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10 Common Menopause Symptoms & How HRT Can Help

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Dr. Michael Green
Medically Reviewed byDr. Michael GreenMD, OB/GYN Chief Medical OfficerRead Bio
Written ByNancy BelcherPhD

As you enter your early 40s, you may begin to seek information and treatment for perimenopausal and menopausal symptoms. There are effective options for natural menopause relief, and support can vary anywhere from home remedies for vaginal dryness to prescription medication for other symptoms. 1Both types of treatments can work effectively together. There are also changes you can make in our own daily life and routine to mitigate your symptoms and improve your experience. In this article, we’ll explore the menopause transition (MT), common symptoms, and various approaches to symptom management.

An Introduction to Menopause

In the late 30s and early 40s, women enter their MT at perimenopause, characterized by declining production of estrogen, progesterone, and testosterone. Eventually, with the continued drop of these hormone levels, menstruation will stop altogether, marking the start of menopause.2

After beginning perimenopause, suddenly waking up at night in a sweat, or having heavy, irregular periods can be a new normal. But every woman is unique, and so are the symptoms she’ll experience. Some women feel overwhelmed by hot flashes and exhausted by disrupted sleep, while others have no obvious symptoms. The average duration of perimenopause is 3-4 years, but it can range from lasting a few months to as many as 10 years. Once a woman has gone 12 consecutive months without a period, she is considered to be in menopause.

Perimenopause starts much earlier than many people might realize; about 10% of women go through perimenopause before they turn 40. While it may be difficult to admit that you are moving into perimenopause, embracing this phase of life will allow you to access effective treatments and find relief. 

Hormonal symptoms can include hot flashes, night sweats, anxiety, weight gain, mood swings, hair loss, wrinkles, low libido, painful sex, vaginal irritation, insomnia, joint pain, UTIs, and depression. If the decline in hormones that causes these symptoms is not addressed, women are at a greater risk of heart attack, diabetes, colon and breast cancer, stroke, bone disease, dementia, and even suicide.2

The good news is that perimenopause and menopause have been studied for over 60 years, and as we learn more about reproductive aging, we are able to provide specific, effective treatment options. One of the revolutionary solutions to come out of years of research is hormone replacement therapy (HRT). Scientists have yet to identify a more effective, natural remedy for perimenopause symptoms. 2-4Bioidentical hormones are indistinguishable from what the body produces naturally, and HRT using these hormones can naturally supplement the body’s reserves.

Common Menopause Symptoms

Declining hormones account for a whole host of various symptoms. While each person will have a different experience, the following are 10 of the most common menopause symptoms:

1. Hot Flashes (Vasomotor symptoms): Hot flashes are the most obvious sign of perimenopause, and they are caused specifically by the drop in estrogen. Hot flashes present as a sudden feeling of warmth that spreads over the body, creating flushing and sweating, especially on the face and upper body. Although HRT is the most effective treatment, other helpful tips include:

  • Avoiding triggers like hot weather, hot beverages, and spicy foods

  • Keeping a record of hot flashes to determine personal triggers

  • Dressing in layers

  • Some antidepressants (SSRIs or SNRIs) when properly prescribed

  • Yoga and slow, deep-breathing techniques

2. Night Sweats & Sleep Disorders: Severe hot flashes with sweating that occur during sleep are called night sweats. When women experience severe night sweats, it can cause sleep disruptions and lead to increased irritability, depression, and weight gain. In addition, the drop in hormones can cause disrupted sleep, tossing and turning, and insomnia. Beyond HRT, women can try cooler bedding and looser-fitting sleepwear made from breathable cotton. Some women use a “chill pillow” filled with cold water, and fans are always a good idea.

3. Weight Gain & Metabolism Changes: Hormonal changes during perimenopause influence weight gain and the redistribution of fat. A decrease in testosterone specifically can lead to less lean muscle and increased fatigue. The combination of fatigue and decreased muscle can result in a lower metabolic rate. HRT can revitalize the metabolism and help with weight management.

4. Irregular Periods & Heavy Bleeding: Fluctuating hormones can affect perimenopausal periods, resulting in inconsistency and heavy flow. HRT or low-dose birth control pills can help reduce bleeding by modulating menstrual flow, regulating periods, and stabilizing the endometrium or uterine lining. Oral contraceptives can be taken until menopause. Abnormal bleeding should be evaluated by an in-person doctor visit. 

5. Skin & Hair Changes: When hormone levels drop, this affects skin, hair, and fingernails. Collagen is what keeps skin toned, fresh-looking, and resilient, and collagen production decreases as hormones drop. As a result, skin can become thinner, drier, and less youthful-looking, and small wrinkles can deepen. HRT can help skin remain youthful.

6. Fatigue & Achy Joints: Joint pain is one of the most common symptoms of aging. It is often related to how fluctuating hormone levels affect the immune system. Estrogen helps prevent inflammation in the joints, so when estrogen levels drop with perimenopause, increased inflammation and joint pain is common. 

