Why the ‘34 Symptoms of Menopause’ List Falls Short

If you were born with a uterus, you know how much hormonal changes can affect your body and emotions during periods, pregnancy, and postpartum.

But menopause is rarely familiar.

Instead of your usual hormone-related symptoms, menopause can show up as a mix of strange, overwhelming, or even subtle changes. Your sleep shifts. Your joints ache. Your bladder feels weird. Sex feels different. And your body seems to be following a completely new set of rules.

A “34 Symptoms of Menopause” list may cover the hot flashes, mood swings, and period changes. But what about your dizziness, body odor, and digestive changes… or that sudden urge to punch your co-worker? It can feel like much more is going on than any checklist is telling you.

The reality is that there aren’t just 34 symptoms of menopause. There can be dozens, they vary from person to person, change over time, and don’t always show up all at once. So, as you read through the list of symptoms below, it’s important to remember that you’re not alone. Many of these symptoms are common but under-discussed. And while menopause can feel isolating, knowledgeable healthcare providers and evidence-based supports can help you make sense of what’s happening in your body.

What is menopause?

Menopause is the point at which your ovaries stop working, your periods stop, and you’re no longer capable of pregnancy.

Before menopause, your ovaries make most of your body’s estrogen. Estrogen is pumped out by your ovarian follicles, the fluid-filled sacs that develop throughout your menstrual cycle and form the eggs you ovulate each month.

As ovarian function slows, estrogen and other important hormones decline. These changes affect way more than your reproductive system. Estrogen has a role in your bone health, muscle and connective tissue, skin, hair, the nervous system, bladder function, sexual health, and how your body feels and moves overall.

In the United States, the average age of menopause is around 52.

Natural menopause is normal as you get older. When menopause happens before age 40, it’s considered premature menopause. This can happen for a few different reasons, like the surgical removal of your ovaries, medical treatments like chemotherapy or pelvic radiation, or certain health conditions, including some autoimmune disorders.

What are the stages of menopause?

You’ll really only know you’re officially in menopause once you have gone 12 months in a row without a period. But your experience of menopause is shaped just as much by the stages before and after that point.

Perimenopause

Perimenopause is the period of time leading up to menopause. It’s sometimes called the “menopausal transition.” During this stage, your ovarian function begins to slow and hormone levels fluctuate.

Early on, your body can often compensate by making more follicle-stimulating hormone (FSH) to help keep your cycles regular. But as your body transitions closer to menopause, those hormonal shifts are harder to balance. This is usually when menopause symptoms start to show up.

The length of this stage is different for everyone, but it usually lasts between 2 and 8 years.

Postmenopause

Postmenopause refers to the years after menopause. On average, you’ll spend about a third of your life in this stage.

Hormone levels remain low during postmenopause, although research suggests estrogen and FSH can continue to fluctuate for several years before stabilizing, often around 2 years after the final period.

Some menopause symptoms improve during postmenopause, while others stay or change. Some symptoms may not even begin until after menopause, which is why searches like “what are the 34 symptoms of postmenopausal” and “post menopausal symptoms” are so common.

Why does menopause affect your whole body?

Menopause is often described as a reproductive milestone. But its effects go far beyond your ovaries.

Estrogen receptors are nearly everywhere in your body, including in your brain, joints, muscles, pelvic floor, bladder, skin, heart, and nervous system. So when estrogen declines, you may feel the impact of menopause everywhere.

It also helps to remember that menopause happens at the same time as normal aging. And as you get older, muscle mass naturally decreases, connective tissue stiffens, and your recovery slows, even without hormonal change. Because these processes happen together, it can be tricky to know what’s related to hormone changes, what’s caused by aging, or what’s influenced by both.

This overlap helps to explain why menopause symptoms can feel confusing or widespread. For example, during menopause:

• Pelvic tissues may become thinner, drier, and less elastic
• Muscle recovery may slow
• Joint lubrication can decrease
• Connective tissue may become stiffer
• Pain sensitivity and nervous system regulation can shift

Understanding that menopause affects your whole body can help explain why symptoms can show up in unexpected ways.

34 symptoms of menopause

The experience of menopause is different for everyone. Some people only feel the changes in their periods, and others may feel like their bodies are unrecognizable. But here are just a few of the symptoms that can be related to menopause. 

