Symptoms and signs of menopause

symptoms signs menopauseMenopause symptoms and the associated signs of menopause are part of a woman’s natural reproductive cycle. Most women will have at least one of a variety of menopause symptoms at some time before, during or after the menopause.
During the early teens, your ovaries will start releasing an egg every month. If the egg is fertilized, pregnancy occurs. If there is no fertilization the egg dies. The uterine lining (endometrium) which was built up in preparation for pregnancy, breaks down and is shed – menstruation. There are 4 main hormones involved in the menstrual cycle:

  1. estrogen
  2. progesterone
  3. follicle stimulating hormone (FSH)
  4. luteinizing hormone (LH)

The two that concern you most with regard to signs of menopause and symptoms of menopause are estrogen and progesterone. The menstrual cycle can be divided into 3 parts:

  1. pre-ovulation
  2. post-ovulation
  3. menstruation

In the pre-ovulatory phase, the developing egg releases a lot of estrogen. This makes the endometrium grow and thicken. In the post ovulatory phase, progesterone is secreted in increasing amounts from the corpus luteum which is left in the ovary after ovulation.
It acts to increase the blood supply to the endometrium making it water-logged and rich in nutrients. If pregnancy does not occur, the corpus luteum dies through lack of stimulation from a growing fetus. Following this, the secretion of estrogen and progesterone declines.

The endometrium does not have enough hormonal stimulation to thrive and starts to break down shedding the top 2 layers and leaving the basal layer intact. This is referred to as menstruation. In the absence of pregnancy, this cycle occurs roughly every month (22-35 days).


  1. Conception has never been a problem for me (pregnant three times on the very first try) and according to the ovulation scope I use each month to, ironically, make sure I don’t get pregnant, I ovulate regularly (and even since all this started, FSH has always been normal) although now that I’m approaching 40, I expect that will start to change.

    To be honest, I don’t think I have POV. The only other possibility that was mentioned was PCOS although other than a couple of weird, wiry chin hairs, I have absolutely no symptoms or signs and believe me, I’ve had enough bloodwork for three lifetimes…lol

    Thanks for your help 🙂

  2. Hi Izzy. I know how frustrating this kind of thing can be. It’s difficult to give you a definite answer because your doctor and Ob/midwife who have been attending to you will have a more accurate idea about what’s going on.
    There are a couple of things I can tell you though.

    1. You can divide ovarian failure into 4 stages with grade 1 being the mildest. This is also known as occult (hidden) ovarian failure where you may have regular menstruation and still experience hot flashes and other menoause symptoms.
    2. Ovarian failure sometimes becomes apparent after pregnancy or coming off oral contraceptives.
    3. Women with ovarian failure may still ovulate once in a while and so pregnancy is not impossible but they do tend to have infertility.
    4. If you ovulate, you will have progesterone in your circulation

    Like I said, I’m assuming you actually do have ovarian failure because your doctor is in the best position to know what’s going on.
    You managed to conceive? You’re really blessed!
    Take care.

  3. Since the birth of my first child, when i was 34, I have had many symptoms of menopause.

    I was put on an estrogen patch and birth control pills, which have helped tremendously but the few times Ihave tried to go off my pills or been late putting on my patch, the symptoms come right back. The main ones are sore muscles/muscle tension, stiff, achy joints, vaginal dryness, heart palpitations and extreme irritability.

    My ob/midwife says that it’s not widely talked about but that it’s not uncommon for your hormones to be permanently altered after childbirth and that she sees a number of women in the same boat as me.

    I’ve never heard of this and have only met one other woman who was having the same exact problems. Have you heard of this happening after childbirth?

    Incidentally, by going off birth control but staying on my patch, I was able to conceive and have another child but I still have the same menopausal symptoms if I’m not vigilant with the patch.

    The doctor who originally prescribed the patch/pill combo for me said I had premature ovarian failure but my progesterone levels were always very normal. If my ovaries were failing, wouldn’t all ovarian hormones be low, not just estrogen?

    Sorry for this long comment and all the questions. it’s just that after seven years, I’m still confused about all of this and wish i knew what was wrong with me.

  4. Hi Kelly. I know it must be a little difficult waiting to see if your period is going to turn up each month, don’t lose hope.
    Out of curiosity, I just wanted to ask how you know that you ovulated 2 days ago.
    As for the sore nipples, there is the tendency for them to be sore in the second half of the menstrual cycle because of increased levels of progesterone. Progesterone causes water retention which can lead to sensitivity and soreness. That said, 2 days after ovulation is too early to know if you’re pregnant. Difficult as it may be, just give it a little time. If it happens, there’s no way you won’t find out eventually.
    Take care.

  5. I actually have a question. I’m 44 and ttc. My nipples are sore and I ovulated 2 days ago. Is this a post-ovulation symptom? I really need to know so I don’t get my hopes up. Thank you for your reply.

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