Menopause: Signs and Symptoms

On a recent forgetfulness-related consultation with Dr Google ( I know, I know), I was aghast to learn of the vast array of symptoms that can herald the arrival of menopause. I know the obvious ones like hot flushes and irregular periods, of course, but I certainly didn’t know the full roll call of physical, mental and emotional elements that collude to bring us toward this transformation.

I started out typing into my phone as to whether stress can impact on one’s memory, and there and then the internet rabbit hole opened up and ushered me in. So I went - as innocently as Alice into Wonderland.

I had been thinking that lockdown and its effects had me feeling a little ‘less than my usual self’, I have noticed a reduction in my confidence (imposter syndrome and the like), and an increased need to think a little longer to recall quite recent memories. For example, I watched all of Defending Jacob on Apple TV last weekend, and on Monday, when my partner asked me what it was like, and was it worth watching, I could not - for the life of me - remember anything of it.

I couldn’t recall the storyline or the actors at all. And he laughed, saying my memory has finally gone the way of my younger years - which annoyed me. Naturally.

But it felt weird. I had no recall of it, for at least five minutes (maybe more). But as I pressured my brain to bring it back, it finally did and I proceeded to give my partner a full rundown of the plot lines, acting reviews and even my own post-show notes and opinions on whether it would have a second season. None of which was necessary, all of which was purely to prove that I had remembered it.

Granted, it’s not a great series and being a person who lives in her head I tend to only ‘file’ things to be remembered on basis of merit - I reckon there is enough information flying around my synapses that a little editing and cognitive curation can’t be a bad thing. Nobody wants a brain full of white noise, but that, my friends, was the impetus for my curious consultation that evening with Dr Google…

So, you ready?

MENOPAUSE SYMPTOMS

Menopause has 34 symptoms (yep, THIRTY-FOUR), and many of us will experience a lot of them, often without seeing them for what they are. We could be potentially fooled into thinking something else was wrong, or life had just become a bit shit and unhappy of late - when actually, and so importantly, they are symptoms of menopause that can be recognised - and then, more crucially - helped with.

So, welcome to Menopause The Musical, I hope you are sitting comfortably, allow me to introduce the cast…

Hot Flushes - heat and a rising red colour, this affects 75% of women.
Night Sweats - hot flushes at night.
Irregular Periods - dropping hormone levels cause a drop in frequency
Mood Swings - more extreme than PMS apparently. Joy.
Vaginal Dryness - Oestrogen dropping causes a reduction in our natural lubrication, leaving sex a little less than fun. Hello, lube.
Decreased libido - our sex drive is controlled by oestrogen. When that goes south, desire can follow.
Headaches - if you are someone who often experiences headaches when you get your period, they may continue.
Breast soreness - familiar to many each month, breasts may feel extra tender through menopause.
Burning mouth - slightly more random, but hormone shifts can cause heat in the mouth and is due to a drop in saliva, from, yes, a drop in hormones.
Joint pain - often considered as the beginning of arthritis, but can often be due to menopause for many.
Digestive problems - our stomachs and intestines are hugely affected by our hormone levels, so redacted levels can increase indigestion, bloating, constipation, diarrhoea and cramping.
Electric shocks - I know - how odd. These can occur more often right before the onset of a hot flush.
Muscle tension - often linked to additional stress and tension.
Tingling extremities - not too common, but sometimes you might feel some pins and needles in hands and feet.
Gum problems - bleeding gums and sometimes a metallic taste in the mouth.
Itchy skin - lowered hormone levels cause collagen to decrease leaving skin feeling tight.
Fatigue - extreme tiredness is hugely common.
Anxiety - Hello darkness my old friend. But not to play it down, anxiety can affect 1 in 3 women in menopause. Important to recognise it for what it is, and try not to allow it to overrule you.
Disrupted sleep - difficulty falling asleep, difficulty staying asleep and sleeping very lightly are very common during menopause.
Hair loss - hair might be more noticeably falling out, or more slow to grow.
Memory lapses - that’s me! Increased forgetfulness can start in perimenopause and throughout menopause. Cognitive brain training is advised if so.
Difficulty concentrating - the brain uses oestrogen to burn glucose for energy, so the menopausal reduction can cause a bit of brain fog and lack of focus.
Weight gain - many women are familiar with gaining weight when on contraceptive pills, this is due to the hormonal shakeup they provide. Similar can happen in menopause when hormones shift again.
Dizzy spells - vertigo and feeling lightheaded are reported as symptoms in many women, again from oestrogen levels falling off the cliff.
Bloating - often one of the very first symptoms women report as the beginning of their menopause.
Stress incontinence - many women experience this as a result of childbirth, but it can increase in menopause. (personally, I definitely feel this increasing and am looking into physio for it - will report back of course).
Brittle nails - that loss of oestrogen and collagen again...
Allergies - hormones are closely linked to your immune system - who knew! So, you may experience a lower level of tolerance to known allergens.
Irregular heartbeat - lower oestrogen levels can overstimulate your nervous system from time to time causing an irregular heartbeat.
Body odour - that excessive sweating again. Also, your individual odour can change.
Irritability - sadness and irritability can increase somewhat.
Depression - lower mood levels can develop to something more serious for some women in menopause, with depression four times more likely to affect women over 45.
Panic Disorder - apparently panic attacks affect menopausal women more than those in any other life stage.
Osteoporosis - bone density decreases by up to 20% with that drop in oestrogen.

What a list eh?

It’s vital to state that not all of these will be experienced by all of us, and that, of course, your medical professional is the person to confer with on all new feelings and symptoms. But I found it very liberating to learn of this list and also to consider it another way: many of these symptoms are emotional at their root, and that looking after our emotions and doing the work of understanding our physical selves is so, so important in our midlife.

Personally speaking, I prefer to think of menopause as a rising, not a settling. Menopause marks a phase of life that I believe to be distinctly about liberty.

It is as significant as puberty was, but as it is experienced by women alone, it doesn’t get the airtime it deserves. It feels downplayed, there is an irritating brevity to the notorious comments of “oh she’s hormonal”, it gets brushed off and not taken seriously.

The phrase, ‘the change’ always felt a little negative and a bit scary. What do you change into? Symbolically, it feels like a loss. Personally, I prefer the idea of a rising; reframing menopause as something more energetic, inspiring and enlivening is a better spin, don’t you think?

So, let’s rise.

Ellie Balfe, August 2020.