Pelvic and urogenital symptoms

Estrogen supports pelvic tissue health, blood flow, and muscle coordination. As levels decline, pelvic floor and urinary symptoms are common, including:

1. Vaginal dryness
2. Pain with sex
3. Urinary urgency
4. Urinary frequency
5. Urinary incontinence
6. Recurrent urinary tract infections
7. Pelvic pressure or heaviness

Musculoskeletal symptoms

Hormonal changes affect collagen, muscle metabolism, and connective tissue resilience. Joints may feel stiff or painful even without an obvious injury. Symptoms may include:

8. Joint pain
9. Muscle stiffness
10. Hip pain
11. Low back pain
12. Frozen shoulder
13. Reduced exercise recovery
14. Tendon irritation or injury

Skin, hair, and nail symptoms

Lower estrogen levels affect hydration, circulation, and even your hair follicles. You may notice:

15. Hair changes (like thinning, dryness, and texture changes)
16. Brittle nails
17. Uneven skin tone
18. Dry or fragile skin

Gastrointestinal symptoms

Although research on menopause and the gut is still growing, it’s thought that hormonal changes may influence gut motility and the microbiome. And some research has linked menopause with increased gastrointestinal symptoms. So, this may be why you notice:

19. Abdominal bloating
20. Constipation
21. Diarrhea
22. Abdominal pain

Sexual health symptoms

Pelvic floor muscle tone and tissue health influence sexual comfort and response. Menopause-related sexual health changes may include:

23. Low libido
24. Pain with touch or arousal
25. Changes in tissue sensitivity

Emotional and cognitive symptoms

Hormones interact with brain chemicals that regulate mood, motivation, and cognition. Plus, menopause is a major life transition that many people feel unprepared for or isolated during. Common symptoms include:

26. Mood swings
27. Irritability
28. Depression or anxiety
29. Memory and concentration changes

Other symptoms

Shifts in metabolism, inflammation, and nervous system balance can affect multiple systems at once. You may experience:

30. Fatigue
31. Changes in body composition
32. Headaches
33. Sleep changes
34. Dizziness

Perimenopause symptoms list

Perimenopause is often when symptoms first appear, and they can feel especially unpredictable because your hormones are fluctuating. Almost any menopause-related symptom can occur during perimenopause, and no two experiences look exactly the same.

That said, some symptoms are more likely to show up during this stage. During perimenopause, you may notice:

• Irregular periods (including shorter or longer cycles, or heavier or irregular bleeding)
• Sleep disturbances (like difficulty falling or staying asleep)
• Anxiety or mood changes
• Joint or muscle pain
• Pelvic discomfort (including vulvar or vaginal dryness)
• Vasomotor symptoms (like hot flashes and night sweats)

When to get help?

Not all menopause symptoms appear on standard lists. You may feel strange or unusual perimenopause symptoms like itchy skin, new allergies, or body odor changes, or insomnia. Sometimes these symptoms appear before you feel hot flashes or changes in your period. And you may have symptoms you think are because of menopause, but they’re because of another health condition.

With that said, if you’re experiencing symptoms that are new, persistent, or concerning, reach out to your healthcare team. They can help determine whether another medical condition is causing your symptoms and discuss treatment options to better support your needs, menopause or not!

What signals the end of menopause?

Menopause is considered complete when you’ve gone 12 consecutive months without a period. This is determined in hindsight, meaning you will only know which period was your last once a full year has passed.

Does menopause ever end?

What most people are really asking is whether the symptoms ever end. But researchers don’t have a clear answer for this. Menopause feels different for everyone.

Research shows that some symptoms do get better as hormonal fluctuations settle down. Brain fog often gets better, cycles no longer disrupt daily life, and some people feel more emotionally stable.

But other symptoms can stick around into postmenopause. For example, hot flashes tend to last 4 to 5 years on average, but for some people they go on much longer. And pelvic tissue changes, joint stiffness, bone and muscle loss, sleep issues, and impact on your cardiovascular and nervous system can be longer-term.

The good news is that even though it can feel overwhelming when you’re in the midst of it, some women report feeling much better as time goes on. This is especially true when they gain education about what’s happening in their body, and they get the right medical and physical support. And others even report feeling excited about this new stage of life. 

What support is available for menopause symptoms?

There isn’t a standard approach to managing menopause symptoms. Support may include medical treatments, lifestyle strategies, movement-based care, pelvic floor physical therapy, and education from menopause-informed providers.

Understanding the wide range of menopause symptoms can help you recognize changes earlier and feel more confident discussing them with a pelvic physical therapist or other menopause-supporting healthcare provider.

Get support with Origin

You do not have to go through menopause alone. Origin’s pelvic health physical therapists work with people in perimenopause, menopause, and postmenopause to address a wide range of symptoms, including bladder and bowel changes, pelvic pain, sexual discomfort, and movement concerns.

In addition to treatment, Origin providers offer education, guidance, and support during a transition that can feel confusing or isolating. Working with a provider who understands how menopause affects the whole body can help you feel informed and supported as your needs change. Book with us today!

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