Early Signs and Symptoms of Menopause – What to Expect First


Written by

Catherine Smith

Published on

A tag cloud of menopause symptoms

Are you approaching your 40s or 50s? Have you ever wondered what signs to look out for in the journey towards menopause? As a woman, it’s essential to understand the early indications of menopause and be prepared for the changes that lie ahead. From irregular periods to physical and emotional symptoms, the menopausal transition can bring about a range of experiences, unique to each individual. So, what are the first signs of menopause? Let’s delve into the topic and shed light on what to expect as you approach this transformative stage of life.

Key Takeaways:

  • Menopause is a natural biological process that usually occurs in a woman’s 40s or 50s, with the average age being 51 in the United Kingdom.
  • Typical early signs of menopause include irregular periods, vaginal dryness, hot flushes, sleep problems, mood changes, and physical symptoms like weight gain and thinning hair.
  • Perimenopause, the period leading up to menopause, is often characterised by irregular periods and can last for several years.
  • Menopause can have an impact on mental health and wellbeing, with symptoms such as anxiety, low mood, and difficulty sleeping.
  • Managing menopausal symptoms can involve lifestyle changes, hormone therapy, non-hormonal therapies, and seeking support from healthcare professionals.

Irregular Periods – The First Sign of Perimenopause

When it comes to perimenopause, the period leading up to menopause, irregular periods are often the first sign of this transitional phase. It’s important to understand the changes that occur during this time and how they can impact your menstrual cycle.

During perimenopause, your periods may become irregular in several ways. They may become shorter or longer, heavier or lighter, and more or less frequent. Menstrual cycles may also become closer together. It’s common for periods to skip a month or several months and then return.

Despite experiencing irregular periods, it’s essential to remember that pregnancy is still possible. Irregular menstrual cycles do not guarantee infertility. If you’re unsure about whether you’re starting the menopausal transition or experiencing a pregnancy, it’s wise to keep track of any changes in your menstruation and consider taking a pregnancy test.

Here are common characteristics of irregular periods during perimenopause:

  • Shorter or longer periods
  • Heavier or lighter flow
  • More or less frequent periods
  • Periods skipping a month or several months and then returning

Understanding the changes in your menstrual cycle and being aware of possible pregnancy are important aspects of managing perimenopause symptoms. By staying informed and regularly monitoring your menstrual health, you can navigate perimenopause with confidence.

Vaginal Dryness and Other Physical Symptoms

Vaginal dryness is a common symptom experienced during perimenopause and menopause. It can lead to discomfort and pain during sexual intercourse, affecting your overall quality of life.

Alongside vaginal dryness, there are several other physical symptoms that you may experience during this transitional phase. These symptoms include:

  • Hot flushes
  • Chills
  • Night sweats
  • Sleep problems
  • Thinning hair
  • Dry skin
  • Weight gain
  • Loss of breast fullness
  • Joint pains
  • Decreased libido

Please note that the intensity and duration of these symptoms can vary among women. It’s important to consult with a healthcare professional if you experience any concerning symptoms or if you notice bleeding from the vagina after menopause.

Common Physical Symptoms of Perimenopause and Menopause

Vaginal DrynessCauses discomfort and pain during sex
Hot FlashesSudden feeling of heat, often accompanied by sweating and flushing
ChillsUnpleasant sensation of coldness, often with shivering or shaking
Night SweatsExcessive sweating during sleep, leading to damp pyjamas and bedding
Sleep ProblemsDifficulty falling asleep, staying asleep, or getting restful sleep
Thinning HairLoss of hair volume and thickness
Dry SkinLack of moisture, leading to rough and flaky skin
Weight GainIncrease in body weight, often around the abdomen
Loss of Breast FullnessReduction in breast size and firmness

Incorporating lifestyle changes and seeking professional advice can help manage these symptoms and improve your overall well-being during perimenopause and menopause.

Mood Changes and Emotional Symptoms

During perimenopause and menopause, it’s common for women to experience mood changes and emotional symptoms. These changes can have a significant impact on daily life and relationships. It’s important to understand and manage these symptoms to maintain overall well-being.

Common Emotional Symptoms

  • Low mood: Feeling down or sad more often.
  • Anxiety: Experiencing feelings of worry or unease.
  • Mood swings: Going from happy to sad, irritable, or angry without much reason.
  • Low self-esteem: Feeling less confident or having a negative self-image.

