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. Hello,
    I am 46 years old. Usually get my period every 26-28 days. Tubes were tied 10 years ago. I have tremendous pain during ovulation every month, which lasts at least 5 days. The pain is so unbearable, I’d almost rather get my period twice.
    This time around my breasts and nipples are not just sore, they ache. It hurt to go running yesterday. I had to actually hold them when I didn’t think anyone was watching. I don’t think I’ve ever experienced this pain before. It reminds me of the pain after pregnancy when you do not breast feed.
    The doctor has said before that he would put me on low dose OC. Cancer, stroke, blood clots, all run in the family. I don’t feel good about taking.
    The ovulation pain I guess is something I must deal with, But the sore nipples and breast has me worried, and concerned. Will this subside or should I go see me gyn before my yearly is due. Also, my mammo is coming up next month as well, but with the pain, should I wait that long?
    I’ve had nothing but pain twice a month since my last child was born, 12 years ago. Im sure my husband would like to trade me in for a newer model.
    Any help would be appreciated.

  2. erm i just typed in sore nipples and came up with all these things- jeezo! im 49 have had flushes for bout 6 months now, and all of a suddn my nipples are so sore and sensitive, in fact i was gonna ask my breast feeding daughter for nipple shields cos it wakes me up a t nitght!!!!!! glad to know im not a psycho and this is normal. i was sick the other day with a bug, sore nipples and for the first time my period is 3 weeks late, my daughter said do u think u could be pregnant!!!!!! doubt it my hubby had a vasectomy 25 years ago and i aint been anywhere else!!!!!! tehehehehehe

  3. having all the same pains and worries

  4. Don’t know where to turn. I haven’t had a cycle for 18 years now. One day, my breasts became very tender with or without a bra. Could I be going thru metapause? Someone help me with the pain….please.

  5. this was really helpful. i have been miserable for about 2 years now and im only 49 and i think i still am gonna be miserable for sometime. although i just bought estroven for the first time today, hope it works. so does everyone else. lol
    my boyfriend says its all in my head. i think men should have to go through this just once in their life, some men anyway. thanmk u

  6. I meant to say less frequent cycles

  7. I am a 49 year old woman and have very frequent cycles, perhaps every 4 months and are scarce. Last year i had exhibited major hot flashes and have become less frequent. Last cycle was 4 months ago and not showing any signs of discomfort…what is wrong with me???

  8. I came across your blog and really enjoyed the content about menopause that you post. You understand the power of physicians using social media to provide reliable medical knowledge and I highly recommend as a complement to your blog.

  9. Hi im 40 yearold and i have some kids ,i tied my tube with my last kid and now is it too late get them untied again to have another baby it been 16 years tied plzz helo

  10. hi I am 45 yrs old and i am itching all over and my joints hurts and my left nipple is so sensitive and itchy…do you think it can be signs of menopause

  11. I am 52 yrs. old and have been perimenopausal for the last 4 years. Lately my period has been often and very heavy; to the point where I cannot function. I have also noticed hair loss to the point where I am very uncomfortable going out in public and even get sunburned scalp. My Dr. suggests an IUD to help with the periods but I wonder if this could also help with the hair loss. Could my hair loss be due to lack of progesterone and could the IUD help? Can hair loss be reversed?

  12. I’m 50 years old. Lately I feel my arm and legs can easily feel numb especially when I woke up in the morning. My period has been very regular but now my last period was 98 days ago. My nipple also feel sore, I think should be ovulation time cause there’s a lot of discharge during this period. Could all these symptoms due to menopause?

    • It’s very possible. You’re at about the right age. You can’t officially say you’re in menopause until you’ve been without a period for a year though so I guess you’ll have to wait a while.

  13. I thank you for this article and agree that yes Brian is a good man. My hubby needs to learn this. I now know that perhaps I am also going through a lot of these symptoms. This has opened me up to getting more information and understanding my body.

  14. hello plss can u help me, i am mensurual circle is irregular for a very long time. this month my period came but it dint flw as it usualy does.after the third day it stoped but den my bbreast started hurting and became heavy,i ve don the urinary pregnancy test and it is breast and nipples still hurt can u profer any solution for me plsss.

  15. plsss i need an answer to my probs,
    i am 27 and my mensural flow is irregular this month i saw my periiod for three days but the flow was not as much as it used to be.aftter my period stoped my breast became very painful and somworth heavy,plsss can u possibly tell me wat dat means. i ve don the urinary pregnancy test and it is negative,and d pain has continued for some time now.awaiting ur responce thank u

  16. Brian is a very good man!

  17. i just wanted to say that Brian you are a good man. wish there were more like you. i also wanted to say that i love this website. thank you for the information. it was very helpful

  18. Hello,
    I am 34 and am experiecing most of the symptoms listed above… Hat led me to this web site was a query about sore nipples and breasts. Once I read the info onsymptoms on menopause so many things started to make sense. Am I too you for this to be a possibility. I have a 15 year old and quit the pill about two years ago. I am not pregnant and like I said I have most of the symptoms listed above. Could it be this or something else? Help please…

  19. Hello, I need information/help, with sore, itchy nipples.I’ll be 47, 2 yrs ago I had a partal hystorectomy, I have only 1 overy left. My nipples have felt hard and very sore even with no bra, my breast also feel heavy and sore when I take my bra off, and yes I have extreme vaginal dryness during intercourse, no sex drive what so ever. I was not put on any kind of HTR and my GYN hasn’t suggested any even with my symtoms. Should I be on something? and what would you recommend over the counter for me. Also KY jelly isn’t all that good for lubercation, could you recommend something better for that? I seldom have hot flashes but if I do they are usually first thing when I get out of bed, this does make it hard to get ready for work as I’m irate. My consentration has gotten so bad that I often forget my childrens birthdays and pin numbers and such, how long does this change thing take????

