Although some women have few or no menopause symptoms, most women do. Similarly, while some women have mild symptoms, others find that their sleep, daily life, and sense of well-being are severely affected. Menopause symptoms eventually subside when hormone levels even out. Postmenopause changes are normal signs of low estrogen and typically continue over time.

Signs and symptoms of perimenopause

Signs that you are in perimenopause include:

• Irregular menstrual periods.
• Less frequent, light menstrual periods.
• Heavier menstrual periods than you are used to having.

Symptoms of menopause

Symptoms related to menopause are caused by changing or dropping hormone levels and usually end 1 or 2 years after menopause. Some women continue to have symptoms for 5 or more years afterward. Menopause symptoms include:

• Hot flashes.
• Sleep disturbances (insomnia).
• Emotional changes, such as mood swings or irritability.
• A change in sexual interest or response.
• Problems with concentration and memory that are linked to sleep loss and fluctuating hormones (not a permanent sign of aging).⁵
• Headaches.
• Rapid, irregular heartbeats (heart palpitations).
• Generalized itching.

Menopause caused by surgery, chemotherapy, or radiation therapy can cause more severe symptoms than usual.⁶ Preexisting conditions such as depression, anxiety, sleep problems, or irritability can get worse during the perimenopausal transition.

Signs of postmenopause

Signs that you have reached menopause and are in postmenopause include:

• No menstrual periods (and no need for birth control measures).
• Drying and thinning of the skin, hair, and nails caused by lower collagen production.
• Vaginal and urinary tract changes, such as:
  • Vaginal dryness, irritation, and itching.
  • An increased risk of vaginal and urinary tract infections (UTIs).
  • Pain during sexual intercourse (dyspareunia).

Other conditions can cause changes in the menstrual cycle or symptoms resembling perimenopause and postmenopause. Examples include pregnancy, a significant change in weight, depression, anxiety, disease, or uterine, thyroid, or pituitary problems.