Understanding menopause symptoms: All about typical complaints

Are you experiencing unexpected hot flashes? Do you lie awake at night even though you're tired? Do you feel exhausted, irritable, or not quite yourself the next day? Has your period become unpredictable, and at some point, the question arises: Is this menopause ?

Menopausal symptoms often develop gradually and initially seem random. In reality, they stem from a profound hormonal shift that affects numerous bodily processes. The good news : you're not powerless against it. This article will tell you which symptoms are typical during menopause, when they begin, how long they can last, and what really helps.

The most important points in brief

• Menopausal symptoms such as hot flashes and night sweats affect around 80 percent of women going through menopause.
  
• The average age for menopause is 50, but can vary between 48 and 53 years.
  
• The symptoms last on average 4 to 5 years, but can last up to 10 years in some women.
  
• Lifestyle changes in diet, exercise, and stress management can significantly alleviate symptoms.

The most common symptoms of menopause

Menopause manifests differently in every woman. While some notice hardly any changes, others experience a wide range of symptoms.

Some of the most well-known symptoms of menopause include:

• Hot flashes and night sweats are among the most common symptoms of this phase of life. These so-called vasomotor symptoms are caused by a sudden dilation of the blood vessels and can last for several minutes. The face, arms, chest, and upper body become warm, the skin temperature rises, and this is often followed by profuse sweating.
  
• Sleep disturbances affect many women during menopause. A study with over 12,000 participants showed that almost 40 percent of women in this phase of life report sleep problems. Notably, sleep disturbances do not only occur in connection with nighttime hot flashes. Women without vasomotor symptoms also report poor sleep (1).
  
• Mood swings and emotional changes : Studies show that women have an increased risk of depression, stress, anxiety, and emotional distress during the menopausal transition. These changes are related to hormonal fluctuations but are also influenced by factors such as sleep deprivation, life stress, and physical ailments.
  
• Vaginal dryness and urogenital discomfort affect many women, but are often kept secret due to shame. The declining estrogen level leads to changes in the vaginal mucosa: blood flow decreases, vaginal lubrication diminishes, the pH level rises, and the tissue becomes thinner. These changes can not only affect the intimate area but also impair sexual function and increase the risk of urinary tract infections (1).

Often underestimated symptoms of menopause

In addition to the well-known symptoms, there are some complaints that are often not directly associated with hormonal changes, although they affect many women.

• Joint problems : The declining estrogen level accelerates bone loss, increases the risk of osteoporosis, and can contribute to the development of joint problems. Studies show that approximately 50% of all menopausal women are affected by impaired bone metabolism (1).
  
• Changes in body hair can include both increased hair loss and unwanted facial hair growth. Hair loss can occur on the head and other parts of the body, while at the same time, the altered hormonal balance can lead to increased facial hair growth (2).
  
• Cardiovascular changes are an important, often overlooked aspect of menopause. Earlier age at natural menopause is associated with an increased risk of cardiovascular disease (3).
  
• Weight gain & body composition: Metabolism changes with age, which is normal. However, hormonal changes during menopause significantly accelerate this process. Basal metabolic rate can decrease by up to 250–300 calories per day, muscle mass declines more rapidly, and fat tissue accumulates more in the abdominal area, the so-called “visceral fat.” This abdominal fat is particularly problematic because it promotes inflammatory processes in the body and increases the risk of cardiovascular disease (4).

Why do symptoms occur during menopause?

The symptoms of menopause are caused by the hormonal changes the body undergoes. With increasing age, the ovaries produce less and less estrogen, androgens, and progesterone. These hormones not only regulate the menstrual cycle but also influence numerous processes throughout the body.

The decline in hormone levels is not uniform, but occurs in waves. Particularly during perimenopause , the phase before the final menstrual period, hormone levels fluctuate significantly: sometimes the ovaries produce a relatively high amount of estrogen, and other times very little.

These hormonal fluctuations are the main reason for the diverse symptoms of menopause. Estrogen and progesterone not only affect the reproductive organs, but also influence many other bodily functions: these include temperature regulation, the sleep-wake cycle, mood, bone metabolism, body composition, and much more (5).

