Signs of menopause that might surprise you
The menopause is a normal part of ageing. It occurs over a number of years and your periods will eventually stop. After the menopause, getting pregnant naturally will no longer be possible.
The menopause usually happens between the ages of 45 and 55, but it can sometimes happen earlier.
Hot flushes and night sweats are two of the most common and best-known menopause symptoms. However, there are a number of less well-known signs of the menopause that you may not be as familiar with.
What are the unusual signs of menopause?
On the whole, the symptoms of menopause can be treated and managed using medicines and self-care. Some symptoms may cause more pain and discomfort than others – your doctor will be able to give you advice on treatment options.
1. Painful sex
During the menopause, you might find that having sex becomes painful. This is because the lining of the vagina becomes drier, thinner and less stretchy (vaginal atrophy). You might also experience some itchiness.
Your uterus (womb), clitoris, ovaries and labia minora (inner vagina lips) all get smaller during the menopause, which can affect your sex life. You might find you have a reduced sex drive and it may take longer to reach orgasm. Even so, it’s still possible to reach orgasm during and after the menopause.
If you’re experiencing pain during sex, there are a few things you can try before seeing a GP, including:
- using (or asking your partner to use) a water-based lubricant before during sex
- using unperfumed soaps to keep the area around your vagina clean
- using moisturisers that are suitable for using in or around your vagina
- You should be able to get these from your pharmacy without a prescription. You might also want to try more foreplay. Being more sexually aroused during sex can result in an increase in natural lubrication.
If you’re experiencing vaginal dryness or pain during sex, it’s best to see your doctor. Depending on your symptoms, your doctor may prescribe antibiotics. If your symptoms return, you might need to take a urine test and be prescribed different antibiotics.
If you have vaginal dryness, your doctor might try to increase your oestrogen levels by prescribing a gel, cream, patch or other medicine. This is known as hormone replacement therapy (HRT).
2. Dry skin
You may find that your skin changes during the menopause. It may look and feel thinner, drier or less elastic. This is because during the menopause your body produces less oestrogen, which is a hormone that reduces your body’s elastin and collagen levels. Elastin and collagen are proteins. Elastin makes your skin elastic, while collagen helps make your skin strong.
As a result of these changes, your skin may look and feel less supple. It’s also possible that you’ll notice your skin gets damaged and bruises more easily.
Skin problems can usually be self-managed, but see a doctor if they are worrying you. Your doctor may be able to recommend other self-care remedies or refer you to a dermatologist for more advice.
3. Urinary tract infections (UTIs)
You might find that you get urinary tract infections (UTIs) during the menopause. This is because during menopause the urethra becomes shorter and its lining becomes thinner. The urethra is the passage your pee uses as it makes its way out of the body.
A shorter urethra makes it easier for bacteria to make their way into the body and cause an UTI. Symptoms include a burning sensation when peeing. A UTI during or after the menopause can also result in the urgent need to pee. In some cases, this can lead to urinary incontinence, which is when you wet yourself unintentionally.
There are things you can do to ease the discomfort of a UTI. Taking paracetamol can reduce pain and a high temperature. You should try and drink enough fluids to ensure that your pee is clear and that you go regularly throughout the day. It’s also important to take some time to rest.
You might find it helpful to avoid sex until you feel better.
You should see a doctor if it’s your first UTI, or if your symptoms get worse or don’t improve after 2 days. They may prescribe antibiotics to help.
Menopause can result in your bones to become weaker and less dense. This happens due to the decrease in oestrogen and it can happen quite rapidly, leading to osteoporosis. Osteoporosis is a condition that weakens your bones, making them fragile and more likely to break.
There are some diet and lifestyle improvements you can make to reduce the risk of weak or fractured bones.
It’s also important to eat a healthy, balanced diet. In particular, getting enough calcium can help you to maintain stronger bones during the menopause.
Examples of calcium-rich foods are:
- dairy foods, such as milk, cheese and yogurts
- green leafy vegetables, such as kale and okra
- bread and other foods that contain fortified flour
- soya drinks that have had calcium added
- sardines, pilchards and other fish where you eat the bones
Vitamin D is also good for your bones.
Doing regular weight-bearing and resistance exercises can help reduce your risk of osteoporosis. Examples of weight-bearing activities include running, dancing and aerobics. Resistance exercises include using weight equipment at a gym.
It’s possible for your doctor to determine your individual fracture risk. Your doctor may assess your diet and recommend changes if you are at risk. They may also prescribe vitamin or mineral supplements.
Bone-strengthening medications can be prescribed to help prevent osteoporosis. HRT may also help to reduce the risk of osteoporosis.
You should always call an ambulance or go to the hospital if you think you have fractured or broken a bone.
5. Brittle nails
During the menopause you might find that your fingernails become brittle and start to break more easily. Like many menopause symptoms, this is due to the decreasing oestrogen levels in your body.
