The surprising menopause symptoms you didn’t see coming

Lesser-known menopause symptoms can sneak up on you — Photo courtesy of valentinrussanov / E+

While many of us associate menopause symptoms with things like hot flashes, night sweats, and moodiness, countless other indicators accompany this period of a woman’s life.

When I began having aching hips at age 43, I never guessed it had anything to do with menopause, which wasn’t even on my radar. It wasn’t until four years later, when the more classic menopause symptoms like hot flashes began that I started to put the pieces together.

I’ve had health issues I had no idea were menopause-related, including food intolerances (sugar, caffeine, and high-fructose corn syrup), irritable bladder syndrome, joint and tendon pain, fatigue, mood swings, dry eyes, severe migraines (which I’d never experienced before), acid reflux that resulted in difficulty swallowing, heart palpitations, and the list goes on. I’ve learned now to assume nearly any health issue I have is likely tied somehow to menopause.

I’m not the only one. Women experience a litany of menopause symptoms without realizing their root cause. Here, an expert explains some of the lesser-known symptoms and how to deal with them.

When does menopause start?

Menopause is a point in time when a woman stops having menstrual periods for 12 consecutive months. The average age of menopause is 51, says Dr. Louise Newson, a physician, women’s hormone specialist, and member of the government-established Menopause Taskforce in the United Kingdom. She educates physicians and the general public about menopause and its treatments.

Women’s ovaries have a set number of eggs, which decline with age, as do the associated hormones estrogen, progesterone, and testosterone. Estrogen and progesterone levels tend to have chaotic ups and downs — especially estrogen.

“For a lot of people, this can trigger menopausal symptoms,” says Newson, who’s created an online Menopause Masterclass course, as well as the Balance app, to help educate and empower others. “A lot of these symptoms are worse in perimenopause than in menopause, especially mental health, because of these fluctuating changes.”

There are three stages of menopause. This first stage is called perimenopause, which begins for most women in their 40s but can begin as early as in their 30s.

“Many women don’t attribute their symptoms to hormonal changes,” says Newson. “They might just think they’re becoming a bit more tired, irritable, having some muscle and joint pains or headaches — just because of life.” According to Newson, women can experience perimenopausal symptoms for many years while still having periods.

Menopause, the next stage, is the point in time when you haven’t had a menstrual cycle for 12 months. Once you’ve crossed through menopause, you are postmenopausal for the rest of your life.

How do you know you’re menopausal?

Talking to your doctor about menopausal symptoms is key to proper diagnosis and care — Photo courtesy of AzmanL / E+

There isn’t a test that can tell you if you’re menopausal, according to Newson, who is also the author of the book, “The Definitive Guide to Perimenopause and Menopause.” This is because our hormone levels dramatically fluctuate even minutes at a time.

Instead of testing hormone levels, she says it’s essential that doctors diagnose patients based on their symptoms, similar to how doctors treat migraines, depression, or other medical issues for which there are no definitive tests.

How does menopause make you feel?

The range of symptoms that can accompany menopause is vast and affects many parts of the body. This is because of the huge role that estrogen, progesterone, and testosterone play in a woman’s body.

“Every single cell in our body responds to these hormones,” says Newson. “But if we don’t have these hormones, our cells in every organ don’t function as well.”

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In a survey of more than 6,000 women, Newson found that the most common symptoms begin in the brain, including brain fog, irritability, reduced concentration, low mood, and poor memory. Other better-known symptoms include headaches, hot flashes, night sweats, mood swings, and vaginal dryness.

What are some lesser-known symptoms of menopause?

There are some surprising symptoms that many women don’t immediately associate with menopause. These can include restless legs, poor sleep, skin changes, pins and needles sensations, coarser hair and nails, dry eyes and mouth, teeth and gum issues, indigestion, urinary tract infections, achy or swollen joints, muscle cramps and stiffness, plantar fasciitis, frozen shoulder, shortness of breath, changes in sense of smell, irritable bowel, heart palpitations, and many others.

How to fight menopause symptoms

Exercise, proper nutrition, and hormone replacement therapy can help treat menopause symptoms — Photo courtesy of FatCamera / E+

Nutrition (estrogen-rich foods) and exercise (strength training) can improve brain, heart, and bone health, thereby counteracting the effects of menopause. Many women also turn to hormone replacement therapy, often referred to as HRT, as they enter perimenopausal years to help alleviate symptoms. Studies have shown that HRT can help reduce a woman’s risk of heart disease (the most significant cause of death in women), osteoporosis, and dementia.

Newson says some people are hesitant about HRT because of a Women’s Health Initiative study released in 2002.

According to Newson, the study looked at women of an average age of 63, many of whom were obese and had increased risk factors for heart disease. They were given HRT in pill form, which can increase the risk of blood clots and stroke, and synthetic forms of HRT, which are chemically different from what our bodies produce.

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The synthetic progesterone used in the study was associated with a slight increase in breast cancer among the women in the study. Newson says the study’s results weren’t analyzed properly, and, because of the small risk, the study was halted, resulting in headlines worldwide that HRT caused breast cancer and heart disease. In actuality, the risk of breast cancer was so small in the study that it didn’t reach statistical significance, Newson says.

“It was the biggest travesty to women’s health that I think ever happened,” she says.

Bottom line: If you’re younger than 60 and not already at high risk of breast cancer or blood clots, the benefits of HRT are likely to outweigh the risks.

Today, doctors typically prescribe a more natural form of progesterone and a natural form of estrogen derived from the yam plant. These are bioidentical, meaning they’re more like what our bodies naturally produce. These hormones also are usually given through a patch or gel to reduce the risk of blood clots.

Can women take testosterone?

HRT is not just about progesterone and estrogen. While testosterone tapers off more gradually than estrogen and progesterone, it, too, can play a major role in symptom management. Newson says she’s seen significant improvement with menopausal symptoms of dry eyes, bladder issues, food intolerances, frozen shoulder, and allergies when she treats women who have low testosterone with testosterone replacement.

If you’re experiencing any of these symptoms — even if you’ve gone through menopause — discuss them with your doctor. Together, you can develop a holistic treatment plan that positions you for optimum health as you navigate these transitional years.