How long do menopausal symptoms last?

One of the most frequently asked questions is: "When will this finally end?" The answer is individual, but there are average values ​​that can provide guidance.

Perimenopause lasts an average of 4 to 7 years . Symptoms are usually most pronounced during this phase, as hormone levels fluctuate significantly. The symptoms are most frequent and intense in the first 1 to 2 years after the last menstrual period.

Hot flashes, for example, last an average of 4 to 5 years. However, in about a quarter of women, they can persist for up to 10 years. Studies also show that early onset of symptoms in perimenopause is often associated with a longer duration of suffering (1).

In most cases, the intensity of the symptoms decreases over time. What seemed very burdensome in the first few years often becomes milder and better tolerated later on.
However, some changes, such as altered metabolism, altered body composition, or the lack of estrogen's protective effect on bones and joints, require long-term lifestyle adjustments to prevent lasting negative consequences.

What helps with menopausal symptoms?

The good news is that there are many proven approaches that can actually help. Combinations of several measures are usually most effective. The important thing is to find the path that suits you, because every woman experiences menopause differently.

Nutrition

• Phytoestrogens: Plant compounds that can act similarly to estrogen in the body. They are found in red clover, soy products (tofu, tempeh, edamame), flaxseed, and legumes.
• Anti-inflammatory foods: Omega-3 fatty acids from fatty fish (salmon, mackerel, herring) or algae oil, but also turmeric and ginger can have an anti-inflammatory effect and relieve symptoms.
  
• A protein-rich diet is crucial for maintaining muscle mass, which decreases during menopause. Include high-quality protein sources in every meal: fish, poultry, legumes, eggs, dairy products, nuts, and seeds. A guideline is approximately 1.0–1.2 g of protein per kilogram of body weight daily.
  
• Reducing problematic foods: Sugar, alcohol, and excessive caffeine consumption can worsen hot flashes, disrupt sleep, and contribute to mood swings. Reducing these substances shows a significant improvement in symptoms for many women (4).

Movement

Regular physical activity is one of the most effective non-drug interventions during menopause. Studies show that exercise has positive effects on many symptoms: from mood swings to weight control and heart health.

• Cardio activities such as walking, jogging, swimming, or cycling improve cardiovascular health, help with weight management, and can boost mood. Studies show that even a weight loss of 5 kg can improve the tolerability of hot flashes by 30% (4).
  
• Strength training helps maintain muscle mass, boost metabolism, and effectively support bone health. Strength training two to three times a week can have a significant impact on preventing osteoporosis.
  
• Yoga can help with various symptoms. Studies show positive effects on mood, sleep, and overall well-being. Its effect on hot flashes is inconsistent across studies, but many women report subjective improvements (6).

Experts recommend : Aim for at least 150 minutes of moderate exercise per week, spread over several days. This way you optimally combine endurance, strength, and relaxation.

Further options for severe menopausal symptoms

If your symptoms are particularly severe or distressing, there are additional measures and therapies that can provide targeted relief.

1. Targeted nutritional supplementation

A balanced diet plays a key role in managing menopausal symptoms. Certain nutrients are particularly important now.

• Vitamin D and calcium are crucial for bone health. During menopause, the risk of osteoporosis increases significantly because estrogen deficiency accelerates bone loss. To counteract this process, it is important to ensure an adequate supply of vitamin D and calcium.
  
• B vitamins play a fundamental role in the nervous system and carbohydrate metabolism. Adequate B vitamin intake can lower homocysteine ​​levels in the blood, thereby reducing the risk of osteoporosis and fractures. B vitamins are also important for the prevention and treatment of cognitive impairment, which is common during menopause (4).

2. Hormone replacement therapy for severe symptoms

Hormone replacement therapy (HRT) is considered one of the most effective options for treating vasomotor symptoms such as hot flashes and night sweats. Studies show that HRT can significantly reduce these symptoms and improve sleep quality.

