What physical and mental complaints are most common during menopause (the change of life) in women?

Joint and muscle pain is the most widely reported physical complaint during menopause worldwide. In a meta-analysis of nearly 482,000 women, an average of 65% were affected by it. European and American surveys confirm this with figures of 68 to 69%. Back pain belongs to this broader pain picture: in Taiwanese data, 58% of women reported back pain, and in Spanish research, low back pain was even identified as the most bothersome complaint.

Hot flushes and night sweats are the most characteristic complaints of the menopause, although percentages vary considerably by region. In high-income countries, approximately 50% of women experience hot flushes, compared with 66% in low-income countries. An Australian study shows how sharply the prevalence increases as the menopause progresses: severe hot flushes occurred in 9% of women before the menopause and in 37% during the late perimenopause. Hot flushes affect both daily activities and work performance.

Fatigue and sleep problems run largely in parallel at high prevalence figures. In large international surveys, 66 to 75% of women felt tired or exhausted. Sleep problems, such as difficulty falling or staying asleep, were reported by 60 to 69%. Hormonal changes and hot flushes both contribute to those poor nights. In addition, the risk of obstructive sleep apnoea also increases after the menopause, most likely due to changes in hormones and fat distribution, although precise prevalence figures for this are not provided in the available studies.

Vaginal dryness and other urogenital complaints increase markedly after the menopause and are directly linked to the decline in oestrogen. The likelihood of vaginal dryness doubles: from 21% in premenopausal women to 45% in postmenopausal women. An Australian study shows that vaginal dryness is the most distinguishing sexual symptom as women go through the menopause. Weight gain is not the most frequently reported complaint, but is rated the most bothersome in European and American surveys.

On the mental health side, memory complaints and concentration problems rank highly. In Taiwanese research, 67% of women cited memory loss as a top complaint. An Australian study adds nuance: memory complaints are less specific to the menopause than hot flushes, and other lifestyle and environmental factors also play a role. A low or depressed mood was reported by 59% in Taiwan; in South America, depression rates are notably high compared with other regions. A higher body weight is associated with more depression as well as anxiety complaints, although no concrete prevalence figures for anxiety are available in the studies used.

Menopausal complaints such as persistent hot flushes and sleep problems are not only burdensome in the short term: they are also regarded as possible predictors of future cardiovascular disease and metabolic problems. Precise figures on this are lacking in the studies provided, but it underlines that women with severe complaints would do well to discuss this with their general practitioner or gynaecologist.