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How do I know I’m entering menopause? The 34 symptoms of menopause.

Menopause and perimenopause can unleash a life-altering range of changes to your body, mind, and spirit, and for some of us, the full transition can last up to 14 years. Whether you first experience perimenopause and menopause early in your 30s or later in your 60s, your symptoms will be unique to your body. While you may be familiar with some of the more common tell-tale signs (hot flashes and night sweats, anyone?), you might be surprised to learn there are a whole host of symptoms that doctors now agree can signal menopause is on its way. StellaVia’s doctor co-founders have identified 34 of the most common symptoms below. Read on to find out what you might likely expect, and how you might lessen their impact day to day.

#1 — Hot flashes

There is certainly nothing “haute” about hot flashes. You sweat through your clothes, your makeup runs, your hair goes flat: hot flashes are among the most common symptoms of menopause, and are experienced by as many as 80% of women. The cause? Dropping levels of estrogen in your body. Most women describe the feeling as a sudden surge of heat seemingly coming from inside your body, spreading up to your chest, neck, and face, causing redness, sweatiness, and chills. Studies show that women who begin experiencing hot flashes earlier in their menopausal transition have to put up with them for longer than their counterparts. Brace yourself. Hormone replacement therapy (HRT) is often successful in lessening the frequency and intensity of hot flashes, but HRT isn’t safe for every woman.

It’s okay to wear a tank top in January (layers are your friend) and carry a cooling mist made with Eucalyptol, which has been shown to balance body temperature to give yourself a quick hit of relief from the heat.

#2 — Night sweats

Have you ever woken up in the middle of the night, drenched with sweat, your sleepwear and sheets soaked through and through? You’re not alone. Night sweats are hot flashes intensified. What causes these steamy episodes? Decreasing estrogen levels, which can affect the hypothalmus, the part of your brain that regulates body temperature (as well as appetite, sleep, and sex drive). Some medicines, such as tamoxifen (often prescribed for breast cancer) can also trigger hot flashes at night.

Avoid triggers such as spicy food, caffeine, nicotine, and alcohol (within reason, of course). Sleep in light layers, and consider moisture-wicking sleepwear. Keep a quick-cooling mist and a carafe of ice water at your bedside for immediate relief.

#3 — Irregular periods

One of the first indicators you’re entering perimenopause is greater irregularity in your cycle. Not knowing when to expect your period can lead to moodiness, cramping, and spotting (especially when you’re wearing white: hello, Murphy’s Law). We all go through this phase differently, but it may start with shorter or longer cycles, a missed period one month followed by a heavy flow the next — but eventually it’ll lead up to the end of periods altogether. After a year of consistently skipping your monthly flow, you’re officially in menopause. (Until that time, you can still get pregnant, so proceed accordingly.)

What better time to take up meditation? It’s been proven to relax the body, battle stress, and help keep your symptoms in balance. HRT is also often prescribed to help regulate the symptoms, but as always, remember to check with your doctor before beginning a hormonal regimen. Supplement with StellaVia SuperBotanical™ Calm Chocolates with Passion Flower Extract, to help reduce anxiety and muscle cramps.

#4 — Mood changes

Happy one minute and upset the next? Fluctuating hormone levels may be to blame. Specifically, estrogen and progesterone levels that affect your neurohormones, which help dictate your moods.

Aerobic exercise, sleeping well, and meditation can help you feel more even-keeled. Tell your close circle of friends to expect more ups and downs — and help elevate your mood when it does dip with StellaVia SuperBotanical™ Calm SmartTarts.

#5 — Breast soreness

Feeling tender? About 100 million of us are experiencing tenderness in our breasts at this very moment. Sore breasts are a direct result of fluctuations in estrogen that affects your breast tissue. This symptom usually resolves by the time you reach menopause, but before then can cause severe discomfort (and ibuprofen just doesn’t cut it). Read more about how to keep breasts comfy and cool here.

*If you notice any abnormal changes in your breasts at any stage, see your doctor immediately.

Don’t. Skip. Mammograms. They can save your life. (It’s happened to us!) And invest in a full-support bra or wear a workout bra, even when you’re sleeping, to keep breasts in place and give you some relief.

#6 — Decreased libido

Many women feel less “in the mood” than they did in earlier years. Like irregular periods, this symptom can be caused by decreasing estrogen and testosterone, the hormones that regulate sex drive.

