Symptoms of menopause and treatment options

Menopause is a natural part of life. But that doesn’t mean it always feels easy. The symptoms can be surprising, frustrating, and sometimes overwhelming. And while there has been more of a spotlight on the symptoms of menopause and perimenopause, they’re not always talked about often enough. 

Fortunately, you don’t have to power through it alone. By understanding what’s happening in your body and knowing your options, you can take charge of this chapter of your life and feel more like yourself again. We’ll walk you through some of the most common symptoms of menopause and perimenopause, plus help you discover the variety of treatment options available today. 

What is menopause?

Menopause marks the end of your menstrual cycles. It happens when your ovaries gradually produce less estrogen and progesterone (the hormones that regulate your period and fertility). Once you’ve gone 12 full months without a period, you’ve officially reached menopause.

Menopause is a major hormonal shift that affects your whole body – not just your reproductive system. There are three stages of menopause. Recognizing which one you’re in can help you choose the right support at the right time.

Learn about the stages of menopause.

Perimenopause

Perimenopause is the transition into menopause itself. It typically starts in your mid-to-late 40s (though it can begin earlier). During this phase, your ovaries start winding down, causing your hormone levels to swing up and down unpredictably.

That hormonal rollercoaster is behind many of the early symptoms of perimenopause, including hot flashes, mood swings, brain fog, and sleep troubles. You might also notice your periods becoming irregular. They might be lighter, heavier, longer, shorter, or even skipped altogether.

Perimenopause usually lasts 4 to 8 years, but for some, it can stretch closer to ten. It ends when you hit that 12-month mark without a period. This includes an absence of monthly spotting and not just a fully-fledged period with light-to-heavy bleeding, depending on your cycle. If you’re still spotting periodically, you’re not officially in menopause.

“Irregular bleeding and spotting are common during perimenopause,” mentions  Dr. Sheryl Ross (Dr. Sherry), Chief Medical Officer of Women’s Health here at QuickMD.  “If you are in perimenopause, you are still ovulating. Even if it’s not consistent, you can still get pregnant.” This makes it all the more important to use contraceptives during perimenopause if you are not trying to get pregnant. 

Dr. Sherry also notes that, “You are not officially in menopause until you have not had a period for one year. Any kind of irregular bleeding or spotting should be evaluated by your healthcare provider.”

Menopause

You’ve officially reached menopause once you’ve gone 12 consecutive months without a period. For most women, this typically happens around age 52, but it can occur earlier or later.

At this point, your ovaries have stopped releasing eggs and producing significant amounts of estrogen and progesterone. While perimenopause is a gradual progression, menopause itself is a single milestone and not a long phase you “live in.” After that, you move into postmenopause.

Postmenopause

Postmenopause is the stage that lasts for the rest of your life. By now, your hormone levels have settled into a new normal, which often means many early symptoms (like hot flashes) begin to fade.

But lower estrogen doesn’t just “go away quietly.” It can increase your risk for bone loss (osteoporosis) and heart disease over time. The good news? These risks can be managed with proactive care.

What are the symptoms of menopause?

Not everyone experiences the same symptoms or with the same intensity. Some sail through perimenopause and menopause with minimal changes. On the flipside, others face daily disruptions. All of it is valid, and you’re not just imagining these feelings. If symptoms are interfering with your life, they’re worth addressing.

Menopause and perimenopause symptoms generally fall into three categories: physical, emotional/cognitive, and lesser-known (but still real) changes.

Physical symptoms

The physical symptoms of perimenopause and menopause are often the most talked-about. There’s a good reason why, because they’re often hard to ignore: 

• Hot flashes: A sudden wave of heat, often with sweating. This happens because shifting estrogen levels confuses your brain’s “thermostat” (the hypothalamus). As a result, your brain and body think you’re overheating, even though you’re not. 
• Irregular periods: A hallmark of perimenopause. Cycles may shorten, lengthen, or stop unpredictably.
• Night sweats: Hot flashes that strike at night, sometimes soaking your clothes and resulting in a restless night’s sleep. 
• Trouble sleeping: Estrogen helps your brain make serotonin, which supports sleep. When it drops, your sleep-wake cycle can get thrown off.
• Vaginal dryness: Lower estrogen thins and dries vaginal tissue, which can lead to itching, discomfort, or pain during sex.
• Fatigue: Between hormonal shifts, night sweats, and poor sleep, it’s no wonder you might feel drained.

