Different women experience different symptoms (physical and/or psychological) during menopause.

The most common physical symptoms that women experience are vasomotor symptoms manifesting as a spontaneous sensation of warmth, usually felt on the chest, neck and face, which may also be associated with perspiration, palpitations and anxiety. These episodes are described as hot flushes, hot flashes and night sweats and can affect up to 70 per cent of women.

Abnormal uterine bleeding is also one of the common symptoms during menopause transition. Vaginal dryness and itching can occur due to atrophic vaginitis as a result of lack of the hormone oestrogen. The vaginal skin becomes more friable and more prone to inflammation and infections causing vaginal discharge. Intercourse can become more painful due to the atrophy as well as decrease in the libido.

Atrophy in the urogenital region also leads to urinary symptoms like frequency, urgency and incontinence (sudden, involuntary leakage of urine).

For some women, it’s the skeletal symptoms that predominate. Back pain, muscle and joint pains can occur. Osteopenia and gradually osteoporosis can affect the bones increasing the risk of fractures.

Skin can sag and become drier and flakier due to loss of collagen and elasticity, which is in turn due to oestrogen deficiency. Some women experience symptoms like headaches, breast tenderness and palpitations more frequently.

Many women experience psychological symptoms as well.

What are the tell-tale signs of menopause that women should be aware of?

There are some symptoms that women may experience during the menopause transition years known as perimenopause. Irregular menstrual periods, hot flashes, sleep disturbances, and mood swings are common, normal signs of perimenopause. Some women experience low libido (sex drive) and/or vaginal dryness. During perimenopause, a woman may be able to conceive, although fertility is very low. The diagnosis of perimenopause can usually be made by reviewing a woman’s medical history, her menstrual history, and her signs and symptoms.

In most cases, testing hormonal blood levels is not recommended because in menstruating women hormone levels are changing all the time. However, in younger women (below 40) menstrual irregularity is infrequently a sign of menopause, so hormone testing may be a useful tool to test whether menopause has occurred. Some women may need to be tested for other causes of symptoms that can mimic perimenopause, such as thyroid disease.

Do some women go through menopause without any "side effects" (hot flushes etc.)? If so, why?

Menopause is a fact of life that affects every woman around the world. However, the physical and mental impact of this change varies both within and across all cultures. The attitude with which a woman approaches menopause can affect her experience of the condition. By combining positive thoughts, a healthy lifestyle, and relaxation techniques, many women find that they are able to cope with the symptoms better and can transform the experience into a more positive one.

Ref: T12