Signs and symptoms of menopause are different from woman to woman, as is her response to each. You may breeze through menopause with few symptoms or changes to your health. Or you may endure a number of physical and emotional changes, including the following:

  • Hot flashes As your balance of hormones changes, your blood vessels may expand (dilate) rapidly, causing your skin temperature to rise and a feeling of warmth to move upward from your chest to your shoulders, neck and head. You may sweat, and as the sweat evaporates from your skin, you may feel chilled, weak and lightheaded. Your face might look flushed, and red blotches may appear on your chest, neck and arms. Hot flashes can last from 30 seconds to as long as 30 minutes. Most subside in 2 to 3 minutes. The frequency of hot flashes varies from woman to woman. You may have them many times a day and night or have them only occasionally. They may be a part of your life for a year or more, or you may never have them at all.
  • Irregular menstruation.Your cycle may stop suddenly or more likely will change gradually, becoming more or less frequent with lighter or heavier flow before eventually stopping.
  • Sleep disturbances and night sweats. Disturbed sleep often is a consequence of hot flashes at night. You may be awakened from a sound sleep with night sweats followed by chills and have difficulty achieving a restful sleep. Lack of sleep can affect your mood and overall health.
  • Vaginal and bladder changes. As your estrogen level declines, the tissues lining your vagina and urethra — the opening to your bladder — become drier, thinner and less elastic. With decreased lubrication, you may experience dryness, burning or itching, discomfort during intercourse and more frequent bladder infections and vaginal yeast infections.
  • Urinary incontinence.You may leak urine (urinary incontinence) as the tissues of your vagina and urethra lose their elasticity. This can happen either along with a greater urgency to get to the bathroom in time or along with coughing, laughing or lifting.
  • Emotional changes You may experience mood swings, be more irritable or be more prone to emotional upset as you go through menopause. In the past, these symptoms were attributed to hormonal fluctuations. There may be a connection between changes in hormone levels and your mood. But other factors that can contribute to changes in mood include stress, insomnia and life events that can occur in this stage of adulthood — such as the illness or death of a parent, grown children leaving home or retirement.
  • Loss of libido.Sexual desire and arousal sometimes decline during perimenopause. The cause may be hormonal, but it also can result from mood changes and irritability. For most women, sexual desire is unchanged after menopause.
  • Changes in appearance After menopause, fat that once was concentrated in your hips and thighs tends to settle above your waist and in your abdomen. You may notice a loss of fullness in your breasts, thinning hair and wrinkles in your skin. Your estrogen levels drop, but your body continues to produce small amounts of the male hormone testosterone. As a result, coarse hair may grow on your chin, upper lip, chest and abdomen.
  • Heart disease. Estrogen plays a role in heart health, helping lower your total cholesterol and LDL ("bad") cholesterol and raise levels of HDL ("good") cholesterol. When your estrogen levels decrease during menopause, it may raise your total cholesterol, increasing your risk of heart disease, stroke and other diseases that affect your heart and blood vessels. Heart disease is the leading cause of death in women as well as in men. Women are 10 times more likely to die of heart disease than of breast cancer. If you smoke, have high blood pressure or diabetes, or don't get regular aerobic exercise and don't consume a heart-healthy diet, you're at increased risk of heart disease.
  • Osteoporosis. During the first few years after menopause, your bone density tends to decline at a rapid rate. This decline increases your risk of developing osteopenia, a loss of bone mass that may progress to a more severe state — osteoporosis. Other common risk factors include a family history of osteoporosis, smoking or going through menopause at a younger-than-average age. Osteoporosis causes bones to become brittle and weak, leading to an increased risk of fractures. You are increasingly susceptible to fractures of the hip, wrist and spine after menopause. On average, one in two women over age 50 fracture a bone as a result of osteoporosis during their lifetime.

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