Tell Your Provider About These Menopause Symptoms

Content medically reviewed by Michaela Heller, MD

Hot flashes are often the most recognized and bothersome symptom of menopause. Other common symptoms include vaginal dryness, sleep disturbances, and mood changes. Some symptoms, like extreme mood swings, urinary incontinence, and bleeding after menopause, should be reported to a health care professional. Learn more about the symptoms of menopause and when to tell your provider about troubling menopause complications.

What Happens During Menopause?

Menopause is officially diagnosed when a woman has gone 12 consecutive months without a menstrual period. The average age of menopause is about 51, although it can happen before or after. Perimenopause refers to the years leading up to menopause, which can begin seven to 10 years prior to a woman’s final menstrual cycle, or in your early-to-mid-40s. This stage is where many experience menopause symptoms.

“During perimenopause, ovarian function slowly declines and there is a decrease in the production of estrogen and progesterone,” said Dr. Michaela Heller, OB/GYN at Essentia Health. “This change in hormone production triggers the cessation of menstrual periods and the changes that come with it, like hot flashes, sleep issues, and vaginal dryness.”

The First Signs of Menopause

Everyone’s transition into menopause is different. Some people first notice changes with their periods, such as spotting, periods lasting longer or shorter than usual, or changes to their bleeding pattern. Others may break out in a sweat during the day or at night, while others may not experience any symptoms commonly associated with menopause.

When to See a Provider for Menopause Symptoms

Menopause is a natural process, but it shouldn’t disrupt your life. Some abnormal menopause-related symptoms can also indicate an underlying condition, like certain cancers. Know the difference between normal symptoms and when to report them to a provider.

Bleeding During Perimenopause and After Menopause

Irregular bleeding patterns or heavy bleeding during perimenopause should be evaluated. You should also be evaluated by a doctor if you experience bleeding after menopause. Remember that menopause is a full 12 months of no menstrual cycles. Tell your provider if you experience any of the following symptoms —

• Bleeding after intercourse
• Bleeding that’s heavier than a usual menstrual period
• Bleeding that occurs with abdominal pain, fever, chills, headache, or changes in bladder and bowel function
• Blood, even if it’s a small amount
• Passing blood clots
• Pink or brown vaginal discharge

Heart Palpitations

Heart palpitations, or the feeling of fluttering in the chest, is a common symptom of menopause. Palpitations can be due to normal hormonal fluctuations but should be evaluated by a health care professional to rule out other conditions, such as atrial fibrillation (AFib) or another arrhythmia (irregular heartbeat).

Debilitating Mood Changes

Talk to your provider if you experience severe mood swings or irritability that impact your daily life, such as your work or personal relationships.

Severe Body Pain 

Mild-to-moderate joint and muscle pain is normal during menopause. If your body pain prevents you from doing normal daily activities, bring this up with your provider so they can help you find relief.

Urinary Tract Infection (UTI) Symptoms

Menopause can weaken the urinary tract’s lining and lead to vaginal dryness, which both contribute to UTIs. Alert your doctor about frequent urination, pain or burning during urination, fever, and abdominal pain.

Early menopause symptoms

Tell your provider if you experience menopause symptoms before age 40. Early menopause symptoms include –

• Brain fog, including memory issues
• Decreased libido
• Hair thinning or skin changes
• Hot flashes, including night sweats
• Irregular periods, which include missing a menstrual cycle and periods that are lighter or heavier than usual
• Mood changes
• Vaginal dryness

This is not an exhaustive list, as everyone has a unique experience with menopause. Always tell your provider about any symptoms that are concerning or troubling you.

Many symptoms of early menopause can be signs of primary ovarian insufficiency (POI), or when the ovaries stop functioning normally before age 40. Because the symptoms of the two conditions mimic each other, some women with POI believe they’re experiencing menopause or premature menopause.

Premature menopause is when a woman no longer gets a period before age 40. With POI, periods may still happen but are usually irregular and lead to difficulty getting pregnant.

Treatment for Menopause Symptoms

Other conditions can have similar symptoms to menopause, therefore your provider may recommend other testing, such as imaging or blood tests, to make sure the correct diagnosis is made. There are several treatment options for symptoms of menopause. Recommended treatments may include –

Lifestyle Changes

Stress management can relieve some menopause symptoms. Activities that promote relaxation, including deep breathing, meditation, and hypnotherapy may offer relief for some of the emotional complications of menopause. Hypnotherapy phone apps have been shown to decrease the number and severity of hot flashes. Cognitive behavioral therapy can also be helpful. Exercising and eating a nutrient-dense diet that includes fruit, vegetables, and minimally processed foods is also key to optimal well-being during menopause.

Hormone Therapy

Hormone therapy, which involves replacing estrogen and sometimes progesterone, can effectively manage hot flashes, vaginal dryness, and other symptoms of menopause. Estrogen and progesterone can be replaced through pills, patches, topical creams, and vaginal inserts. Hormone therapy is not right for everyone, so your provider will take into consideration your heart health and any cancer risk you may have prior to prescribing them. Just like any other medication, there can be risks associated with hormone therapy. It is important to discuss these risks with your provider and make a decision together when deciding on the best treatment option for you.

Non-hormonal Therapies

Several non-hormonal medications can help manage menopause symptoms. These include certain antidepressants and gabapentin to relieve hot flashes and suppositories for vaginal dryness. Your provider can help you explore these options and determine the most appropriate medication for your symptoms.

Alternative Therapies

Some individuals find relief through therapies like acupuncture, herbal remedies, and massage. While these approaches may be helpful for some, it's essential to do your research and discuss them with your provider, as they may interact with other medications or have potential side effects.

“It’s also important to note that menopause is not a disease, but a normal part of the aging process,” Dr. Heller said. “That being said, symptoms may still be troubling, and we are here to help you through it.”

To ensure you feel your best before, during, and after menopause, talk to your provider about the best ways to stay healthy, strong, and comfortable during this transition.