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Perimenopause

Your Ultimate Guide to Menopause Symptoms

Zoe Kaplan
Zoe Kaplan

Nearly nine in ten people who go through menopause experience symptoms (and often many of them at one time). Learn how to find relief.

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Nearly nine in ten people who go through menopause experience symptoms (and often many of them at one time). Learn how to find relief.

Perimenopause
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Nearly nine in ten people who go through menopause experience symptoms (and often many of them at one time). Learn how to find relief.

In most simple terms, menopause is the time when you’ve gone 12 consecutive months without a period. Yet the word “menopause” can mean much more than that: it’s a time that marks a biological transition; a natural sign of getting older; the end of reproductive years.

Essentially, menopause is much more than the end of your periods. A lot is going on in your body during this time—especially with your hormones. Estrogen and progesterone levels decline, and their dip can cause a wide range of physical, emotional, and mental changes known as menopause symptoms.

If you’re experiencing menopause symptoms—especially more than one—you’re not alone. But what exactly should you look out for? How do you know for sure that you’re in menopause (vs. perimenopause)? And is there any way to get relief? Here’s your ultimate guide to menopause symptoms.

What is menopause?

Quite literally, menopause is the 12 consecutive months after your last period. 

In the years leading up to menopause, your ovaries start producing less estrogen and progesterone. These hormones play a key role in regulating your menstrual cycle—which means when they start to decline, you’ll start to see irregular periods and irregular cycles. This transitional period, which can last anywhere from many months to many years, is called perimenopause.

>>MORE: Perimenopause vs. Menopause: What's the Difference?

Over time, your periods will likely become less and less frequent, until eventually you won’t get them anymore. The 12 months after your last period is menopause.

All of the time after those 12 months is called post-menopause. At this point, your menstrual cycles have completely stopped. Your ovaries aren’t releasing eggs anymore, and therefore it’s not possible to become pregnant naturally. Because your estrogen and progesterone levels are now much lower, you may still experience menopause symptoms for a few years post-menopause, but they generally tend to get better over time.

What are menopause symptoms?

Menopause symptoms are a range of physical, mental, and emotional symptoms that occur during this transitional period, most often due to declining levels of estrogen and progesterone. If you experience any of these symptoms, you’re not alone—almost all (85%) of people who go through menopause report menopause symptoms. 

While every person’s experience is unique, there's a common chorus of symptoms that can appear during menopause. You might experience multiple symptoms at once, too. According to one study, participants experienced an average of 10.7 menopause symptoms. 

Here are some of the most frequent ones:

  • Hot flashes: These are the signature signs of menopause, affecting up to 80% of women. They come on suddenly and intensely, causing a wave of heat to flood your upper body, often accompanied by sweating, flushing, and a rapid heartbeat. They can strike at any time, day or night, lasting anywhere from seconds to minutes.
  • Night sweats: These are hot flashes that disrupt your sleep, which can leave you drenched in sweat and in need of a change of pajamas.
  • Vaginal dryness: Vaginal walls can become dry, thin, and even inflamed, making intercourse uncomfortable or even painful.
  • Mood swings: Fluctuations in estrogen can trigger emotional swings, anxiety, irritability, and even symptoms resembling mild depression—up to one-third of people going through menopause report a depressed mood.
  • Sleep disruption: Hot flashes, night sweats, and emotional changes can all contribute to difficulty sleeping.
  • Brain fog: Changes in memory and concentration, like difficulty focusing, forgettingfulness, and trouble recalling words can come from sleep disruption. 
  • Joint and muscle pain: Stiffness, aches, and pains in your joints and muscles are a common complaint during menopause.
  • Changes in weight: Menopause can lead to weight gain, especially around the abdomen, due to changes in metabolism and body composition.
  • Changes in libido: Decreased estrogen levels and vaginal dryness can cause a decline in sex drive.
  • Headaches: More frequent or intense headaches can occur during menopause.
  • Hair loss or thinning: You might notice some hair loss or thinning on your scalp, although hair growth can increase on your face and body.
  • Changes in skin: Your skin may become drier, thinner, and lose its elasticity.
  • Urinary tract issues: You may experience increased urinary urgency or frequency, or even mild incontinence.
  • Heart palpitations: Some women experience a fluttering or racing heart sensation during hot flashes.

How do you know you're in menopause?

If you're experiencing some of these menopause symptoms, you might be in perimenopause or entering menopause. Many perimenopause symptoms are the same as menopause symptoms, which can make it confusing to figure out what stage you’re in—but there’s a key difference. 

In perimenopause, you can still get pregnant. In menopause, you’re no longer ovulating, so you no longer can get pregnant. 

