Women may have different signs or symptoms at menopause. That’s because estrogen is used by many parts of your body. As you have less estrogen, you could have various symptoms. Many women experience very mild symptoms that are easily treated by lifestyle changes, like avoiding caffeine or carrying a portable fan to use when a hot flash strikes. Some women don’t require any treatment at all. Other symptoms can be more problematic.

Here are the most common changes you might notice at midlife. Some may be part of aging rather than directly related to menopause.

Change in your period. This might be what you notice first. Your periods may no longer be regular. They may be shorter or last longer. You might bleed more or less than usual. These are all normal changes, but to make sure there isn’t a problem, see your doctor if:

• Your periods come very close together
• You have heavy bleeding
• You have spotting
• Your periods last more than a week
• Your periods resume after no bleeding for more than a year

Hot flashes. Many women have hot flashes, which can last a few years after menopause. They may be related to changing estrogen levels. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Hot flashes can be very mild or strong enough to wake you up (called night sweats). Most hot flashes last between 30 seconds and 10 minutes. They can happen several times an hour, a few times a day, or just once or twice a week.

Vaginal health and bladder control. Your vagina may get drier. This could make sexual intercourse uncomfortable. Or, you could have other health problems, such as vaginal or bladder infections. Some women also find it hard to hold their urine long enough to get to the bathroom. This loss of bladder control is called incontinence. You may have a sudden urge to urinate, or urine may leak during exercise, sneezing, or laughing.

Sleep. Around midlife, some women start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily, or you wake too early. Night sweats might wake you up. You might have trouble falling back to sleep if you wake up during the night.

Sex. You may find that your feelings about sex are changing. You could be less interested. Or, you could feel freer and sexier after menopause. After 1 full year without a period, you can no longer become pregnant. But remember, you could still be at risk for sexually transmitted diseases (STDs), such as gonorrhea or even HIV/AIDS. Your risk for an STD increases if you have sex with more than one person or with someone who has sex with others. If so, make sure your partner uses a condom each time you have sex.

Mood changes. You might feel moodier or more irritable around the time of menopause. Scientists don’t know why this happens. It’s possible that stress, family changes such as growing children or aging parents, a history of depression, or feeling tired could be causing these mood changes.

Your body seems different. Your waist could get larger. You could lose muscle and gain fat. Your skin could get thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. Are these changes a result of having less estrogen or just related to growing older? Experts don’t know the answer.

In addition, in some women, symptoms may include aches and pains, headaches, and heart palpitations. Since menopausal symptoms may be caused by changing hormone levels, it is unpredictable how often women will have hot flashes and other symptoms and how severe they will be. Talk with your doctor if these symptoms are interfering with your everyday life. The severity of symptoms varies greatly around the world and by race and ethnicity.

Note: This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date. Content reviewed: June 26, 2017

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