Signs and Symptoms of Menopause

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Mickie Griffith-Autry, PhD, NP-C

Mickie Griffith-Autry Article



The transition into menopause brings about many physiological and psychological changes in a woman's body. Menstrual irregularities, vasomotor instability, vaginal changes, urinary problems, sleep disturbances, depression and mood changes, sexual concerns, headaches, and skin and hair changes are just a few that numerous women experience. 

Menstrual irregularities are usually the first change that is noted. The menstrual cycle may become longer, shorter, heavier, or lighter. Theses changes may cause worry, anxiety, and inconvenience to many women. It is important to remain aware that birth control remains of major concern during this time.

Vasomotor instability, e.g. night sweats and hot flashes affect 80-85% of all women. These symptoms last approximately 3-5 years and can significantly affect a woman's quality of life. Without treatment 25-30% of women will continue to experience hot flashes after 5 years of the end of menses.

Vaginal dryness remains the number one complaint of menopausal women. As the amount of estrogen declines in the body, the vaginal vault tissue becomes dry and less distensible. Vaginal dryness may lead to bleeding during sexual intercourse, vaginal itching, increase in susceptibility of urinary tract infection, and vaginal bacterial infection.

Urinary problems affect an estimated 10-30% of all menopausal women. Many women suffer from involuntary loss of urine or urinary incontinence, urinary urgency, voiding frequency, and urge urinary incontinence. Urinary problems can greatly negatively impact a woman's quality of life and affect her daily activities.

Sleep disturbances or sleep deprivation is believed to be affected by the lower estradiol levels that occur with menopause. Nonrestorative sleep, hot flashes or night sweats, and sleep apnea episodes contribute to insominia. It is important that if sleep disturbances occur your health care provider determine other risk factors that you may have that are contributing.

Depression and mood changes are not uncommon. The literature reports that greater than 10% of all menopausal women suffer from irritability, tearfulness, fatigue, depression, and or anxiety. The pattern of adjustment varies from each individual woman.

Libido concerns especially the lack of sexual desire and pain with intercourse may further compound or be a resulting factor in depression and mood changes. Again the physiological factors that contribute to sexual functioning are hormone related.

Headaches are known to be problematic for the menopausal woman. Fluctuating levels of estrogen contribute the frequency and severity of headaches. It is important that the etiology of the headache be evaluated by your health care provider.

Skin and hair changes causes a major concern for many menopausal women. Skin maintenance accounts for approximately 30 billion dollars spent annually on purchasing cosmetics and other treatments that claim to combat the visual effects of aging. Hair changes other than graying are typically not that common in the menopausal population. Thinning of the scalp, hair loss, and facial hair may occur in midlife. The loss of estrogen and testosterone are implicated in hair changes in the literature.

In conclusion, menopause changes many body systems. These changes may be gradual or have a rapid onset. A thorough understanding by the menopausal woman and her health care provider are necessary so that these changes are adequately assessed and evaluated for optimal quality of life during a woman's aging years.  


Ms. Autry earned her Bachelor of Science degree in nursing from Jacksonville State University, her Masters of Science degree in nursing from the University of Alabama Huntsville, and her PhD from Walden University. Her research dissertation was entitled Pelvic muscle strengthening: Impact on sexual functioning in the menopausal woman. Ms. Autry is certified by the American Academy of Nurse Practitioners, the American Nursing Credentialing Center, and the Certification Board for Urological Nurses and Associates. She has completed multiple postgraduate preceptor programs in female sexual medicine, pelvic pain, and pelvic floor dysfunction. Ms. Autry is an active member of the Society of Urological Nurse Associates, North American Menopause Society, American Urological Society, and the International Pelvic Pain Society and founder of two women's health support groups. She is a national and local speaker for multiple pharmaceutical and medical companies, has participated in clinical trial studies, and has published articles in the Society of Urological Nurse Associate and North American Menopause Society journals.


Mickie Griffith-Autry, PhD, NP-C



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