So, how can you tell if you’re in menopause? You’ll need to focus on what’s going on inside your body:

  • Track your cycle: Keeping a menstrual calendar can help you identify changes in your period patterns, such as irregular bleeding, skipped periods, or heavier or lighter flow.
  • Hormone testing: Testing your hormone levels over time can help you understand trends in your hormone decline—specifically estrogen and progesterone—and confirm whether you’re still ovulating or not.

The Oova perimenopause kit allows you to track key perimenopause and menopause hormones (estrogen, progesterone, and luteinizing hormone) from the comfort of your own home. You’ll get insights into how your body is changing over time and get confirmation on whether you’re still ovulating—and therefore, whether you’re still in perimenopause.

Menopause risks

Menopause itself isn’t a disease, and it’s a very natural part of getting older. However, the hormonal changes during this transition can do more than cause menopause symptoms. There are some health conditions to be aware of:

  • Osteoporosis: Decreased estrogen levels weaken bones, making them more susceptible to fractures.
  • Heart disease: Estrogen often offers a protective effect against heart disease in women. When estrogen levels decline because of perimenopause and menopause, the risk of cardiovascular disease increases. 
  • Breast cancer: Menopause doesn’t directly cause any cancer, yet there is an increased risk of breast cancer with age. This is because longer exposure to estrogen increases risk of cancer; women who experience menopause after the age of 55 are at higher risk of ovarian, breast, and uterine cancers.

Menopause symptoms: hormonal and non-hormonal treatment

Menopause symptoms can range from frustrating to debilitating—and no matter what you’re facing, there are options for treatment that can improve your quality of life.

Hormonal treatment

Because many menopause symptoms are caused by declining levels of estrogen and progesterone, hormone replacement therapy can help improve symptoms. This therapy replaces the declining levels of estrogen and progesterone. It comes in various forms, including pills, patches, and creams.

Hormone replacement therapy is often most successful in alleviating hot flashes, night sweats, and vaginal dryness. 

However, hormone replacement therapy comes with its own risks, ranging from blood clots to strokes. It’s important to discuss your individual health profile with a professional to review your risk factors and understand if hormone replacement therapy is the right option for you.

Non-hormonal treatment

If hormonal therapy isn’t an option, or you’d like to try a natural approach, there are various lifestyle changes and adjustments you can make to management symptoms.

  • Diet: Limiting foods that can exacerbate hot flashes like caffeine, alcohol, and spicy foods, can help make these symptoms less severe. Plant-based diets that minimize oil and specifically increase soybean intake have also been proven to reduce the frequency and severity of symptoms. 
  • Exercise: Studies show that physical activity can decrease the severity of menopause symptoms. Regular aerobic exercise, like running and swimming, and low-intensity exercise like yoga can help with hot flashes and night sweats. 
  • Stress management: Stress can exacerbate menopause symptoms. Practices like yoga, meditation, and deep breathing can help you manage stress, find inner calm, and reduce the severity of symptoms.
  • Sleep hygiene: Establishing a regular sleep schedule, creating a relaxing bedtime routine, and maintaining a cool bedroom temperature can all contribute to better sleep during menopause.
  • Supplements: Certain supplements like black cohosh, red clover, and vitamin D may offer some relief from hot flashes and other symptoms. However, it's important to talk to your doctor before starting any supplements, as they can interact with medications you're already taking. (Learn what perimenopause vitamins help relieve specific symptoms.)

Menopause symptoms: the bottom line

Menopause, or the 12 months since your last period, is a time of a lot of changes in your body—especially hormonal changes that can wreak havoc on your body. Dealing with menopause symptoms can be frustrating, confusing, challenging, and even emotional.

Yet while menopause is a significant transition in a person’s life, it doesn’t have to define your everyday life. With knowledge, open communication with health professionals, and care for your health, you can navigate this stage—and your menopause symptoms—with confidence and empowerment.

About the author

Zoe Kaplan
Zoe Kaplan is a writer and content strategist passionate about creating content that helps people navigate the world a little more easily. Zoe has worked across verticals, from women's career development to reproductive health. You can check out more of her work at zoeakaplan.com.

