What complaints are most common during menopause?
The most common menopausal complaints are joint and muscle pain, fatigue and sleep problems; hot flushes are the most characteristic but do not top the prevalence rankings. If you recognise several of these complaints, it is worthwhile discussing them with your GP, who can consider what may help for each one.
Joint and muscle pain is the most common menopausal complaint worldwide: around 65% of middle-aged women experience it. That is more than hot flushes, sleep problems or fatigue, although those percentages are not far apart.
Fatigue and sleep problems follow closely. Fatigue is reported by 66 to 75% of women, depending on the region. Sleep complaints, both difficulty falling asleep and staying asleep, affect more than half to two thirds of women. Together with joint pain, these are therefore the three complaints that come up most frequently.
Hot flushes are the most characteristic symptom of menopause, even though they do not top the prevalence rankings. They increase considerably as menopause progresses: from fewer than 9% in women who are still menstruating to more than 37% in late perimenopause. The severity of hot flushes also varies greatly by region: in Europe and the US, 34 to 40% of women report moderate to severe hot flushes, compared with only 16% in Japan.
Low mood, depressive complaints and memory problems are reported by more than half of women, but they are less specific to menopause than hot flushes. Other factors, such as living conditions and weight, also play a major role in these complaints.
Vaginal dryness doubles in prevalence after menopause: from around 21% before to nearly 45% after. It is therefore a reliable indicator that menopause has truly begun. Weight gain has a lower percentage than joint pain or fatigue, but women themselves name it as the most bothersome complaint. Finally, sleep apnoea, in which breathing repeatedly stops during the night, also increases after menopause. This raises the risk of cardiovascular disease, but in women it is regularly missed because the symptoms differ from those in men.
Based on multiple large-scale surveys and a global meta-analysis (PMID 38956480), supplemented by regional studies from Europe, the US, Asia and a Dutch AMY study. The data are associative: cause and effect have not been fully established for most complaints. Prevalence figures vary considerably by region and study design.
Why do women experience anxiety symptoms after menopause?
Fluctuating oestrogen levels disrupt brain systems that regulate anxiety and mood, causing some women to experience anxiety symptoms for the first time during menopause. Exercise demonstrably helps, and when symptoms are severe, hormone therapy is a recognised first-choice treatment: discuss this with your doctor.
Does my weight and metabolism change during the menopause transition?
During the menopause transition, your body composition changes profoundly: more fat mass, less muscle and more dangerous abdominal fat. Your total weight on the scale may barely shift, yet something genuinely significant is taking place.
Which hormone levels are tested during menopause?
During menopause, the hormones measured most commonly are FSH, LH, oestradiol, progesterone, testosterone and AMH; elevated FSH combined with reduced oestradiol (below 20 pg/ml) is the most reliable sign that menopause has begun, but always have your results explained by your doctor, as body weight and background influence reference values.
What helps against menopause symptoms like hot flushes and mood swings?
Hormone therapy works best against hot flushes and night sweats. Those who cannot or do not wish to use it can choose from proven non-hormonal medications and psychological therapy. Herbal supplements have no demonstrable effect.
Which supplements genuinely help with menopause symptoms?
Soy isoflavones and phytoestrogens from red clover have the strongest support for menopause symptoms, particularly hot flushes. For vitamin D there is moderate evidence that it helps prevent bone fractures, which is especially relevant during and after menopause.
Can low progesterone levels cause symptoms before menopause?
Yes, low progesterone levels in the second half of your cycle can cause symptoms even before menopause, such as sleep problems and fertility issues. A blood test taken mid-way through that second half shows where you stand.