Menopausal symptoms

Symptoms of menopause

Menopause is characterised by multiple physiological and psychological changes in a woman’s life. These are results from the changes to the woman’s hormone levels.

Menopause or cessation of menstrual cycles is a normal part of a woman’s life. The diagnosis of menopause is made after 12 months of amenorrhoea.9

Many women experience multiple symptoms before, around or at the time of menopause. Hot flushes and night sweats are the two most common symptoms of menopausal transition. They are also associated with disturbed sleep and irritability, thus affecting a woman's overall quality of life.1

Menopause can be associated with a variety of vasomotor symptoms and a few of the common ones are listed below.1-6

Why is it important to know about symptoms of menopause?

There are several symptoms of menopause and some of those might occasionally overlap with the symptoms of other medical conditions. A good knowledge about these symptoms, along with a detailed patient history helps in the early diagnosis and management of menopause.

Overview of symptoms of menopause

Irregularity in periods

The majority of women experience irregular menstrual periods during the menopausal transition period. Some women experience shortened cycles or longer periods of amenorrhoea. This irregularity in periods is indicative of the large fluctuation of the ovarian estrogen secretion.4

Hot flushes

Hot flushes are the most common sign and symptom of menopause. They persist for a few months in some women, but could last for more than 10 years in others.1,3 The pathogenesis of hot flushes has not been fully understood yet; however, it is suggested to be influenced by variations in the levels of hormones such as estrogen, norepinephrine and serotonin.1

Night sweats

Night sweats are hot flushes that occur with perspiration during sleep. According to the National Sleep Foundation, women with night sweats experienced an average of 3 episodes per week.1 Night sweats can be strong enough to disturb sleep.1

Insomnia

Vasomotor symptoms may be associated with insomnia. Menopausal women are more likely to have difficulty falling asleep, staying asleep and achieving refreshing sleep.1

Mood swings

Menopause-associated changes in mood may be caused by several other factors, such as high sensitivity to environmental events secondary to decreased hormonal levels.1

Changes in body fat distribution

Weight gain does occur at midlife, but is a result of age and environmental factors rather than the menopause per se.6,8

Hormonal changes during menopause results in an increase in total body fat and redistribution of fat to the abdomen.6,8

The increase in central abdominal fat correlates with a risk of dyslipidemia and an increased risk of cardiovascular disease.8

Vaginal dryness

One of the early signs of reduced estrogen on the vagina is reduced lubrication during sexual activity.7

Without the production of estrogen, the skin and support tissues of the lips (vulva) and vagina become thinner and less elastic and the vagina can become dry. Approximately half of post-menopausal women experience vaginal dryness.7

  • References

    1. 1) Utian WH. Psychosocial and socioeconomic burden of vasomotor symptoms in menopause: a comprehensive review. Health and Quality of Life outcomes. 2005 Dec;3(1):47.
    2. 2) Dalal PK, Agarwal M. Postmenopausal syndrome. Indian J Psychiatry. 2015 Jul;57 Suppl 2:S222.
    3. 3) Harlow SD, Gass M, Hall JE et al; STRAW+ 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop+ 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab. 2012 Apr;97(4):1159-68.
    4. 4) Santoro N. Perimenopause: from research to practice. J Womens Health (Larchmt). 2016 Apr;25(4):332-9.
    5. 5) Soares CD, Cohen IS. The perimenopause, depressive disorders, and hormonal variability. Sao Paulo Medical Journal. 2001 Mar;119(2):78-83.
    6. 6) Davis SR, Castelo-Branco C, Chedraui P et al. Understanding weight gain at menopause. Climacteric. 2012 Oct;15(5):419-29.
    7. 7) Women's Health Concern (WHC) Vaginal Dryness, accessed on: https://www.womens-health-concern.org/help-and-advice/factsheets/vaginal-dryness/. Last accessed: January 2021.
    8. 8) Baber RJ, Panay N, Fenton AT. 2016 IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric. 2016 Apr;19(2):109-50.
    9. 9) NICE guideline NG23 Menopause: diagnosis and management, 2015 accessed on: https://www.nice.org.uk/guidance/ng23/resources/menopause-diagnosis-and-management-pdf-1837330217413. Last accessed April 2021.

Femoston®

Femoston is a combination of 17β estradiol and dydrogesterone, which is indicated for postmenopausal women at least 6 months since last menses to provide relief from vasomotor symptoms.

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