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