  20. hy i have times when i feil like i have bean in boxing ring &havent bean a sleep all night my simptons adifernt each mounth i dont have pleeding

  21. Hello, I need some advise. I’m 39 and I have no interest in sex. I have a boyfriend of 5 years and I have no interest for sex in the last 2 years. I actually have to be drunk to even think about sex. My hair is really thinning and falling out. I have my periods every month and I am not on the pill. Is there something I can take to help me?

  22. I’m 41, and I’ve noticed that I feel sore all over my body when my period is starting–it’s like a bruised feeling. I don’t know if that has to do with anemia because I’ve been anemic before. And by the way, you’re a good man, Brian…:)

  23. I am 40 years old. I had a hysterectomy when I was 30.
    My nipples have for a few years gone hard for no reason. For the last few days I have a sore right nipple and it won’t go down. Last time I had sex it was sore, which was unusual. I have notice a memory problem. Is it menopause?

  24. I am late 47 and I have a partial hysterectomy several years ago. Within the last 48 hours my right nipple has been extremely sore. I don’t even have to wear a bra. just be with a t-shirt on and my nipple is extremely painful and sore. I had my annual breast exam and 4 months ago and everything was fine. I ‘m wondering if it could be a premenopause symptom. I have been having hot flashes at night and sometimes during the day. It’s only the right nipple.

  25. i’d like to know if there’s a correlation post-menopause between fluttering heartbeats/pounding and sore nipples? I asked by GYN a month or so ago to do a hormone balance blood check, but she told me it was pointless since I am on the combi-patch (HRT). That doesn’t sound logical to me – what if, even tho’ I’m on the patch, my hormones are imbalanced? Maybe I’m lacking Testosterone or something the patch doesn’t provide.
    Would appreciate your answer. (P.S. I’m extremely healthy w/no problems otherwise).

  26. Fantastic website, thank you so much, I am 51 and have been going through these symptoms for a couple of years so much that I have divorced after 30 years of marriage because he just did not understand that I needed time to go through my change and nobody seemed to understand or diagnose my symptoms. I have experienced loss of weight, itchy skin mostly in the winter, mood, depression, hair loss, pins and needles, achy all over and pretty much everything you described above. My new problem which lead me to your website is sore breasts for about a month, I used to get them every month but they would go away they have enlarged a cup size and are sore all the time. Thank you for your website I am glad I found it.

  27. Im 41 and been diagnosed by blood test to be on tyhe change (menapausal) i have also irregular periods, sore tender breasts, and skin is so dry. I thoughts i was to younge but can happen any any age, not forgetting moods swings

  28. i am 44 and 9 days late for my period i have no signs of the menopause the only thing i am experiencing is sore breasts and nipples i done a pregnacy test which was neg i have never been late before and was wondering what was going on if the test was neg and im late im now confused

  29. I am 51 years old. I still menstruate every 28 days, although my periods are very heavy the first three days. The problem I am writing about is that about a week or so before my period is due, I experience vaginal soreness/pain during intercourse. This does not happen every month, but I am noticing that it happens most months at this point. I do not experience vaginal dryness – so that can’t be the problem. I am assuming that it has something to do with hormone levels, but I am not sure. I usually refrain from intercourse during that time, and after my period is over, everything is fine again, so I am not asking for what to do to stop the pain – I am just curious to know what is going on, since I have never had this before!

  30. I am a 52 year old female. About a week ago my ovaries hurt really bad on the right side and my nipples have been hurting about 2 weeks now. They are so tender to the touch I cant even touch them. What is going on?

  31. Hi Sharon,
    I am 54 years old and have had very few menopausal symptoms but the pins and needles all over my body but mainly in my lower arms are driving me nuts. does anyone have any solutions or should I visit my doctor?

  32. Sharon Griffiths

    Hi ,
    my name is Sharon I am 50 years old ,I am experiencing pins and needles mainly in my hands and wrist areas but also at times in my feet and even back I am very frustrated with this as drs have not as yet been able to pin point a aprobable cause which makes me worry that it may be of a more serious nature even though blood tests have failed to show anything I was wondering if anyone out there is having any similar experiences I would be grateful for some feedback thanks , Kind Regards Sharon.

  33. Great post and a great blog.
    My wife is soon to be 48 years young. She is beautiful, but she suffers from such a bad self image, and I do believe she is in her menopausal years, and I just need some information on what I can do to be more helpful during these times for her. What can I expect and how can make these times for her a little bit easier.

    Thank you so much.

    Brian Gosur

  34. Hello to all 🙂 I can’t understand how to add your site in my rss reader. Help me, please

  35. Very informative, good article .thank you

  36. I’ve also noticed that my skin has been affected as I reach a menopause age. Is it natural to have scaly skin as a result of menopause?

  37. What is referred to here as “Yoga of Awareness” is traditionally known as Kundalini yoga. I would agree – this isn’t the typical yoga course, and an experienced Kundalini instructor would be in order.

  38. hello there, i am 41, and have been in menopause since i was 37, i was allite disappointed at first, but , i was blessed to be able to concieve two kids, i do however sometimes feel like iam ovulating sometime, and can you still get discharges related ot you cycle, i do get a llittle linning build up so the gyno put me on drug to take only twice a year to shed it , to keep me from getting uterin cancer, oh yes , i did have one of my ovary removed at a 10, because of a tumor, would this have any bearing on my early meno, oh guess what girls , there is one good thing about menopause, no more very painful periods, and no more stinking, awful blood, but i want more kids though, can i still do it thanks heather

  39. 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 🙂

  40. 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.

  41. 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.

  42. 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.

  43. 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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