Experts suggest talking about your changing levels of desire with your partner to increase intimacy, consider trying new things in the bedroom, and stay in good physical shape to keep your confidence up. Use StellaVia SuperBotanical™ V Cream to help reduce inflammation and increase cellular regeneration.

#7 — Vaginal dryness

According to StellaVia co-founder Dr. Allyson Shrikhande, nearing menopause, vaginal tissues become thinner and more easily irritated, resulting from the natural decline in of estrogen in your body. This can cause sex to be uncomfortable, and can be equally as frustrating to your partner as it is to you. Keep the lines of communication open and take matters into your own hands, with our help.

Many doctors prescribe the application of estrogen cream to the area (if ok’d by your M.D.), or non-hormonal creams to help lubrication and make intercourse easier and less painful. Look for all-natural brands like StellaVia SuperBotanical™ V Cream that contain ingredients like Hyaluronic Acid to plump the area and rebuild tissue elasticity.

#8 — Headaches

If you experience migraines, they may worsen during perimenopause, says Mark W. Green, M.D., director of the Center for Headache and Pain Medicine at the Icahn School of Medicine at Mount Sinai. As is often the case, the decrease of estrogen in your body can be to blame. On a positive note, some women’s headaches become less severe during menopause.

Diet can have an effect on headaches. Keep a food diary of what you eat and how you feel afterwards; you may find some helpful patterns that can help ease the pain and severity of headaches. Avoiding alcohol, especially red wine, aged cheeses like Parmesan, caffeine, or dairy products can help — as can acupuncture and regular exercise.

#9 — Tingling extremities

Some women experience a tingling, electric feeling in their hands and feet during perimenopause and menopause. This is caused by fluctuations in estrogen, which has a complex effect on the central nervous system, producing symptoms like shocking, numbing, and electric sensations in your extremities. These can often become severe, causing you to lose your balance due to numbness in your feet or not be able to use your hands to do everyday tasks. This is one of the more serious effects of menopause.

As with many symptoms, some standard routines may help. Avoid alcohol and caffeine, get eight or more hours of sleep a night, drink plenty of water, don’t smoke, and see a doctor if tingling becomes severe. Practicing mindfulness and meditation can also help.

#10 — Burning mouth

Pain in the mouth may feel burning, tender, tingling, hot, scalding, or numb. It can affect your sleep, diet, and everyday life to the point that even talking becomes uncomfortable, and food tasteless. That’s no way to live.

Often medical professionals prescribe a low dose of centrally-acting antidepressants (as stress is thought to exacerbate the condition). Another (albeit surprising) remedy involves applying desensitizing agents like capsaicin (found in hot pepper sauce) mixed with water to reduce oral pain. Another option? Consider supplements containing alpha lipoic acid.

#11 — Changes in taste

No, we don’t mean just that you prefer elegant midi-dresses to look-at-me micro-minis these days. We’re talking about actual changes in your tastebuds, due to estrogen fluctuations. As levels fall, it can affect saliva (making less), which can reduce or change your sensation of taste. This can also affect your sense of smell.

Try taking a zinc supplement, about 15 mg a day to help if you’re experiencing a metallic taste. Stay hydrated. Stop smoking. Get regular checkups with your dentist. If all else fails, try Sea Buckthorn Oil to help in the production of more saliva.

#12 — Fatigue

It’s a vicious cycle. Your hormones are in a state of flux. This can cause severe fatigue and make you wake up in the middle of the night, only making fatigue and stress worse. Lower levels of progesterone may also lead to irritability and make you less able to relax. And as we all know, stress can be exhausting and can even make you sick.

According to Dr. Shrikhande, a regular bedtime, exercise, and meditation daily can aid in a good night’s sleep. A StellaVia supplement like our SuperBotanical™ GumDrops can provide a pick-me-up to help increase the functionality of your endocannabinoid system.

#13 — Bloating

For once, your estrogen may be too high instead of pulling its normal disappearing act. When estrogen is high (often during perimenopause when hormones are fluctuating), you tend to retain water, causing bloating. This state may affect kidney function, and contribute to a water/salt imbalance. The result? Put your skinny jeans at the bottom of the drawer (for now).