Changes in Concentration and Memory

Perimenopause and menopause can also bring changes in concentration and memory, often referred to as “brain fog.” This can make it difficult to focus, remember things, or multitask effectively. It’s important to be patient with yourself during these moments and implement strategies to help manage these challenges.

Managing Mood Changes and Emotional Symptoms

Managing mood changes and emotional symptoms involves a combination of strategies:

  1. Seeking support from healthcare professionals: A healthcare provider can offer guidance, recommend appropriate treatments, and address any concerns you may have.
  2. Making healthy lifestyle choices: Eating a balanced diet, engaging in regular exercise, getting enough sleep, and practicing stress-reducing activities like yoga or meditation can all contribute to emotional well-being.
  3. Building a support network: Talking to friends, family, or joining support groups can provide a sense of understanding and connection during this transitional phase.

By taking proactive steps and seeking the support you need, you can effectively manage mood changes and emotional symptoms during perimenopause and menopause, allowing for a smoother and more positive experience.

Concerns and Complications of Menopause

Menopause is a natural phase in a woman’s life, but it can come with certain concerns and complications that may impact her overall health and wellbeing. After menopause, the risk of developing certain medical conditions increases. It’s essential for women to be aware of these complications and take preventative measures to protect their health.

Heart and Blood Vessel Disease

One of the major concerns of menopause is the increased risk of heart and blood vessel disease. In fact, heart disease is the leading cause of death in women. During menopause, hormonal changes can affect the health of blood vessels and increase the risk of developing heart disease. It’s crucial for women to maintain a healthy lifestyle, including a balanced diet, regular exercise, and regular check-ups, to protect their heart health.

Osteoporosis and Increased Fracture Risk

Osteoporosis, a condition characterised by the loss of bone density, is another complication that women may face after menopause. The decrease in estrogen levels during menopause can accelerate bone loss, which puts women at a higher risk of fractures, especially in the first few years after menopause. It’s important for women to focus on building and maintaining strong bones through a combination of weight-bearing exercises, a calcium-rich diet, and, if necessary, medications prescribed by a healthcare professional.

Urinary Incontinence and Changes in Sexual Function

Urinary incontinence and changes in sexual function are common complications that can occur after menopause. The decline in estrogen levels can lead to changes in the pelvic floor muscles, causing urinary incontinence or difficulties with bladder control. Additionally, menopause can also affect sexual function, leading to vaginal dryness and decreased libido. Open communication with your healthcare professional and exploring different treatment options including specialist physiotherapy, use of techniques such as hypopressives (which is an excellent way of improving pelvic floor function) and hormone therapy, can help manage these complications and improve quality of life.

Comparison of Menopause Complications

ComplicationDescriptionPreventive Measures
Heart and Blood Vessel DiseaseIncrease in the risk of heart disease and blood vessel problems after menopause.Maintain a healthy lifestyle, including a balanced diet, regular exercise, and regular check-ups. Seek advice on protecting heart health.
Osteoporosis and Increased Fracture RiskDecrease in bone density after menopause, leading to an increased risk of fractures.Focus on building and maintaining strong bones through weight-bearing exercises, calcium-rich diet, and, if necessary, medications prescribed by a healthcare professional.
Urinary Incontinence and Changes in Sexual FunctionChanges in pelvic floor muscles can cause urinary incontinence and difficulties with bladder control. Menopause can also lead to vaginal dryness and decreased libido.Open communication with healthcare professionals, pelvic floor exercises, and exploring treatment options like hormone replacement therapy.

Regular check-ups and preventive health care are essential during and after menopause to detect any potential complications early and ensure proper management. By being proactive, women can minimise the impact of these complications and maintain their overall health and wellbeing.

Causes and Factors Influencing Menopause

Menopause is a natural biological process that occurs as reproductive hormones decline with age. Hormonal changes during menopause can lead to various physical and emotional symptoms. While menopause is primarily influenced by age, there are other causes and factors that can influence its onset.

1. Natural Causes

The most common cause of menopause is the natural aging process. As women age, the ovaries produce less estrogen and progesterone, leading to the eventual cessation of menstruation. The average age for menopause in the United Kingdom is 51, but it can occur anywhere between the late 40s and early 50s with perimenopause occurring in some cases up to 10 years before.