Emotional & cognitive symptoms

Menopause and perimenopause don’t just come with physical changes. Many women are surprised to learn that their mood swings, anxiety, or “fuzzy thinking” are tied to hormonal changes and not stress or aging alone. If you feel like you’re struggling with everyday tasks, it’s not just you. Many women experience:

• Mood swings: Estrogen helps regulate serotonin (your “feel-good” brain chemical). When it dips, it can impact your emotional balance, especially if your stress and cortisol levels are high.
• Anxiety: Lower serotonin and norepinephrine are both influenced by estrogen. Those fluctuating hormones can leave you feeling on edge.
• Brain fog: You might forget names, lose your train of thought, or feel mentally sluggish. Estrogen supports blood flow to the brain and neurotransmitter function. So, when it drops, your focus can suffer.
• Lower libido: Between vaginal dryness, reduced sensitivity, and fatigue, interest in sex may decline. This is common and treatable.
  

The intensity of these symptoms will vary. And while they’re totally normal, that doesn’t make them any less uncomfortable or frustrating. 

Less common symptoms

These symptoms don’t get as much attention, but they’re still part of the picture for some:

• Urinary changes: Frequent urination or urgency, due to thinning urethral tissue and weakened pelvic muscles.
• Burning mouth syndrome: A tingling or burning sensation in the mouth, possibly linked to dry mouth from low estrogen.
• Gum sensitivity or inflammation: Less saliva means more bacteria—leading to gum issues.
• Heart palpitations: Some women notice their heart racing or skipping beats briefly. Hormone shifts can affect heart rhythm temporarily.
• Joint and muscle pain: Estrogen helps maintain joint lubrication and muscle strength. Its decline may lead to stiffness or aches.
• Skin changes: Dryness, itchiness, and even adult acne can flare up due to hormonal fluctuations.

Duration of menopausal symptoms

So, how long do menopause symptoms last? It varies from woman to woman. For many, the most intense symptoms peak during late perimenopause and ease up within a few years after menopause. However, some women continue to experience hot flashes or sleep issues for 5–10 years or more. 

Here’s a breakdown of what symptoms can look like during each stage of menopause:

How long each symptom lasts will depend on your unique body chemistry and whether you pursue treatments. If symptoms start before age 40, or if they’re severe enough to disrupt your life at any age, it’s worth talking to a provider. You don’t have to just “wait it out.” Help is available for you, and you can get back on track to feeling more like yourself again. 

Learn more about perimenopause.

What makes menopause symptoms worse?

Certain lifestyle factors can amplify discomfort during menopause and perimenopause. They include: 

• Smoking and alcohol
• Spicy foods, caffeine, or hot drinks (common hot flash triggers)
• High stress (which spikes cortisol and worsens mood swings)
• Being overweight (fat tissue produces some estrogen, but excess weight can actually intensify hot flashes and sleep issues)
  

It bears repeating that if your symptoms feel “off” for your age or severity, don’t dismiss them. Premature menopause (before 40) or other conditions could be at play.

Treatment options for menopause symptoms

While perimenopause and menopause are chock full of irritating life changes and hormonal shifts within your body, the good news is that many of these unpleasant symptoms are treatable. Because every woman is unique, the best options for you will vary depending on your symptoms, health history, and preferences.

