedding more. These changes are thought to be associated with fluctuating levels of oestrogen and progesterone. 

Sexual and vaginal menopause signs 

Changes in sex drive 

Libido may be reduced for some during perimenopause and menopause, due to fluctuating hormone levels and other menopause symptoms such as low mood and vaginal dryness. 

Decreasing fertility 

Fertility drops by an average of 50% for women over 40, with ovulation becoming more erratic the older women get. However, it’s important to note that every woman’s fertility is different and that it’s difficult to predict. 

Irregular periods 

Irregular and erratic periods are common during perimenopause and are thought to be caused by a fluctuation in oestrogen and progesterone. As well as becoming unpredictable and infrequent, periods may be lighter or heavier than usual. 

Vaginal dryness 

From perimenopause through menopause, many women may suffer from vaginal dryness, tightness, and discomfort. A drop in oestrogen means the vagina’s walls are thinner and dryer, causing pain or itchiness and leading to less natural lubrication being produced. 

Urinary and pelvic menopause signs 

Bladder weakness 

Incontinence in menopause is thought to be associated with hormonal changes, which may thin the lining of the urethra and affect the stomach and pelvic muscles (also known as pelvic relaxation). Stress incontinence, urge incontinence, and overflow incontinence may all occur. 

Recurrent UTIs 

During menopause, hormonal changes may affect the thinning of the lining of the urethra, which could make it more prone to infection. This means menopausal women may be more susceptible to get urinary tract infections (UTIs) more often, as well as other bladder and vaginal infections. 

Digestive and bodily change menopause signs 

Bloating  

Changes in oestrogen and progesterone may cause bloating of the stomach and could affect some women from the perimenopause stage onwards. 

Changes in breast size 

The GenM study showed that 20% of women experience breast growth from perimenopause onwards, which is thought to be caused by shifting hormones and the natural aging process. This symptom may also be influenced by general menopause weight changes. 

Nausea and digestive problems 

Nausea and digestive problems are common symptoms. Nausea, sickness, bloating, heartburn, and indigestion, especially in the morning, are thought to be more prevalent in perimenopause, whereas wind, constipation, and stomach ache can be more commonly experienced during menopause.  

Sagging breasts 

The reduction in reproductive systems and ability to produce milk may lead to the glandular tissue in the breasts to shrink. Combined with depleting collagen levels, this can mean some people experience breasts sagging or looking further apart, nipples turning down, and stretch marks appearing. 

Sore breasts 

Breast discomfort or pain in menopause and perimenopause may be experienced, which may feel similar to the achy soreness that many women experience in the build-up to their periods, but sometimes worse. It can affect one or both breasts and can sometimes feel like a stabbing or burning pain. 

Tingling extremities 

Paraesthesia is the term used to describe tingling extremities, pins and needles, and body parts ‘going to sleep’, which many women report, but for most it disappears after menopause.  

Weight gain  

Weight gain is reported as a common symptom for menopausal women, even for those whose diet hasn’t changed. This can be down to reduced muscle mass and slowing of metabolism, as well as a combination of other menopause symptoms. 

Muscular, bone, and joint menopause signs 

Joint pain 

Musculoskeletal aches may occur when oestrogen levels affect the cartilage (bone connecting tissue) around joints, causing inflammation and pain. Some women may experience worse joint pain first thing in the morning. 

Loss of bone density 

A change in oestrogen, which is essential for healthy bones, can lead to reduced bone density and osteoporosis, a condition that leaves bones fragile and more likely to break. Bones can weaken more significantly in the first couple of years after periods stop. 

Muscle tension 

Stiffness, soreness, and muscle pain, especially when waking up, may be experienced in menopause. Fluctuations of oestrogen, progesterone, and cortisol levels can cause muscles to tighten and tire. It is thought that women are more prone to losing muscle mass after 40, which may contribute to these symptoms. 

Cardiovascular and autonomic menopause signs 

Breathing difficulties 

Some women may suffer from breathing difficulties, which can be shortness of breath or reduced tolerance to exercise. Menopause may also make pre-existing breathing conditions, like asthma or chronic obstructive airway disease, worse.  

Dizziness 

Dizziness, light-headedness, and feeling off-balance or wobbly when standing up may be experienced during menopause. Research indicates the feelings could be down to oestrogen or insulin levels, as well as problems with the inner ear. 

Headaches and migraines 

Sometimes more prominent in perimenopause, headaches and migraines may occur due to fluctuating hormones. While they can cause dizziness and nausea, some women experience an improvement as they progress into menopause. 

Heart palpitations 

Irregular or skipped heartbeats, which can feel like a racing or fluttering feeling, may occur randomly, or often during or after a hot flush. Fluctuating hormones affect many bodily functions including, in this case, the cardiovascular system. 

Mouth, eyes, and sensory menopause signs  

Burning mouth syndrome 

40% of women suffer from burning mouth syndrome during menopause according to GenM, which can feel like a spicy burning sensation, as well as dryness, a metallic taste, or pain. This is thought to occur because of the changing oestrogen levels in saliva, which may affect the taste buds. 

Changes in taste and smell 

As well as burning mouth syndrome, menopause can also change some women’s ability to smell and taste. This is thought to be due to reduced saliva flow which may be caused by changing levels of oestrogen. 

Dental problems 

Bleeding and receding gums, tooth decay and loss, and bone loss in the jaw can all be signs of menopause according to the GenM study. These symptoms may occur due to an increase in bacteria caused by an increase in mouth dryness.  

Dry eyes 

Around 10% of women suffer from dry eyes during menopause, which may be caused by a reduced production of tears. This may also lead to a stinging or burning sensation, as well as blurred vision. 

Dry mouth 

Like burning mouth syndrome and changes in taste, the reduction of salvia may lead to a dry mouth. This leaves some women in menopause at higher risk of tooth decay, receding gums, and infections.

Other menopause signs 

Worsening PMS 

Extreme PMS (premenstrual syndrome) can occur in perimenopause, as hormones start fluctuating. This can lead some women to experience more intense versions of their average PMS symptoms. 

Why symptoms vary so much

More than half of woman can only name 3 signs of menopause, most are affected by multiple of these symptoms. However, which symptoms and how severely they impact each individual can widely vary.  

This is partly down to hormonal fluctuation. As you will know from reading about the symptoms above, changing oestrogen levels are a major contributor to many signs of menopause, as well as changing levels of progesterone, collagen, and more. The extent to which these hormones fluctuate, as well as how this affects the individual, varies from woman to woman.

This means that no two menopause journeys are alike.

Some symptoms may come and go in a matter of days, while others can be prevalent for years, with menopause journeys and symptoms often up to and over 15 years. It really is different for each of the millions of women around the world going through menopause.

The role of MTick products

With such a disparity of awareness from symptom to symptom (some are well known, others are taboo, rarely talked about, or little known), GenM have developed the MTick certification to help identify menopause-friendly products.

An overwhelming 94% of menopausal women want to shop ‘menopause-friendly’ labelled products, the MTick may help women by highlighting items that have been identified as relevant to menopause-related needs.  

While the MTick doesn’t ‘cure’ menopause, it helps women manage their symptoms, their way, using solutions from reliable brands with menopause-friendly labelling. 

While menopause is inevitable, struggling through it without the knowledge to manage the journey effectively isn’t.  

Knowing the signs is the first step towards taking back control. 

To find out more about GenM, the MTick, and how Pharmacy2U are working with them, read our Health Hub article here. 

Browse our range of MTick-certified products and start living your best menopause journey, here.  

This content is provided for general information only and does not replace medical advice. If you have concerns, speak to your healthcare professional.