Sources

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https://www.oova.life/blog/progesterone-supplementation-guide
Can I take progesterone if I'm breastfeeding?
Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.
https://www.oova.life/blog/progesterone-supplementation-guide
Is it safe to take progesterone throughout pregnancy?
Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.
https://www.oova.life/blog/progesterone-supplementation-guide
Can progesterone supplementation cause weight gain?
Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.
https://www.oova.life/blog/progesterone-supplementation-guide
Can I switch from pills to suppositories or vice versa?
Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.
https://www.oova.life/blog/progesterone-supplementation-guide
Will progesterone supplementation delay my period?
Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.
https://www.oova.life/blog/progesterone-supplementation-guide
Should I take progesterone pills orally or vaginally?
For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.
https://www.oova.life/blog/progesterone-supplementation-guide
When should I start taking progesterone after ovulation?
Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.
https://www.oova.life/blog/progesterone-supplementation-guide
What's better: progesterone cream or pills?
Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
How can I tell if I have low or high progesterone?
The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
When during my cycle should I test progesterone levels?
Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
What are the main differences between low and high progesterone symptoms?
Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
Can you have symptoms of both low and high progesterone?
Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.
https://www.oova.life/blog/10-dpo
Can stress affect 10 DPO symptoms?
Yes, stress can worsen or mimic 10 DPO symptoms. Stress increases cortisol, which can cause cramping, fatigue, and mood changes similar to both PMS and early pregnancy. During the two-week wait, try stress-reduction techniques like gentle exercise, meditation, or spending time with loved ones.
https://www.oova.life/blog/10-dpo
Is it better to test at 10 DPO or wait?
It's better to wait until 12–14 DPO for more accurate results. Testing at 10 DPO often leads to false negatives because hCG levels may still be too low. If you absolutely can't wait, use a sensitive early detection test with first morning urine, and be prepared to retest in 2–3 days if negative.
https://www.oova.life/blog/10-dpo
What does implantation bleeding look like at 10 DPO?
Implantation bleeding at 10 DPO is typically light pink or brown, much lighter than a period, and lasts 1–2 days. It's often just spotting when you wipe or a few drops on a panty liner. However, only 15–20% of pregnant women experience implantation bleeding—most don't have any bleeding at all.
https://www.oova.life/blog/10-dpo
Why am I cramping at 10 DPO?
Cramping at 10 DPO can be caused by elevated progesterone (whether you're pregnant or not), implantation (if you're pregnant), or premenstrual cramping. Unfortunately, cramping alone can't tell you if you're pregnant since progesterone causes similar symptoms in both scenarios.
https://www.oova.life/blog/10-dpo
What are the chances of a BFP at 10 DPO?
If you're pregnant, you have about a 50–60% chance of getting a positive test at 10 DPO. This means there's a 40–50% chance of a false negative even if you conceived. Chances improve significantly by 12–14 DPO.
https://www.oova.life/blog/10-dpo
What DPO is most accurate for pregnancy testing?
14 DPO (the day of your missed period) is the most accurate time to test, with 99% accuracy. 12 DPO offers 80–90% accuracy. 10 DPO has only 50–60% accuracy. For best results, wait as long as you can—ideally until 12–14 DPO.
https://www.oova.life/blog/10-dpo
Is 10 DPO too early to test?
10 DPO is considered early for pregnancy testing. While some women get positives at 10 DPO, accuracy is only 50–60% if you're pregnant. For best results, wait until 12 DPO (80–90% accuracy) or 14 DPO/missed period (99% accuracy).
https://www.oova.life/blog/10-dpo
Can you have implantation at 10 DPO?
Yes, implantation can still occur at 10 DPO, though 84% of women have already implanted by this point. Late implantation at 10–12 DPO is normal. If implantation happens at 10 DPO, you won't get a positive pregnancy test for another 2–3 days.
https://www.oova.life/blog/10-dpo
What does a negative test at 10 DPO mean?
A negative test at 10 DPO does not mean you're not pregnant. It's very common to get negatives at 10 DPO even if you conceived. Your hCG levels may still be too low, or implantation may have occurred later. Wait until 12–14 DPO to retest for more accurate results.
https://www.oova.life/blog/10-dpo
Can you get a positive pregnancy test at 10 DPO?
Yes, but only about 50–60% of pregnant women will get a positive at 10 DPO. The other 40–50% have hCG levels that are still too low to detect. If you test negative at 10 DPO, wait 2–3 days and test again.
https://www.oova.life/blog/high-progesterone-symptoms
Can high progesterone cause weight gain?
Yes, elevated progesterone can cause temporary weight gain through water retention and bloating. This is a normal part of the luteal phase and early pregnancy.
https://www.oova.life/blog/how-to-increase-estrogen
Does stress affect estrogen levels?
Yes, chronic stress elevates cortisol, which can suppress estrogen production and disrupt hormonal balance. Stress reduction through meditation, yoga, adequate sleep, and self-care practices helps maintain optimal estrogen levels.
https://www.oova.life/blog/how-to-increase-estrogen
When should I consider medical treatment for low estrogen?
Consider medical intervention if natural methods don't improve symptoms after 3 months, if symptoms severely impact quality of life, if you're experiencing early menopause (before 40), or if you have fertility concerns. Hormone replacement therapy may be appropriate in these cases.
