Symptoms vary, but among the physical changes experienced in perimenopause and beyond are:1,2,3

·       periods occurring as frequently as 2-3 weeks or with several months between;

·       the volume of bleeding each cycle may double by late MT;

·       hot flushes and night sweats are often accompanied by palpitations and/or anxiety;

·       breast tenderness may decline as the perimenopause progresses into late MT, but may linger for three years post-menopause;

·       joint and muscle pain;

·       loss of muscle mass;

·       increased risk of osteoporosis post-menopause;

·       vaginal dryness and discomfort, with associated difficult/painful sexual intercourse (dyspareunia) and recurrent lower urinary tract infections;

·       loss of libido, both from vaginal dryness and declining hormone levels as the ovarian follicles decline.

Depression, low mood and anxiety are associated with the hormonal changes. Headache and difficulty sleeping may also add to low mood, while for nearly half of women who experience migraine, their migraine can worsen. Unfortunately, cyclical migraine can be harder to anticipate during MT as periods become more irregular.1,6

After menopause, vaginal symptoms likelihood increases. Vaginal dryness tends to increase with time, although some women may not experience urogenital atrophy until a decade after their final period.1