What are the signs and symptoms of menopause? How to recognize?

Most women have some sign of climacteric, which can vary in intensity or mechanism of action. For example, lighter, more typical or more comprehensive (such as muscle pain).

In general, they start to manifest 2 years before and last for up to 1 year after menopause .

The farther or farther from menopause, the more subtle and mild they tend to be, just as, in general, they are more intense when they are close to the last menstrual period.

Not all women experience this transition or experience any or all of the manifestations. There are those who go through menstrual termination without presenting any symptomatic aspect, other than menstrual absence.

Some of the most common pictures can be:



The fatigue constant may be indicative of the approach of menopause. In general, women over 30 years old who complain of constant and exaggerated tiredness , reduced productivity and mental tiredness may be initiating symptomatic pre-menopausal conditions.

In addition, fatigue can be the result of anemias, hypoglycemia and hypothyroidism , which are conditions with a higher risk of developing with the approach of menopause. These frameworks, then, need to be evaluated and monitored.


Characterized by dysfunction of the thyroid gland, the disease is quite common among women, especially above 65 years of age.

Symptoms may include feeling unwell, menstrual dysregulation, slow metabolism, weight gain, drowsiness, hair loss.

In addition to the very similar symptoms, menopause can affect thyroid hormone rates and favor hypothyroidism.

Hormonal changes

Among the classic symptoms is hypoestrogenism, which is the drop in estrogen production. But, especially in periods close to menopause, there may still be an increase or oscillation of the hormone.

The increase can be one of the factors that cause bloating and mastalgia (pain in the breasts).

Menstrual changes

The regularity of menstruation tends to be affected. Although menopause is the last menstrual period, before it occurs, in general, there is irregularity of the cycles, which may present a reduction in blood flow, minimization of monthly periods or even an increase in menstruation in a short period of time.

Read more:  What is Irregular Menstruation? Know the types, causes, symptoms

Hot flushes (heat waves)

According to a survey by the University of Pittsburgh, about 80% of women suffer from hot flashes during the climacteric.

Hot flushes are transient manifestations of intense heat on the skin, especially in the upper part of the body (arm, waist, neck and face). The frequency is quite varied, and may occur randomly or even several times a day.

Most women experience hot flushes for periods between 3 and 5 years close to menopause, but there are those who experience hot flashes until they are 70 years old.

In general, they can start with the arms or torso, affecting the whole body, and include chills, tremors, palpitations and feelings of anxiety .

The exact cause of the symptom is not known, but studies suggest that hot flashes are caused by changes in the hypothalamus due to reduced estrogen. The brain region is responsible, among other things, for controlling body temperature.

These changes cause the hypothalamus to perceive the body as hotter than it really is and initiate processes to cool it down.

As with physical activity, blood vessels dilate so that blood flow is favored and heat is mitigated. In addition, sweating occurs to lower the body surface temperature.

Thus, this set of reactions is possibly the mechanism of hot flushes.

Excessive sweating and night sweat

Sweating is a variation of hot flushes, which can be prevalent at night or during the day. Some women may experience excessive sweating throughout the day or only when hot flushes occur.

In addition, the manifestation can be so intense that it creates obstacles to routine, sleep and social activities.

Psychological disorders

The emotional changes are quite intense in the phase close to menopause and researches indicate that during the periods that precede it, there are 2 times more chances of the woman to go into depression .

As progesterone rates drop , neurotransmitters that act on the Central Nervous System (CNS) can be affected and result in psychic changes, such as more irritation, sound sensitivity, depression, anxiety, agitation or apathy.

That is, the lack of estrogen can prevent these neurotransmitters from acting properly and, thus, interfere with the action and release of serotonin , GABA acid and endorphins, responsible for pleasure and mood controls, for example.

The hormonal variations are intensified by the pressure and social demand that occur during the aging process.

The aesthetic, functional and independent aspects can be affected and changes in the body and routine are not always well accepted.

Especially if there are previous cases of depression and anxiety, the risks of psychological damage are high.

In addition, women who still wish to become pregnant may have the most intense emotional conditions due to self-collection or family and social.

Interrupting the desire to experience motherhood can be very harmful to mental health , especially because there is an intense demand for female reproductive function.

Vaginal dryness

The mucous membranes of the vagina need lubrication, especially during sex. The tissue depends on estrogen rates to maintain lubrication and hydration. But when the hormone drops, atrophy of the vagina and vaginal dryness begin to occur.

As tissue friction is greater, itching, injury, irritation and pain occur more frequently. Even the dryness of the intimate region generates great discomfort during sex which, if left untreated, can affect the woman’s sexual life and worsen emotional conditions.

Read more:  Sex in menopause: 5 tips to combat libido reduction

Weight gain

Many women experience weight gain when they are close to menopause, but there is no direct relationship between the hormonal drop in estrogen and the numbers on the scale.

Research carried out at Monash University and published in the medical journal Climacteric suggests that putting on weight, in fact, is a sum of factors resulting from routine changes, the drop in metabolism by age and changes in fat distribution due to menopause.

That is, the end of menstruation affects the way the body stores fat, causing it to concentrate mainly on the hips and waist.

This factor, together with changes in diet, in the pace of physical activities and in the emotional state, can cause weight gain.

The Hospital de Clínicas de São Paulo carried out a study for 10 years with about 6 thousand Brazilian women, over 40 years old, and pointed out that more than half of the participants were obese or overweight at the age of menopause.

According to the survey, weight gain during menopause can aggravate the symptoms of hot flashes and depression, as well as joint or muscle pain.

Urinary infections

With the aging process, problems related to the urinary tract tend to be more frequent. But with the hormonal drop, urinary tract infections (such as cystitis ) can become more accentuated.

Mood changes

Without characterizing psychological disorders (such as anxiety and depression), feelings of sadness, agitation, irritability, mental tiredness and lethargy can be accentuated and occur constantly.

Emotional symptoms can be quite similar to those of PMS, but in a more pronounced and intense way.

Sleep disorders

The insomnia can manifest in periods near menopause, especially when hot flashes and sweats occur at night.

Some women experience hot flashes so intense that they can result in impediments to sleep, discomfort and even interruption of sleep in the middle of the night, resulting in changes in all activities during the day.

Changes in concentration and memory

In addition, difficulties with concentration, reduced memory and mental tiredness can also occur due to hormonal changes.

The brain has several receptors that interact with estrogen and, therefore, hormonal reduction can lead to changes in memory, focus, memorization and the ability to perform multiple tasks.

As there is, for most women, changes in mood and sleep, the functional impairment can be even greater. That is, if the woman sleeps badly and feels irritated in the daily tasks, for example, the dispersion can be even more intense.

Facial hair

Hormonal changes can cause changes in the amount of hair on the body, but especially on the face.

The woman’s body produces a small amount of androgen hormones, which are considered male hormones, but which have the effects controlled by the action of estrogen.

But with the fall of the female hormone, the action of androgens cannot be inhibited and, therefore, hair can grow more easily.


Some studies indicate that female hormones may be associated with migraine . Women who experienced headaches during premenstrual periods or when using contraceptives have higher rates of migraine in periods close to menopause.

Although some patients may continue to experience headache after menopause, a significant number report that the pain ceases when the last menstruation occurs.

Tissue changes

The lack of estrogen can have a direct action on skin tissues, nails and hair. The layers of the skin may show more dryness, flaking and, especially on the face, more wrinkles may appear.

Read more: Skin Hydration: importance, how to moisturize, products and tips

The hair can suffer weakening and dryness, causing more fall and difficulty in growth. Fingernails, on the other hand, can chip and break more easily, and also have growth difficulties.