2. Surgical Causes

In some cases, menopause can be triggered by surgeries that remove the ovaries, such as a hysterectomy. Without ovaries, the hormones necessary for menstruation and fertility are no longer produced, leading to the onset of menopause.

3. Medical Treatments

Certain cancer treatments, such as chemotherapy and radiation therapy, can also cause menopause. These treatments can damage the ovaries, leading to a decline in reproductive hormones and the cessation of menstrual cycles.

4. Primary Ovarian Insufficiency (POI)

Primary ovarian insufficiency, also known as premature ovarian failure, is a condition in which the ovaries stop functioning before the age of 40. This can be caused by autoimmune disorders, genetic conditions, or unknown factors. POI results in a decrease in reproductive hormones and the onset of menopause at an earlier age.

5. Lifestyle Factors

Several lifestyle factors can influence the timing and experience of menopause. Smoking, for example, has been found to increase the risk of early menopause. On the other hand, certain dietary choices, such as consuming a diet rich in fruits and vegetables, may delay the onset of menopause.

Overall, the causes and factors influencing menopause can vary from person to person. It’s important to discuss any concerns or symptoms with a healthcare professional to determine the underlying cause of menopause and explore available treatment options.

Causes and FactorsImpact
Natural aging processGradual decline in reproductive hormones
Surgical removal of ovariesImmediate onset of menopause
Medical treatmentsDamaged ovaries leading to early menopause
Primary Ovarian Insufficiency (POI)Early menopause due to ovarian dysfunction
Lifestyle factorsSmoking increases risk of early menopause

Managing Menopause Symptoms

When it comes to managing menopausal symptoms, there are several options available to help you navigate this transitional phase with ease. By making certain lifestyle changes, exploring different treatment options, and working closely with a healthcare professional, you can effectively alleviate and manage your symptoms. Here are some approaches you can consider:

Lifestyle Changes:

Adopting a healthy and balanced diet, as well as engaging in regular exercise, can have a positive impact on managing menopause symptoms. A diet rich in fruits, vegetables, whole grains, and lean proteins can help alleviate symptoms like hot flashes and mood swings. Regular physical activity, such as walking, yoga, or swimming, can improve overall well-being and promote better sleep.

Hormone Replacement Therapy (HRT):

Hormone replacement therapy, which involves replacing estrogen and progesterone, can be an effective treatment option for managing menopause symptoms. It can help alleviate hot flushes, vaginal dryness, and sleep disturbances. However, it’s important to discuss the potential risks and benefits with your healthcare professional to determine if hormone replacement therapy is suitable for you.

Non-Hormonal Therapies:

There are also non-hormonal therapies available to manage menopause symptoms. These may include certain medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), which can help with mood swings and hot flushes. Other non-hormonal options include vaginal moisturisers or lubricants for vaginal dryness.

Alternative Medicines:

Some women find relief from menopause symptoms by exploring alternative medicines. Natural supplements like evening primrose oil and red clover extract are thought to help alleviate symptoms. However, it’s important to consult with your healthcare professional before trying any alternative medicines, as their safety and effectiveness can vary.

Remember, managing menopause symptoms is not a one-size-fits-all approach. What works for one person may not work for another. It’s essential to work closely with your healthcare professional to determine the best approach for managing your individual symptoms and concerns. They can provide personalised guidance and support throughout your menopausal journey.

Mental Health and Wellbeing During Menopause

Menopause can have a significant impact on your mental health and overall wellbeing. As hormone levels fluctuate, you may experience symptoms such as irritability, low mood, anxiety, and difficulty sleeping. These symptoms can affect your mood, daily life, and relationships, making it important to prioritize your mental health and seek support.

During this time, it is crucial to reach out to healthcare professionals who specialise in menopause for guidance and assistance. They can provide you with personalised advice and treatment options to manage your menopause symptoms and support your mental wellbeing.

In addition to professional support, don’t hesitate to lean on your loved ones for emotional support. Sharing your experiences and feelings with trusted family members or friends can help alleviate some of the emotional burden and provide a sense of understanding and comfort.

Furthermore, incorporating lifestyle changes into your routine can have a positive impact on your mental health and wellbeing. Stress management techniques, such as deep breathing exercises, meditation, or yoga, can help reduce anxiety and promote relaxation. Engaging in regular physical activity, such as walking or swimming, releases endorphins that boost mood and improve overall mental wellbeing.

