Common Symptoms of Menopause (and Perimenopause) You May Not Know About

Written by

Having a strong understanding of the many symptoms associated with menopause as well as the time leading up to it, known as perimenopause, may help women better navigate this stage of their life.

A Quick Look at Perimenopause and Menopause

The primary cause of perimenopause/menopause are hormonal imbalances; most notably estrogen and progesterone. One of the greatest contributors to hormonal irregularities is disruption of the menstrual cycle. In healthy women, the menstrual cycle begins with an increase in estrogen production that reaches its peak 14 days later. At this point an egg is produced, which releases progesterone thereby helping to normalize the estrogen/progesterone ratio. As a woman ages, the menstrual cycle can become increasingly dysregulated resulting in notable imbalances of estrogen and progesterone. These imbalances are the leading cause of perimenopause/menopausal symptoms.

Perimenopause encompasses the entire the time span beginning at declining menstrual function and ending at menopause. Perimenopause and its symptoms typically remain between 3 to 5 years. However, it is possible for this transitional time to last for as little as six months or as long as 12 years.

Menopause, which follows perimenopause, describes the natural process wherein a woman loses the ability to menstruate and by extension the capacity to reproduce. A woman is only considered menopausal if a full year has passed since her last period. Women generally experience menopause around 51 years of age, but it can develop earlier or later.

Learn even more about perimenopause and menopause here.

Symptoms of Perimenopause and Menopause

Perimenopause and menopause involve a great deal of erratic hormonal activity resulting in a wide range of inconsistent symptoms. The occurrence of these symptoms is primarily dictated by the values of estrogen and progesterone in the system. For example, perimenopausal/menopausal women deficient in estrogen are likely to experience a different set of symptoms compared to those with a deficiency in progesterone. That said, symptoms are not exclusive to the specific deficiencies and any of the following issues may develop as a woman progresses through perimenopause/menopause.

Hot Flashes and/or Night Sweats

Sudden changes in body temperature, or hot flashes, may precede menopause and continue for some time after. This exceptionally common symptom typically lasts between one to five minutes and produces sensations of heat in the upper body. Flushness of the face and neck, blotches on the chest, back, and arms, and heavy sweating or shivering may also occur. Hot flashes that happen while sleeping may result in night sweats and premature waking, which can contribute to a reduction in sleep quality.

Irregular Periods

One of the most easily recognized changes in perimenopausal/menopausal women is irregularities in period frequency, duration, and heaviness. Perimenopausal/menopausal women often notice that their periods are shorter or longer and their flow becoming lighter or heavier. Changes like these are to be expected. However, significant changes such as exceptionally short times between periods, spotting, periods lasting longer than a week, or periods resuming after no bleeding has occurred for over a year are indicative of further dysfunction and should be reported to a doctor.

Changes in Mood

Hormones play an important role in mood regulation. As such, the hormonal dysregulation experienced by women going through perimenopause/menopause often trigger notable disruptions in mood. Irritability, anxiety, anger, sadness, and even depression may stem from hormonal shifts triggered by perimenopause/menopause.

Vaginal Changes and Libidinal Decline

Depending on the ratio of estrogen to progesterone, changes in vaginal texture and elasticity may develop. Vaginal dryness and increased occurrence of vaginal infection are common among perimenopausal/menopausal women. These developments may make sexual intercourse uncomfortable or unappealing. Hormonal deficiencies may also reduce sex drive thereby decreasing the sexual desire even further.

Bladder Issues

Loss of bladder control that causes leakage when laughing, coughing, sneezing, or exercising may occur during perimenopause. Sudden urge to urinate and an inability to retain urine, also known as incontinence, may also develop. Additionally, perimenopause/menopause increases the likelihood of developing bladder or urinary tract infections.

Sleep Troubles

Even without the occurrence of perimenopause/menopause, women often have difficulty getting good quality sleep. Perimenopause can exacerbate sleep issues and insomnia by increasing the occurrence of sleep disturbances, nighttime anxiety, and prompting irregularities in wakefulness.

Changes in Weight

Weight fluctuations are common among women going through perimenopause/menopause. Hormonal changes may cause the body to become more willing to let go or retain muscle and fat. These two substances have significant influence on total weight. Furthermore, the body may begin retaining water, which can cause the numbers on the scale to change while also prompting sensations of bloating.

Perimenopause/menopause is a highly individualized condition. The severity of symptoms is dependent on many individual patient factors, prime among them being hormone values. Therefore, some woman may experience symptoms infrequently and at mild intensity while others have the potential of regularly suffering from severe discomfort.

The Long-term Effects of Menopause

Until now, this discussion of perimenopause/menopause has focused primarily on symptoms shared between the two condition. There is however an important difference between perimenopause and menopause symptom quality and severity.

Unlike perimenopause, menopause notably increases the risk of developing long-term degenerative symptoms. As menopause is established, levels of estrogen, progesterone and other hormones continuously declines until reaching their lowest values. Studies suggest that the significant drop in hormones increases the likelihood of developing the following chronic and degenerative issues:

  • Cardiovascular disease
  • Decline in cognitive ability
  • Hair loss
  • Musculoskeletal decay
  • Neurodegenerative disease such as Alzheimer’s and dementia
  • Notable memory loss
  • Osteoporosis
  • Prolapse of the bladder
  • Thinning skin
  • Weakness and achiness

If menopause is left unattended, these symptoms can bring about hardship and significantly degrade overall wellness. Therefore, even if the fleeting symptoms of menopause such as hot flashes, changes in mood, and irregular periods have ceased, it is important to care for your body as there is greater risk for serious dysfunction. Now that you familiar with the common concerns and symptoms associated with perimenopause/menopause you can take the proper steps to prepare for this important and natural transition.

At Holtorf Medical Group, our physicians are trained to provide you with the most up-to-date and innovative treatments to address perimenopause and menopause. If you are experiencing symptoms of perimenopause/menopause, but aren’t getting the treatment you need, call us at 877-508-1177 to see how we can help you!


1. NIH. “What Are the Signs and Symptoms of Menopause?” National Institute on Aging.

About Holtorf Medical Group

The Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease.

We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.