The Signs of Peri-Menopause and Menopause
for Women and Their Health Care Providers
The purpose of this list of signs is to inform women and their
health care providers about menopause so that appropriate action
can be taken. That action may include evaluating the effectiveness
of various herbs,
hormones, drugs, vitamin
supplements or simply waiting it out.
Menopause
is not just hot flashes. The hot flash is a cardinal sign, but
not the only one, nor does it occur in everyone. Varying subsets
of signs occur in each individual. A common experience of the
women who developed this list is a misdiagnosis by a physician
or psychiatrist and often years of anxiety about the symptoms,
and/or inappropriate treatment. The sudden onset of these signs
can be very disturbing. The realization that ìthis is menopauseî
can be a healing relief. An estimated 15 out of 100 women between
the ages of 45 and 55 will have debilitating symptoms caused by
lowered ovarian hormones and they will consult a physician or
other health care provider for help. However, most women will
not have a difficult menopause and will enjoy entering
a new phase of their lives.
One goal of the women who developed this list is that every health
care provider have a card in their top desk drawer with these
34 signs. The list should be scanned whenever a woman over 30
consults any health care provider. The primary goal is that this
list, and the notes that follow, reach every woman so that it
is there when, and if, she needs it.
Signs 1-14 are the major, most common signs of peri-menopause
and menopause; the signs that a woman most often consults a physician
or other health care provider about. Signs 1-16 are the most responsive
to estrogen replacement therapy, progesterone or testosterone.
These signs are not simply a matter of aging. They are also seen
in young women after the ovaries are removed.
- Hot flashes, flushes, night sweats and/or cold flashes, clammy
feeling (see note)
- Bouts of rapid heart beat
- Irritability
- Mood swings, sudden tears
- Trouble sleeping through the night (with or without night
sweats)
- Irregular periods; shorter, lighter periods; heavier periods,
flooding; phantom periods
- Loss of libido
- Dry vagina (see note)
- Crashing fatigue
- Anxiety, feeling ill at ease
- Feelings of dread, apprehension, doom (see
note)
- Difficulty concentrating, disorientation, mental confusion
- Disturbing memory lapses
- Incontinence, especially upon sneezing, laughing; urge incontinence
(see note)
- Itchy, crawly skin (see note)
- Aching, sore joints, muscles and tendons (see
note)
- Increased tension in muscles
- Breast tenderness
- Headache change: increase or decrease
- Gastrointestinal distress, indigestion, flatulence, gas pain,
nausea
- Sudden bouts of bloat
- Depression (see note)
- Exacerbation of existing conditions
- Increase in allergies
- Weight gain (see note)
- Hair loss or thinning, head, pubic, or whole body; increase
in facial hair
- Dizziness, light-headedness, episodes of loss of balance
- Changes in body odor
- Electric shock sensation under the skin and in the head (see
note)
- Tingling in the extremities (see note)
- Gum problems, increased bleeding
- Burning tongue, burning roof of mouth, bad taste in mouth
- Osteoporosis (after several years)
- Changes in fingernails: softer, crack or break easier
NOTES:
Symptom 1 (flashes) Hot flashes are due to the hypothalamic response
to declining ovarian estrogen production. The declining estrogen
state induces hypophysiotropic neurons in the arcuate nucleas
of the hypothalamus to release gonadotropin-releasing hormone
(GnRH) in a pulsatile fashion, which in turn stimulates release
of luteinizing hormone (LH). Extremely high pulses of LH occur
during the period of declining estrogen production. The LH has
vasodilatory effects, which leads to flushing.
Symptom 8 (dry vagina) results in painful intercourse
Symptom 11 (doom thoughts) includes thoughts of death, picturing
oneís own death
Symptom 14 (incontinence) reflects a general loss of smooth muscle
tone Symptom 15 (itchy, crawly skin) feeling of ants crawling
under the skin, not just dry itchy skin
Symptom 16 (aching sore joints) may include such problems as
carpal tunnel syndrome
Symptom 22 (depression) different from other depression, the
inability to cope is overwhelming. There is a feeling of loss
of self. Hormone therapy ameliorates the depression dramatically.
Symptom 25 (weight gain) often around the waist and thighs, resulting
in ëthe disappearing waistlineí Symptom 29 (shock
sensation) ìthe feeling of a rubber band snapping in the
layer of tissue between skin and muscle. It is a precursor to
a hot flashî
Symptom 30 (tingling in extremities) can also be a symptom of
B-12 deficiency, diabetes, alterations in the flexibility of blood
vessels, or a depletion of potassium or calcium
Some of these signs may be symptoms of medical conditions that
should be checked such as hypothyroidism, diabetes or depression
with another etiology.
This list of the signs of peri-menopause and menopause was developed
by women on the Internet Menopaus mailing list, based at Hershey
Medical Center/Penn State University Hospital, Hershey PA. The
electronic mailing list has approximately 475 subscribers, with
about 230 participating actively at the time the list of menopause
signs was developed in January 1996. Contact judy.bayliss@hmc.psu.edu
for more information.
The women who directly contributed text and/or ideas to this
list of signs are:
Lucy L. Brown, PH.D. brown@aecom.yu.edu,
Judy Bayliss, founder & owner of Albert Einstein College of
Medicine mailing list: Menopaus judy.bayliss@hmc.psu.edu,
Krista Glickman, Susan Jessen, Betty Clark, Susan Klee, Susan
Ariew, Graciela Spivak, Jennifer Hesketh Aviles, Christine Cody,
Jean Bauer, Bonnie Dreps Voigtlander, Keri Webb, Joan Starker,Roberta
J. Leon, Miriam Biddelman.
See also