Implementing self-care practices is also essential during menopause. Take time for activities that bring you joy and relaxation, whether it’s reading a book, taking a relaxing bath, or indulging in a hobby. Prioritising self-care can help reduce stress levels and contribute to a positive overall mindset.

Tips for Managing Menopause Symptoms: Mental Health Edition

  • Seek support from healthcare professionals specialising in menopause.
  • Share your experiences and feelings with trusted loved ones.
  • Practice stress management techniques, such as deep breathing exercises.
  • Engage in regular physical activity to release endorphins.
  • Make time for self-care activities that bring joy and relaxation.

Menopause Support and Wellbeing Resources

Menopause Support GroupsJoin local or online support groups to connect with others experiencing menopause.Local community centers
Online platforms
Therapy ServicesSeek professional therapy services specialising in menopause and mental health.Local therapists or counsellors and online counseling platforms
Wellbeing AppsExplore mobile applications focused on mindfulness, stress reduction, and sleep improvement.Headspace 


In conclusion, menopause marks a natural transition in a woman’s life, accompanied by a range of signs and symptoms. During perimenopause and menopause, women commonly experience irregular periods, vaginal dryness, hot flushes, mood changes, and physical symptoms. It is crucial to seek medical advice and support to effectively manage these symptoms and promote overall health and wellbeing.

By taking proper care and seeking understanding, women can confidently navigate this transitional phase and achieve a smoother journey through menopause. Whether it’s through lifestyle adjustments, hormone replacement therapy, or alternative treatments, there are a variety of options available to help manage menopause symptoms. It’s important to consult with healthcare professionals to determine the best approach tailored to individual needs.

Menopause is a significant life stage that requires support and understanding. By prioritising self-care, seeking medical guidance, and harnessing the wealth of available resources, women can embrace the changes that come with menopause and continue to live their lives to the fullest.


What are the first signs of menopause?

The first signs of menopause can vary among women, but common early symptoms include irregular periods, vaginal dryness, and hot flashes. Other signs may include sleep problems, mood changes, weight gain, thinning hair, and dry skin.

What are the symptoms of perimenopause?

Perimenopause is the period leading up to menopause and can be marked by symptoms such as irregular periods, vaginal dryness, hot flashes, mood changes, sleep problems, and physical changes like thinning hair and dry skin.

What is the first sign of perimenopause?

The first sign of perimenopause is often irregular periods. During this time, menstrual cycles may become shorter or longer, heavier or lighter, and more or less frequent. It’s common for periods to skip a month or several months and then return.

Can you get pregnant during perimenopause?

Even though periods may be irregular during perimenopause, it is still possible to get pregnant. If you’re unsure about starting the menopausal transition, it’s important to keep track of changes in your menstruation and consider taking a pregnancy test if there’s any uncertainty.

What are the physical symptoms of menopause?

Physical symptoms of menopause can include hot flashes, night sweats, vaginal dryness, sleep problems, thinning hair, dry skin, weight gain, and changes in breast fullness.

What are the emotional symptoms of menopause?

Emotional symptoms of menopause can include low mood, anxiety, mood swings, low self-esteem, and changes in concentration and memory often referred to as “brain fog.”

What are the concerns and complications of menopause?

Menopause can increase the risk of certain medical conditions such as heart and blood vessel disease, osteoporosis, urinary incontinence, and changes in sexual function.

What causes menopause?

Menopause occurs naturally as reproductive hormones decline with age. It can also be triggered by surgeries that remove the ovaries or certain cancer treatments. Primary ovarian insufficiency, which causes premature menopause, can also occur.

How can I manage menopause symptoms?

There are various options for managing menopause symptoms, including lifestyle changes such as maintaining a healthy diet and regular exercise. Hormone therapy, non-hormonal therapies, and alternative medicines can also be effective. It’s important to work with a healthcare professional to determine the best approach for you.

How does menopause affect mental health and wellbeing?

Menopause can impact mental health and wellbeing, leading to symptoms such as irritability, low mood, anxiety, and difficulty sleeping. Seeking support from healthcare professionals and loved ones, as well as practicing stress management techniques and self-care, can help improve mental health during this time.

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Dr Catherine Smith

Dr Catherine Smith is the founder of The Coil Clinic. A GP and Women's Health Expert with nearly 20 years of experience. She is a BMS Certified Menopause Specialist