Stay hydrated! Hydration keeps the gastrointestinal tract moving smoothly. Exercise regularly; working up a sweat releases water retention and improves gastrointestinal motility, too. Eat a diet low in foods that cause gas such as beans, broccoli, and fatty foods. Avoid carbonated beverages that cause excess gas in the stomach. Reduce your salt intake. Eating too much salt can also cause water retention and swelling. And consider eating probiotics to promote digestive health.

#14 — Other digestive changes

“Decreasing estrogen affects the metabolism, often resulting in obesity, decreased metabolism and insulin resistance,” says StellaVia co-founder, Dr. Jessica Shepherd.

Eat a hormone-optimizing diet with phyto-estrogen rich foods such as tofu, tempeh, and miso. Consuming plenty of vegetables and fruits, beans, flax seed, and legumes is beneficial, as is decreasing alcohol intake as much as possible.

#15 — Joint pain

There are many estrogen receptors in our joints, so as the hormone decreases in our bodies, it causes pain and discomfort as these areas lose tissue, and bones begin to rub together. Estrogen also protects from bone loss and keeps inflammation low, all positives in the quest to avoid injuries and stay feeling as healthy as possible.

Dr. Shrikhande recommends adding “cinnamon, turmeric, ashwagandha, and primrose oil to your diet to fight inflammation. Implement magnesium as well.” The Arthritis Foundation says that magnesium “strengthens bones; maintains nerve and muscle function; regulates heart rhythm and blood sugar levels; and helps maintain joint cartilage.” Staying well-hydrated can provide joint lubrication. For more information, read our post about Menopause and aching leg muscles.

#16 — Muscle tension and aches

Because there are estrogen receptors all over the body, many women experience muscle discomfort due to declining hormone levels which causes inflammation — in addition to the general wear-and-tear of aging.

When exercising, make sure to stretch before and after your workout. And whatever you do, keep your muscles moving. Inactivity can results in weight gain, which will only put more pressure on your muscles and joints, making everything even worse. To help soothe sore muscles, carry StellaVia’s SuperBotanical™ Sore Muscle Roll-on in your gym bag.

#17 — Electric shock sensations

As estrogen subsides, the body’s neurons are affected and can begin to behave in unpredictable ways. This can result in (sometimes alarming) sensations that feel like you’ve been shocked. Some women describe the feeling as “a rubber band snapping in the layer of tissue between the skin and muscle.”

Get your B Vitamin levels checked: low levels may contribute to the unpleasant feeling. And reign in your anxiety, if possible, as it seems make the electric sensations lessen. StellaVia SuperBotanical™ Calm Tonic with Myrcene acts as a mild sedative.

#18 — Itchiness

As estrogen wanes, so does your production of collagen (the building block of youth), making skin thinner and susceptible to outside stressors like the sun and wind. At the same time, the production of natural oils that keeps your skin moisturized begin to taper off. These factors can lead to uncomfortable, itchy skin.

Apply a cool compress to the area. Take a colloidal oatmeal bath, and shower in warm (not hot) water. Use unscented soaps and lotions so as to not introduce other irritants, and apply more moisturizer as needed. Increasing your Omega 3 fatty acid intake can also help.

#19 — Sleep disturbance

Hot flashes and a racing brain can make it practically impossible for you to fall — and stay — asleep. In fact, up to 60% of women who are postmenopausal experience frequent bouts of insomnia. “Estrogen fluctuations are causing neurons that control temperature and anxiety levels to go a bit haywire. These vasomotor symptoms can be helped,” says Dr. Shepherd.

Increase your exercise regimen and practice mindfulness. Don’t eat too late in the evening, and keep your bedroom as cool as you can handle. Shut off screens (including your cell phone), and sleep in minimal or moisture-wicking clothing. Finally, consider melatonin or other natural sleep aids, like StellaVia SuperBotanical™ Sleep Tonic to promote better sleep and less grogginess.

#20 — Difficulty concentrating

Welcome to what we like to call “brain fog.” You know the drill: you forget an important appointment, you can’t find your glasses (though they’re perched on your head), names of acquaintances seem to have vanished… What do you have to thank for this? Drops in levels of progesterone, and often lack of truly restful, REM sleep. After all, if you’re not rested you’re hardly firing on all cylinders. What’s more, the hormones that are slowly but surely decreasing in your body are related to activity in the hippocampus, a brain region key in memory processing. The good news? Harvard researchers have shown that not all women go through brain fog during menopause.