If you have brittle nails, it may help to:
- keep your hands out of cleaning liquids and detergents – for example, try wearing rubber gloves when you’re doing the washing up
- use a soft brush to keep your nails clean
- use moisturising hand cream
- keep your nails trimmed back to where they meet your skin – this can encourage them to grow back healthily
Having brittle nails isn’t usually something to worry about. However, you should see your doctor if you notice the skin around your nails becoming red, sore or swollen. These may be the early signs of an infection.
6. Hair loss or thinning
Losing hair can often be a concern during the menopause. Again, this is due to a fall in oestrogen levels in your body.
If your hair is falling out or becoming thinner due to the menopause, try using gentle shampoos and moisturising conditioners, and avoid using hot hair dryers.
Eating a healthy diet may also help if your hair starts to thin. In particular, having a low intake of iron, iodine, B-vitamins or zinc has been associated with hair loss.
You should see a doctor if you are worried about your hair loss during menopause.
Your doctor may be able to prescribe medications to stimulate growth. HRT may also help to manage the hair loss.
7. Aches and pains
General aches and pains can be a feature of the menopause. Again, these symptoms are linked to a drop in oestrogen levels. Some areas of your body may get painful and swollen. Most commonly affected are small joints of your hands and feet, as well as your neck, knees and elbows.
Lots of people can get aches and pains, but you should see your doctor if your pain is stopping you from enjoying daily life. They can help to rule out any other causes, such as osteoarthritis or rheumatoid arthritis.
In particular, you should call an ambulance or go to the hospital if you develop a swollen joint that is painful and hot. This may be a sign of septic arthritis and would need urgent treatment.
Read more about what causes joint pain during menopause.
8. Problems with memory and concentration
During the menopause, you might find you have trouble concentrating or remembering things. You may also have difficulty multitasking.
This may be linked to hormone imbalances that happen during menopause. It may also be the result of poor sleep, which can be due to night sweats.
It’s normal to forget things from time to time. However, if it’s a regular problem and it’s affecting your day to day life, you should see a doctor and have it checked. This is in case it’s a sign of a more serious condition.
Unusual symptoms of perimenopause
The time before the menopause is called the perimenopause. During this time, your periods are likely to be irregular. The perimenopause ends and the menopause begins 12 months after your last period.
You may experience lots of different symptoms during the perimenopause. Many of these are similar (or the same as) menopause symptoms.
Common symptoms of the perimenopause include:
- irregular periods
- hot flushes
- night sweats
- mood swings
Less well-known symptoms of the perimenopause include:
- problems with memory and concentration, including multi-tasking
- joint and muscle pain
- heavy menstrual bleeding – around 25% of those going through the perimenopause have at least one heavy period before they become irregular and/or lighter
When to see a doctor about unusual menopause symptoms
You should call an ambulance or go to an emergency department if:
- you have a joint that is red, hot and very painful
- you have had an injury and think you might have broken a bone
- you have a high or low temperature and feel very unwell or dizzy, have a fast heart rate or fast breathing (these could be signs of sepsis)
- feeling confused, drowsy or have trouble speaking
- you haven’t peed all day
- you feel suicidal or like you might hurt yourself
You should see a doctor as soon as you can if:
- you have joint pain with swelling or redness
- you have night sweats with weight loss or swollen glands
- you are losing weight without meaning to
- you have blood in your urine, pain on one side of your back (these could be signs of a kidney infection)
- you have pain deep inside when you have sex
- you are still bleeding after the menopause (your periods have been stopped for 12 months)
- you have redness or pus around your nail
Also see your doctor if:
- your symptoms are not getting better with self-care measures or they keep coming back
- you have noticed unusual discharge from your vagina
- you have noticed bleeding in between your periods or after you have had sex
- you have symptoms of a urine infection (peeing often, pain when you pee or needing to pee urgently), particularly if they’re not getting better after 2 days
- your nails have changed in colour, shape or texture (this could be a sign of a nail infection or another medical condition)
- you’re losing hair suddenly or unexpectedly, your hair falls out in clumps (or you have bald patches) or your head burns or starts to itch
- you’re worried about your memory or concentration
- you feel anxious or low in mood
Your health questions answered
Can menopause make you feel weak and shaky?Answered by: Healthily's medical team
Yes, menopause can make you feel weak, shaky and dizzy at times. This can result from various different symptoms that – either on their own or combined – can affect your health.
For example, night sweats can stop you from sleeping and leave you feeling tired and irritable.
Hot flushes, meanwhile, can make your face, neck or chest feel hot. This feeling can spread to the rest of your body, causing sweating and chest palpitations.
You might also experience mood swings or anxiety, which can sometimes leave you feeling shaky.
- the symptoms of menopause are wide ranging
- lesser-known menopause symptoms include dry skin, hair loss and memory problems
- most menopause symptoms can be treated at home or with prescribed medicines
- diet and exercise can help alleviate some symptoms of menopause
- see your doctor if any menopause symptoms negatively impact your day to day life