https://www.oova.life/blog/how-to-increase-estrogen
What are the signs that my estrogen is increasing?
Signs of rising estrogen include more regular menstrual cycles, reduced hot flashes, improved vaginal lubrication, better mood stability, increased energy, and improved skin elasticity. You may also notice reduced symptoms that originally indicated low estrogen.
https://www.oova.life/blog/how-to-increase-estrogen
Can exercise increase estrogen levels?
Yes, moderate exercise stimulates estrogen release and helps maintain hormonal balance. Aim for 150 minutes of moderate cardio weekly plus strength training twice per week. However, excessive exercise can actually lower estrogen, so balance is key.
https://www.oova.life/blog/how-to-increase-estrogen
How long does it take to increase estrogen naturally?
With consistent dietary and lifestyle changes, you may notice improvements in symptoms within 4-8 weeks. However, significant hormonal changes typically take 2-3 months. Tracking your cycle and symptoms can help you monitor progress.
https://www.oova.life/blog/how-to-increase-estrogen
What foods increase estrogen levels naturally?
Foods high in phytoestrogens can help increase estrogen naturally. The best options include flax seeds (high in lignans), soy products (tofu, tempeh, edamame), lentils, chickpeas, whole grains (oats, quinoa, brown rice), and garlic. These plant compounds mimic estrogen's effects in the body.
https://www.oova.life/blog/perimenopause
What helps relieve hot flashes quickly?
Cool environments, layered clothing, herbal teas, and medical treatments like gabapentin or HRT may help—depending on severity. Lifestyle changes like reducing caffeine and alcohol can also provide relief.
https://www.oova.life/blog/perimenopause
Are there tests to confirm perimenopause?
Yes. Tests measuring estradiol, LH, and FSH levels can indicate hormonal shifts—but diagnosis is often symptom-based since hormone levels fluctuate widely during perimenopause.
https://www.oova.life/blog/perimenopause
How do I know it's perimenopause and not something else?
A doctor may recommend hormone testing (like LH, E3G, and PdG) and track symptom timing. Diagnosis is often based on symptoms combined with age and menstrual pattern changes.
https://www.oova.life/blog/perimenopause
What's the earliest age perimenopause can start?
Some women begin experiencing symptoms as early as their mid-30s, though perimenopause typically starts between ages 38-45.
https://www.oova.life/blog/perimenopause
Does perimenopause affect mental clarity?
Yes. Brain fog and difficulty concentrating are common during hormone fluctuations in perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What happens after the last sign of perimenopause?
After your final period, you enter postmenopause. You'll need 12 consecutive months without a period to confirm menopause. Many symptoms gradually improve, though some like vaginal dryness may persist without treatment.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
When do perimenopause symptoms finally stop?
Some symptoms like brain fog improve after menopause, while others like hot flashes may continue for up to 10 years post-menopause. Vaginal symptoms often persist or worsen without treatment. Each person's timeline is different.
https://www.oova.life/blog/high-progesterone-symptoms
Is high progesterone a sign of pregnancy?
Yes, high progesterone is one of the earliest indicators of pregnancy. Progesterone levels rise significantly after conception to support the developing embryo and reach their peak during the third trimester.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Can you still get pregnant in late perimenopause?
Yes, you can still get pregnant during perimenopause as long as you're having periods, even if they're infrequent. Continue using birth control until you've gone 12 consecutive months without a period and have officially reached menopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Do symptoms get worse before perimenopause ends?
Yes, most perimenopause symptoms intensify in the final 1-2 years before menopause. Hot flashes peak around your final period, vaginal symptoms worsen, and mood changes increase. However, brain fog typically improves in late perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
How long does late perimenopause last?
Late perimenopause typically lasts 1-3 years before your final period. However, the exact duration varies significantly from person to person. You've reached menopause after 12 consecutive months without a period.
https://www.oova.life/blog/high-progesterone-symptoms
What are the symptoms of high progesterone?
High progesterone symptoms include fatigue, bloating, breast tenderness, weight gain, anxiety, depression, headaches, and food cravings. During pregnancy, you may also experience increased nipple sensitivity and muscle aches.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What are the first signs that perimenopause is ending?
The earliest signs include longer gaps between periods (60+ days), intensifying hot flashes that peak around your final period, and worsening vaginal dryness. These symptoms typically increase in late perimenopause before you reach official menopause.
https://www.oova.life/blog/high-progesterone-symptoms
When should I be concerned about high progesterone?
Consult a healthcare provider if you experience high progesterone symptoms outside your luteal phase when not pregnant, or if symptoms include severe pelvic pain, abnormal vaginal bleeding, or rapid weight gain while on hormone therapy.
https://www.oova.life/blog/high-progesterone-symptoms
How do you test progesterone levels?
Progesterone can be measured through blood tests at your doctor's office or at-home urine tests that measure PdG (a progesterone metabolite). Testing is typically done during the luteal phase, about 7 days after ovulation.

About the Oova Blog:
‍Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.

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