Not sure where to start? Here are a few options to explore:

Hormone therapy

When used appropriately, menopause hormone therapy (MHT) is one of the most effective ways to relieve moderate-to-severe symptoms. Sometimes called hormone replacement therapy (HRT), MHT is offered under the guidance of a licensed provider who can track your progress and how well you respond to a recommended dosage. MHT can include: 

• Estrogen therapy (alone) is an option if you’ve had a hysterectomy.
• If you still have your uterus, you’ll usually take estrogen + progesterone to protect the uterine lining.
• Testosterone is another common hormone in the mix for MHT, which can improve sexual function and overall well-being. 
• Forms include pills, patches, gels, creams, and vaginal rings. Your provider will work with you to help you choose the best option for your lifestyle. In fact, some options are available as face creams, made with testosterone, and/or estrogen + progesterone in their formulation. 
  

As with any medication, there are benefits and risks to explore. An honest discussion with your provider detailing your personal and family medical history can help you make an informed decision about which type of MHT is best for you, plus help you feel more comfortable and confident. 

Non-hormonal prescription treatments

If you decide MHT isn’t for you, you still have plenty of non-hormonal, FDA-approved alternatives. Speaking with a licensed provider can help you find an option that best fits your needs. Options can include:  

• Antidepressants (SSRIs/SNRIs): Low doses can reduce hot flashes and help with mood swings. 
• Gabapentin: Originally for seizures, it’s now used off-label for night sweats and hot flashes.
• Fezolinetant (Veozah®): A newer, non-hormonal pill that works directly on the brain’s temperature control center. It’s approved specifically for hot flashes.
• Non-hormonal vaginal creams & lubricants: For dryness and discomfort during sex.

Lifestyle changes & alternative therapies

In some cases, making adjustments to your daily routine and health habits can make a big difference in reducing some of the symptoms of menopause and perimenopause. From natural remedies to “life hacks,” these won’t always replace medical treatment for severe symptoms, but can still be a game-changer.

• Dietary changes: Eating spicy, greasy, or sugary foods can worsen symptoms because they can cause inflammation throughout the body. Caffeine and spicy foods, in particular, can contribute to hot flashes. Opt for more fruits, veggies, and lean proteins. 
• Regular exercise: Exercising can help improve your mood because it triggers the release of feel-good chemicals, but make sure to exercise indoors or when it’s not very hot outdoors. As an added benefit, bodyweight exercises (like yoga or pilates) can help boost bone health. 
• Build good sleep habits: Insomnia and restless sleep can be another annoying symptom of menopause. (Partly due to night sweats and evening hot flashes.) Creating a darker, cooler, less noisy sleep environment can help you get some much-needed rest. Additionally, lightweight bedding, breathable PJs, and a fan can reduce night sweats. 
• Stress management: Because stress can trigger menopause symptoms, engaging in activities like meditation, yoga, and similar options can help you unwind, lower cortisol, and ease anxiety. 
• Avoid known triggers: Every woman’s experience is different. And while some things (like caffeine, alcohol, and spicy foods) can be common triggers, you might notice a surge in symptoms after eating specific foods or coming out of high-stress situations. Keeping a symptom journal can help you spot your personal triggers. 
• Cognitive behavioral therapy (CBT): CBT focuses on helping you better understand your symptoms and reframe how you respond to them. This can have a positive impact on some of the emotional impacts of menopause and perimenopause. 
• Natural supplements: Supplements like black cohosh or red clover have been reported to reduce hot flashes. Chat with your provider about holistic options to see if they might be a good fit for your menopause or perimenopausal symptoms. 

How to choose the right treatment for menopause symptoms

Menopause and perimenopause can be a frustrating time in your life. On top of dealing with major changes in your life (and body), there’s so much information to sift through when all you want is a little relief. But you don’t have to figure this out alone. 

Working with a licensed provider can give you added peace of mind and help point you in the right direction. They’ll work with you to: 

• Review your medical history
• Help weigh risks vs. benefits
• Adjust treatment if side effects arise
• Offer support, not judgment

Take action against menopause symptoms with QuickMD

If your menopause and perimenopause symptoms are taking a toll on your quality of life, help is available. Here at QuickMD, we believe that menopause care should be personalized, not one-size-fits-all.