7. Loss of Sex Drive & Vaginal Dryness/Atrophy: Hormone imbalances affect libido and the vagina. When estrogen levels drop, vaginal tissue becomes drier, thinner, and less elastic, and the vagina can become smaller. Lack of lubrication can make sex uncomfortable, and the vagina can become itchy, easily irritated, and more prone to infections. Libido can be impacted by vaginal dryness, pain during intercourse, and/or depression. HRT and vaginal estrogen cream can help relieve vaginal dryness, improve elasticity, and maintain libido. Continued sexual activity will improve vaginal tone, and lubricants can make intercourse less painful.

8. Mood Swings, Anxiety, Irritability, & Depression: Perimenopausal mood swings are very common. The sudden decline in estrogen and progesterone levels reduces the production of serotonin and dopamine - the chemicals responsible for mood regulation. Fixing the underlying hormonal imbalances is one of the most effective ways of reducing mood swings and challenges with mental health. It is crucial to seek the advice of a healthcare professional to help mitigate mood changes before depression occurs. 

9. Difficulty with Concentration, Memory, Fogginess, & Dizziness: Many women are alarmed to discover they have trouble remembering things, experience mental blocks, or have difficulty concentrating as they age. Women can even experience a dizzying, spinning sensation that can include feelings of light-headedness or unsteadiness. These concerning symptoms are also caused by fluctuating hormone levels, and they can adversely impact daily life. 

10. Incontinence: Vaginal tissue is responsible for supporting the bladder and urethra, so as decreasing estrogen affects the vaginal tissue, this function can be compromised. Decreasing hormones also thin and weaken the urethra. Estrogen replacement can return the vaginal tissue to a more youthful state, which can go a long way to improving urinary incontinence. As women age, they may experience any of the following three types of incontinence:

  • Stress Incontinence – you pee while laughing, coughing, sneezing, or with exertion, which happens when the internal muscles fail due to age, surgery, or childbirth.

  • Urge Incontinence – you are trying to “hold it,” but your bladder doesn’t listen and empties instead. 

  • Overflow Incontinence – you are not aware your bladder is full and accidentally urinate. 

Other Menopause Treatments 

While HRT is the most effective treatment for addressing the root cause of symptoms, lifestyle changes can also make a big difference in the number and severity of symptoms and contribute toward overall feelings of wellness. These options are particularly important for women who are not candidates for hormone replacement, due to their medical history. Whether taking HRT or not, try implementing the following:

  • Exercise can improve metabolism, energy levels, and joint health, reduce hot flashes, and even help treat osteoporosis. Women who are sedentary suffer more from perimenopause symptoms than those who exercise.

  • Eat a healthy, nutritious diet, and incorporate multivitamins proactively. Nutrient needs change with age, so it is important to choose supplements that are tailored to menopause.

  • Maintaining a healthy weight can help to minimize menopausal symptoms. Women who are overweight tend to have more trouble with hot flashes, sleep, and anxiety.

  • Quit smoking; smoking leads to more hot flashes and is linked to early menopause.

  • Yoga, meditation, and relaxation can help reduce menopause symptoms. For relaxation, try deep breathing exercises in the morning and evening.

  • Acupuncture may help to limit the severity and frequency of symptoms.

Vitamins and Supplements

The best way to get necessary vitamins, minerals, and antioxidants is through a well-balanced and colorful diet, but most people’s diets have gaps. If not consistently reaching the daily nutritional requirements, women can miss out on vital elements their bodies need to help lessen or alleviate everything from hot flashes to mood swings and to protect them from cardiovascular disease and mental decline. Taking multivitamins helps to ensure that all of the necessary nutrients are provided daily.2 Winona offers safe, regulated, vitamin supplements that are specially designed to ease menopausal symptoms and support healthy aging.

Herbal Supplements: Many women try herbal supplements to manage their menopause symptoms, including the root of Black Cohosh, soy, and flaxseed. While these herbal supplements are sold widely, Winona does not suggest using them. Botanicals and herbs may have poor oversight, and they can cause unwanted side effects and affect how other medications work. If you feel the need to try natural remedies for your symptoms, consult with your physician before use.


All of the symptoms above can adversely impact a woman’s life, but effective menopause treatments, like HRT, are available to help you embrace this stage as a positive beginning. With support from Winona, you have the opportunity to take preventive action against health risks associated with ever-decreasing hormones through HRT and other natural approaches.

Hormone replacement is a safe and physiologically natural way for you to regain your vitality, and HRT can restore proper hormone levels using substances that are bioidentical to those produced by your own body. Winona’s healthcare platform is a place to safely connect with a healthcare provider to receive care and to ask the sometimes difficult and embarrassing questions.

The decision to treat and whether to prescribe a product available through Winona is up to the patient and their Winona-affiliated providers who are all licensed, board-certified, and never financially motivated to prescribe. We believe that if women can embrace their evolving bodies and provide their body with what it needs, they can move through this phase with grace and wellness.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”

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