Menopause Symptoms Explained: Full Guide

Menopause Symptoms Explained: Hot Flushes, Night Sweats and Beyond

 

If you're approaching your mid-to-late forties or fifties and starting to notice changes in your body, mood, or sleep, you might be wondering whether this is menopause, or something else entirely. Understanding what actually happens during menopause, and the wide range of symptoms it can bring, can help you make sense of what you're experiencing and work out what genuinely needs attention.

 

What Happens at the Menopause?

 

The monthly cycle is governed by a number of reproductive hormones, the main ones being oestrogen, progesterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH). At the menopause, women literally run out of eggs. Every woman has a supply of around 2 million eggs from the moment she is born, and over the years these are gradually used up. Eventually, a woman reaches an age where there simply aren't any more.

 

When this happens, the body tries to encourage ovulation by releasing more of the hormone FSH. This hormone is released every month in a normal cycle, but during menopause, when the body registers that ovulation isn't taking place, even more FSH is pumped out. Interestingly, as the ovaries decline their oestrogen production, the body has a backup plan: the adrenal glands can produce a form of oestrogen called oestrone to help compensate for the decline. This is one reason why keeping the adrenal glands healthy matters so much during this transition. Oestrogen is also produced from fat cells, which is why being ultra-slim isn't necessarily beneficial in the long run, particularly around menopause - though being overweight isn't the answer either.

 

Leading up to the menopause, ovulation becomes less likely because oestrogen levels decline during the first two weeks of the cycle, meaning progesterone won't be produced in the second half. Without rising oestrogen levels in the first two weeks signalling the ovaries to produce less FSH, FSH levels in the bloodstream keep climbing. This means a period can still happen even without ovulation occurring.

 

The Three Phases of Menopause

 

Medically, the whole passage through menopause is termed the "climacteric", while your last period specifically is known as "the menopause". There are three distinct phases:

• Pre-menopause: periods are still regular, but the first symptoms, such as hot flushes and mood changes, may begin to appear.
• Peri-menopause: ovarian function declines, periods can become irregular, and symptoms may become more noticeable or severe.
• Post-menopause: this stage lasts from your last period onwards.

 

How Do You Know You're in the Menopause?

 

If you see your doctor because you suspect you've entered menopause, they will typically measure your FSH levels. As a woman progresses through menopause, FSH levels rise higher, so this measurement gives a reasonably good indication of what stage you may be at, though levels can vary from month to month.

 

The Full Range of Menopause Symptoms

 

Symptoms vary enormously from woman to woman. Some sail through menopause with barely any symptoms beyond their periods stopping, while others experience much more intense effects, including being completely drenched in sweat day and night, needing to change nightclothes multiple times, or even showering in the middle of the night.

 

The recognised symptoms of menopause include:

• Hot flushes
• Night sweats
• Vaginal dryness
• Mood swings
• Declining libido
• Osteoporosis
• Ageing skin
• Lack of energy
• Joint pains
• Weight gain
• Headaches
• Changes in hair quality

 

Interestingly, men also experience many of these symptoms as part of the general Western ageing process, including irritability, declining libido, changes in weight, ageing skin and hair, depression and anxiety. This is a useful reminder that not every symptom experienced around this age is necessarily down to the menopause specifically - it may simply be part of the ageing process more broadly, affecting both sexes.

 

Why Correct Diagnosis Matters

 

Unfortunately, if a woman around the age of 45 visits her doctor with any of these symptoms, they're often immediately attributed to "hormones", with HRT frequently offered as the first line of treatment. Many women who have been placed on HRT for supposed hormone problems later discover they weren't actually menopausal at all. A variety of other health conditions can produce symptoms very similar to those of menopause, so it's worth not assuming - or allowing your doctor to assume - that menopause is automatically the cause without proper investigation.

 

Common Questions About Menopause Symptoms

 

Are all menopause symptoms hormonal? Not necessarily. While symptoms like hot flushes, night sweats and vaginal dryness are commonly linked to declining oestrogen, many other symptoms associated with menopause - such as joint pain, ageing skin, changes in hair quality and low energy - are also part of the general ageing process and affect men in similar ways. This overlap is exactly why it's worth investigating rather than assuming every symptom is menopause-related.

 

Why do FSH levels rise during menopause? FSH rises because the body is trying to stimulate ovulation. As the ovaries run out of eggs and stop responding, the pituitary gland releases progressively more FSH in an attempt to trigger a response, which is why elevated FSH is used as a marker for where a woman is in the menopausal transition.

 

Can you still have periods without ovulating? Yes. As oestrogen levels decline earlier in the cycle leading up to menopause, ovulation becomes less likely, but a period can still occur even when ovulation hasn't taken place.

 

What's the difference between perimenopause and menopause itself? Perimenopause refers to the phase where ovarian function is declining and periods may become irregular, often accompanied by more noticeable symptoms. "The menopause", strictly speaking, refers to your very last period, with post-menopause describing everything from that point onwards.

 

Making Sense of Your Own Experience

 

Because the range of possible symptoms is so broad, it can be genuinely helpful to keep a simple daily or weekly note of what you're noticing, alongside your cycle if you're still menstruating. Over a few months, patterns often become clearer - which symptoms cluster together, whether they worsen around a particular point in your cycle, and whether they're improving, worsening, or staying steady. This kind of tracking gives you and your doctor much more useful information than trying to recall symptoms from memory at a single appointment, and it can help avoid the trap of everything being attributed to "hormones" without proper investigation first.

 

The Bottom Line

 

Menopause is a natural transition marked by declining egg supply, rising FSH, and a wide, often unpredictable range of physical and emotional symptoms. Because so many of these symptoms overlap with general ageing or other health conditions, understanding the full picture puts you in a much stronger position to seek the right kind of support, whether that's medical investigation, natural approaches, or both together.

 

This article is for information only and is not intended to be a substitute for medical advice. Always consult a qualified doctor or health practitioner before making changes to your diet or supplement routine.