Keep it moving! Exercise (both physical and mental) is key for keeping sharp. Don’t turn to HRT to help symptoms of brain fog; studies show that this protocol doesn’t improve the symptoms. Wait it out. Oftentimes brain fog lessens dramatically in postmenopausal women. And stay sharp with StellaVia SuperBotanical™ Focus SmartTarts, which have Suntheanine®, shown to improve relaxation and sharpen focus. Want to learn more? Read about how to get rid of brain fog here.

*Suntheanine® is a registered trademark of Taiyo International, Inc.

#21 — Memory lapses

This symptom is similar to “brain fog” but can also be a harbinger of other troublesome outcomes. If you or your loved one is repeating questions or comments, neglecting hygiene, forgetting how to use common objects, or getting lost in places they know well, a visit to the doctor is in order, stat.

Don’t overreact to a couple of gaffes; these are natural at any age. If forgetfulness becomes an ongoing problem, make an appointment with your doctor.

#22 — Thinning hair

As hormone levels drop, hair grows more slowly and thins out. And the drop in hormones produces the production of androgens (a group of male hormones). The result? Your hair follicles shrink, resulting in hair loss.

Reduce stress, which exacerbates hair loss. Practice breathing exercises and keep a daily journal (both are proven to lessen anxiety). Stay hydrated; pass on juices and sodas and stick to water. And as much as possible, be kind to your hair. Try to avoid heat tools, extensions, and artificial chemicals found in most hair dyes. If you’re still concerned, talk to your doctor about other medications you may be taking; some may have hair loss as a side effect.

#23 — Brittle nails

Like your hair, your nails need moisture (which affects keratin, the protein that makes up nails) to keep them healthy. As your estrogen levels decline, brittle and weak nails may be the result.

Keep nails short, so they’re less prone to breaking. Wear gloves during household chores and outdoor tasks. Use nail polish, which functions as a protective layer to help with breaking or chipping (and be sure to use a non-acetone polish remover).

#24 — Weight gain

Most of us gain weight — especially around our mid-sections — during major hormonal changes. As we age, muscle mass typically diminishes while fat increases. Excess weight can increase your risk of breast, colon, and endometrial cancers.

Move more, including both cardio and strength training. Eat less, and more thoughtfully. Skip the sweets and limit alcohol. And if you need extra motivation for follow-through, seek support from a friend or trainer.

#25 — Stress incontinence

Called “the leaky valve” syndrome, this is one of the more frustrating side effects of changing hormones, when you might leak small amounts of urine when you cough, sneeze, laugh, exercise, or jump. As estrogen levels begin to fall during perimenopause, the urethra — the short tube that passes urine out of the body — thins out. Simultaneously, the surrounding pelvic muscles may weaken with aging. The result? Less-than-pleasant, occasional leakage.

See your doctor; there are medications that can help lessen the frequency of “oops” moments. (And, as Sex and the City’s Samantha Jones frequently recommended, do your Kegel exercises to train and strengthen the pelvic floor muscles. (To avoid leakage during sex, urinate before you get going.)

#26 — Dizzy spells

Hormonal changes and blood sugar level distruptions (plus the potential of anxiety) are the main reasons behind menopausal vertigo. Do have yourself checked out if the dizzy spells come on suddenly; menopause isn’t the only possible cause. Inner-ear problems, low blood pressure, and even high levels of stress can cause you to lose your equilibrium.

To quell an attack of dizziness, try lying still in a cool, dark room. Move your head as little as possible. At night, sleep with your head slightly raised (try two pillows). When getting up, move slowly and carefully. If the problem becomes more severe, you may need a walking cane to keep you from falling, a common problem associated with menopausal dizziness. And see your doctor if dizzy spells become frequent.

#27 — Allergies

“It seems that the changes in hormones during menopause can worsen allergy problems, including runny nose and itchy eyes,” says Dr. Shepherd. High or low levels of estrogen and progesterone can activate histamines (the chemicals in your body that cause allergic reactions).

Don’t be surprised if you need to start carrying tissues or allergy pills in your bag. If allergies are exacerbated at home, consider installing a HEPA air filter in your bedroom. (And most important, remember: This too shall pass!)