The decision for or against hormone replacement therapy (HRT) should always be discussed individually with your doctor. The benefits and potential risks will be weighed. Women who experience severe symptoms early in menopause often benefit more than women who start therapy later.

3. Local estrogen preparations

For urogenital complaints such as vaginal dryness and pain during intercourse, local estrogen preparations can be very effective. These are inserted directly into the vagina (as a cream, tablet, or ring) and act primarily locally, without affecting the entire body. Non-hormonal vaginal moisturizers can also help with mild to moderate vaginal dryness (7).

The right treatment for you depends on your individual symptoms, medical history, and personal preferences. An open conversation with your doctor is the first and most important step.

Conclusion

Menopause is not an illness, but a natural phase of life that every woman goes through. The symptoms can be challenging: from hot flashes and joint pain to weight gain and changes in body composition. But you are not helpless against them.

With the right knowledge and targeted measures such as a balanced diet, exercise, stress management, and medical support if needed, you can actively shape this phase. The sooner you start adapting your lifestyle, the better you will get through menopause.

See this time as an opportunity to pay even more attention to your body and your health. For a vital and pain-free life, even in the years after menopause.

Frequently Asked Questions

1. What are the most common menopausal symptoms?
   Common symptoms include hot flashes, night sweats, sleep disturbances, mood swings, weight gain, and joint pain.
2. When do menopausal symptoms begin?
   Symptoms can begin as early as perimenopause, usually a few years before the last menstrual period, often between the ages of 45 and 50.
3. How long do menopausal symptoms last?
   On average, the symptoms last 4–5 years, but in some women they can last up to 10 years. The intensity usually decreases over time.
4. Why do hot flashes occur during menopause?
   Hot flashes are caused by hormonal fluctuations, especially the decreasing estrogen level, which affects temperature regulation in the body.
5. Can menopausal symptoms affect mood?
   Yes, hormonal changes can lead to mood swings, irritability, stress, and increased susceptibility to depression.
6. What measures help against menopausal symptoms?
   A combination of a balanced diet, exercise, stress management and, if necessary, medical support can significantly alleviate the symptoms.
7. Does exercise help with menopausal symptoms?
   Yes, endurance training, strength training and yoga in particular can have a positive effect on hot flashes, mood swings and sleep disorders.
8. Can dietary supplements alleviate menopausal symptoms?
   Certain nutrients such as vitamin D, calcium, B vitamins and omega-3 fatty acids support bones, nervous system and metabolism and can alleviate symptoms.
9. When is hormone replacement therapy appropriate?
   Hormone replacement therapy can significantly improve hot flashes and sleep problems in cases of severe symptoms. The decision should be made individually in consultation with a doctor.
10. Are there long-term health consequences of menopausal symptoms?
    Hormonal changes can affect metabolism, bone health, and heart health. A healthy lifestyle helps minimize potential risks.

literature
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2. Weidlinger S, Weidlinger M, Heidemeyer K. Menopause and its effects on skin and hair. Gynecological Endocrinology 2023; 21(4):290–7. doi: 10.1007/s10304-023-00526-1.
3. El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD et al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation 2020; 142(25):e506-e532. doi: 10.1161/CIR.0000000000000912.
4. Erdélyi A, Pálfi E, Tűű L, Nas K, Szűcs Z, Török M et al. The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients 2023; 16(1). doi: 10.3390/nu16010027.
5. Yang JL, Hodara E, Sriprasert I, Shoupe D, Stanczyk FZ. Estrogen deficiency in the menopause and the role of hormone therapy: integrating the findings of basic science research with clinical trials. menopause 2024; 31(10):926–39. doi: 10.1097/GME.0000000000002407.
6. Money A, MacKenzie A, Norman G, Eost-Telling C, Harris D, McDermott J et al. The impact of physical activity and exercise interventions on symptoms for women experiencing menopause: overview of reviews. BMC Women's Health 2024; 24(1):399. doi: 10.1186/s12905-024-03243-4.
7. Mehta J, Kling JM, Manson JE. Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts. Front Endocrinol (Lausanne) 2021; 12:564781. doi: 10.3389/fendo.2021.564781.