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Menopause Symptoms – Causes and Treatment

Menopause brings a wide range of physical and emotional symptoms. Learn which complaints are typical and when it is advisable to seek medical advice.

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Things worth knowing about "menopause symptoms"

Menopause brings a wide range of physical and emotional symptoms. Learn which complaints are typical and when it is advisable to seek medical advice.

What is Menopause?

Menopause is a natural biological process that marks the end of a woman´s reproductive years. It is defined as the point in time 12 months after a woman´s last menstrual period. The transitional phase leading up to menopause is called perimenopause, while the years following are known as postmenopause. On average, menopause occurs around the age of 51.

During this transition, the ovaries gradually reduce their production of key female hormones – primarily estrogen and progesterone. Because estrogen plays a role in many body functions, its decline can trigger a wide variety of physical and emotional symptoms that differ greatly from woman to woman.

Common Symptoms of Menopause

Vasomotor Symptoms

The most well-known menopause symptoms are hot flashes and night sweats. A hot flash is a sudden feeling of warmth, usually most intense over the face, neck, and chest, often accompanied by flushing and heavy sweating. Night sweats are episodes of excessive sweating during sleep that can significantly disrupt rest and overall sleep quality.

Sleep Disturbances

Many women experience difficulty falling or staying asleep during menopause. In addition to night sweats, hormonal fluctuations can directly affect the sleep-wake cycle, leading to insomnia and daytime fatigue.

Psychological and Emotional Changes

Hormonal changes during menopause can also affect mental health. Common psychological symptoms include:

Mood swings and irritability
Low mood or mild depressive episodes
Anxiety and inner restlessness
Difficulty concentrating and memory lapses, often called brain fog

Urogenital Symptoms

Estrogen deficiency affects the mucous membranes of the urogenital tract, leading to symptoms such as:

Vaginal dryness and itching (vulvovaginal atrophy)
Painful intercourse (dyspareunia)
Increased urinary urgency or involuntary urine loss (urinary incontinence)
Greater susceptibility to urinary tract infections

Physical Changes

Other physical changes that may occur during menopause include:

Weight gain, especially around the abdomen
Changes in skin and hair (dryness, hair thinning)
Joint pain and muscle tension
Heart palpitations
Headaches
Breast tenderness

Long-term Effects on Bone and Heart Health

Over the long term, declining estrogen levels increase the risk of osteoporosis (bone loss) and cardiovascular disease. These changes may not be immediately noticeable but should be monitored through regular medical check-ups.

When to Seek Medical Advice

Not all menopause symptoms require medical treatment. However, it is advisable to consult a doctor if:

symptoms significantly affect daily life or quality of life,
severe depression or anxiety disorders develop,
irregular or unusually heavy bleeding occurs,
urogenital symptoms persistently affect wellbeing.

Diagnosis

Menopause is primarily diagnosed based on a woman´s medical history and reported symptoms. A doctor may also order blood tests to measure hormone levels – particularly follicle-stimulating hormone (FSH), which is typically elevated during menopause, as well as estradiol and thyroid-stimulating hormone (TSH) to rule out other conditions.

Treatment Options

Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT), also called menopausal hormone therapy, is considered the most effective treatment for severe menopause symptoms. It can significantly relieve hot flashes, night sweats, and vaginal dryness. The use of HRT should be discussed and individually tailored with a healthcare provider, as it may carry certain risks such as an increased risk of blood clots or, in some cases, breast cancer.

Non-Hormonal Treatment Options

For women who cannot or prefer not to use hormone therapy, several non-hormonal alternatives are available:

Herbal remedies such as black cohosh (Cimicifuga racemosa) or isoflavones (phytoestrogens from soy or red clover)
Certain antidepressants or antiepileptics to reduce hot flashes
Local estrogen preparations (creams, suppositories) for vaginal symptoms
Pelvic floor exercises and bladder training for incontinence

Lifestyle Measures

In addition to medical therapies, the following lifestyle adjustments can help relieve symptoms and support overall health:

Regular physical activity (e.g., aerobic exercise, yoga)
A balanced, calcium-rich diet to protect bone health
Avoiding smoking and excessive alcohol consumption
Stress management and relaxation techniques
Good sleep hygiene and sufficient rest

References

The NAMS 2017 Hormone Therapy Position Statement Advisory Panel: The 2017 hormone therapy position statement of The North American Menopause Society. Menopause, 24(7), 728-753 (2017).
World Health Organization (WHO): Research on the Menopause in the 1990s. WHO Technical Report Series, Geneva.
Stuenkel C.A. et al.: Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology and Metabolism, 100(11), 3975-4011 (2015).

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