#28 — Osteoporosis

Called a “silent disease” because bone loss occurs without symptoms (until you get your first fracture) women over 50 have the greatest risk of developing this condition. Changing hormones, womens’ lighter, thinner bones, and longer life-span compared to men can account for some of this condition. Being petite and thin ups your chances. Check with your family to see if osteoporosis runs in your family, as it is a hereditary condition.

Keep those bones strong and your tissues flexible. Exercise for 30 minutes every day, and make sure you’re ingesting enough calcium and Vitamin D. Quit smoking and limit alcohol to less than three drinks a day.

#29 — Irregular heartbeat

Palpitations can be scary. Are you having a heart attack? Changing hormones are usually the cause, making your heart pound and flutter. They often appear during the middle of a hot flash and can even make your vision blurry and speech slurred.

To reduce the frequency of uncomfortable heart palpitations, drink less coffee and other caffeine-leaden drinks. Stop smoking! And be aware that, although palpitations are usually harmless, a woman’s risk of coronary heart disease increases after menopause, so keep your doctor on call.

#30 — Body odor

Just when you’ve finally chosen your signature scent, your body may have other plans. Hot flashes that leave you sweaty or vaginal odor due to changes in body chemistry can cause unpleasant odors. If it’s bothersome, see a doctor. But if you’re experiencing small changes, there are at-home remedies that work.

Dress in light, moisture-wicking layers such as silk, chiffon, and athletic-wear materials. Also, drink more cold water: bring a reusable water bottle whenever you leave the house to keep your body hydrated. Carrying a cooling mist can help with sweatiness, too (StellaVia’s Hot Flash Spritz has a refreshing, bracing scent that will make you forget about any lingering smells).

#31 — Irritability

Constantly annoyed? Welcome to perimenopause! Irritability and feelings of sadness are the most common emotional symptoms of menopause. Many women report they feel they’re on an emotional roller coaster. You may also experience lack of motivation, aggressiveness, difficulty concentrating, and fatigue. Studies show that about 20% of women have symptoms of depression during perimenopause and menopause.

Support can be so helpful. Join our StellaVia Circle @stellaviacircle or a women’s group to discuss these feelings with others who are going through it. Keep exercising (as hard as it may be to make yourself put on those sneakers, it’s worth it in the long run), and if symptoms persist, see your doctor to discuss antidepressants and therapy. Self-care (and the right support system) will help you get through this time of transition.

#32 — Depression

The same hormones that control your menstrual cycle also influence serotonin, a brain chemical that promotes feelings of well-being and happiness. When serotonin levels fall, it can set off a depressive episode (especially if you’ve experienced one before in your life).

Consider asking your doctor about antidepressant medication and/or cognitive behavioral therapy (CBT). Stay healthy by avoiding too much caffeine, exercising regularly, and keeping alcohol consumption to a minimum. The good news? When you reach menopause (after perimanopause), often depressive feelings lift.

#33 — Anxiety

Hormone fluctuations can be responsible for anxious feelings. But frequent, troubling high anxiety is not normal, and can signal an underlying issue, perhaps with mental health.


Hot flashes and sleep disturbances that keep you from getting enough rest can exacerbate anxiety. Do your best to create a space that lets you rest through the night as often as possible. And to help create conditions for better sleep, try StellaVia’s Sleep Patches with soothing lavender oil to help quell anxiety.

#34 — Panic disorder

As anyone who’s experienced a panic attack knows, they can be scary. Hormonal changes and stressors in daily life like aging parents, career changes, and relationship issues can leave you feeling out of control and helpless.

It may be hard to self-diagnose a panic attack, because many of the symptoms are similar to other menopausal effects including sweating and palpitations. The good news? These attacks usually subside as menopause comes to a close. If they don’t, make an appointment with a psychiatrist to discuss talk therapy and possible treatments.

Everyone’s menopause journey is different — and each of us has unique symptoms along the way. Learning what others have experienced can help you anticipate symptoms that might come your way — and prepare an action plan for addressing them. Listening to the advice of specialists, taking good care of yourself, and investing in products that are proven to help lighten the load are all ways you can manage these changes and take control of your body’s transition. And we’ll be here to help you find the right remedies to make every day more manageable and enjoyable.

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