Beyond Hot Flashes: The Lesser-Known Symptoms of Menopause

Most women associate menopause with hot flashes, and while they’re one of the most common symptoms,¹ menopause can affect the body in other less talked about ways.

Declining levels of estrogen are behind many of these changes, but symptoms like joint pain, bladder changes or dry eyes can be unexpected and confusing.^2,3

In this article, we look at both the common and lesser-known menopause symptoms, why they happen, and what you can do to manage them.

Common Symptoms of Menopause

During this life stage, many women experience symptoms like:

• Irregular periods¹
• Hot flashes and night sweats¹
• Vaginal dryness¹
• Low libido²
• Mood changes like irritability²
• Sleep disturbance¹
• Weight gain⁴

But every woman’s experience is unique, meaning that menopause symptoms aren’t limited to this list.¹

Lesser-Known Side Effects of Menopause

Estrogen is a hormone your ovaries make to keep many parts of your body healthy, including your bones, skin, bladder, and heart.^3,5

Because it plays a role in so many areas, changes in your estrogen levels could lead to a wider range of menopausal side effects than you might expect.³

Joint Pain and Body Aches

Joint pain can happen because of fluctuating estrogen levels, reducing your body's natural anti-inflammatory response.^6,7

This in turn could lead to menopausal arthralgia, a condition that affects your hands, knees, hips, or lower back, causing pain, swelling, and stiffness.^6,7

This condition can sometimes be confused with aging or arthritis,⁸ but with the right approach, it can be managed.

• Try weight training to help support joint strength.⁷
• Eat an anti-inflammatory diet including omega-3-rich foods, berries, and whole grains like brown rice.⁷
• Hormone therapy may be an option to explore.⁷

If you experience persistent pain or symptoms that affect your daily life, such as reduced mobility, let your doctor know.⁷

Bladder Changes and Urinary Symptoms

Estrogen helps keep the bladder and urethra healthy and elastic.^6,9 As levels drop, these organs become thinner and weaker, which may affect how your bladder works.⁹

These shifts are part of a collective group of symptoms called genitourinary syndrome of menopause (GSM).⁹

For some women, menopause and bladder changes are linked and can cause:

• Recurrent urinary tract infections (UTIs): Persistent burning sensation when you pee⁹
• Stress incontinence: Leaks when you cough, sneeze, or exercise¹⁰
• Urinary urgency: A strong need to pee⁹
• Nocturia: Frequent peeing at night ¹⁰
• Overactive bladder: Frequent bladder pressure¹¹

Bladder issues are common as you get older, but you can actively support your bladder health by:¹¹

• Practicing regular pelvic floor exercises to tighten your pelvic floor
• Maintaining a healthy weight to reduce pressure on your bladder
• Doing bladder-training exercises to improve your bladder muscle control
• Asking your doctor about vaginal estrogen to help ease your symptoms

And when you need a little extra, discreet support, TENA’s incontinence products for women are designed to help you stay comfortable, protected, and confident through every part of your daily life.

Brain Fog and Memory Challenges

You might not connect menopause and brain fog, but it’s a common experience.¹²

Many women notice memory lapses, difficulty concentrating, slower thinking, and mental fogginess during menopause.^13,14

Estrogen-related symptoms like brain fog can occur because changing hormone levels may affect how your brain uses important chemicals like serotonin and dopamine.³

Also, some symptoms of menopause, such as sleep disturbances, mood changes, and hot flashes, could make brain fog more noticeable.¹³

Dealing with brain fog can feel distressing, especially when it affects your work, confidence, and daily life, but it sometimes improves with time.¹³

Anxiety and Low Mood

While everyday stress and menopausal anxiety can feel similar, they have different causes. Stress is triggered by external pressures on your brain and body, while menopausal anxiety is linked to declining estrogen levels.^14,15

These hormonal changes can affect brain chemicals that help control your mood, such as serotonin.¹⁵

Even if you’ve never experienced anxiety or depression before, you might:

• Feel on edge, restless, or overwhelmed without a clear cause¹⁶
• Feel empty, unmotivated, or sad¹⁷
• Experience worsening mental health symptoms¹⁸

Menopause and mental health changes can feel like a lot to deal with, but your doctor can advise you about supportive therapies, including cognitive behavioral therapy (CBT).¹⁵

Skin Changes

Estrogen supports skin hydration and collagen production, which keeps your skin soft, plump, and firm.19 When levels drop during menopause, you might notice:

• Hormonal acne or breakouts¹⁹
• Itching or a sensation of something crawling under your skin^19,20
• Drier, thinner, and less elastic skin¹⁹
• Slower wound healing²¹
• Sensitive or reactive skin²¹

To support your skin health:

• Use an SPF daily.¹⁹
• Follow a hydrating skincare routine.¹⁹
• Use a gentle cleanser instead of soap on your face.²¹
• Speak to your doctor about your options for HRT.¹⁹
• Eat foods rich in omega-3, such as mackerel and salmon.²¹
• Eat hydrating foods like watermelon.¹⁹

Changes in Hair Growth

Lower estrogen could increase the hormone androgen.²² While it sounds like a male hormone, it’s also present in women, just in smaller amounts.²³

When its levels increase, this can cause:

• Facial hair growth, especially on your chin and upper lip²²
• Thinning of the hair on your head²⁴

Both hair loss and excess growth can make you feel a little self-conscious, but there are some things you can do to manage both:

• Maintain a healthy weight to help support more balanced hormones.²²
• Reduce stress levels by practicing yoga or breath relaxation methods like.²⁴
• Eat a balanced diet.²⁴
• Use threading, shaving or waxing to remove excess hair.²⁵
• Ask your doctor about electrolysis and laser hair removal.²³

If you notice sudden changes or have diabetes, it’s a good idea to speak with your doctor.²³

Eye Changes

Estrogen affects the glands that help produce tears.²⁶ When your hormone levels change, you might notice dry, gritty, irritated, or blurry eyes, along with increased sensitivity to light.²⁶

You can ease your symptoms by:²⁶

• Using lubricating eye drops
• Reducing screen time
• Wearing sunglasses in windy or bright conditions
• Using a humidifier
• Not wearing contact lenses; they may feel uncomfortable

If your symptoms persist, your vision changes or you have painful eyes, it’s best to book an eye exam with your optometrist.²⁶

Dry Mouth

Estrogen changes can even affect saliva production, causing menopausal symptoms like:²⁷

• Dry mouth (AKA Xerostomia)
• Burning sensation in your mouth
• Bad breath

These changes could also put you at risk of dental issues such as gum sensitivity and tooth decay. Some tips to help you through this phase include:²⁷

• Using alcohol-free mouthwash
• Drinking enough water throughout the day
• Avoiding spicy or dry foods
• Cutting back on caffeine, fizzy drinks, and alcohol if they make things worse
• Avoiding smoking
• Keeping up with good oral hygiene
• Going for regular dental check-ups

Letting your dentist know you’re going through menopause can also be helpful.

Heart Palpitations

Heart palpitations can happen both during and after menopause.²⁸ That’s because hormonal changes during this time may affect your nervous system, causing a racing, fluttering, or skipping feeling in your chest.^28,29

These symptoms can feel frightening, but they’re usually harmless and often happen alongside hot flashes.²⁸ But if there's chest pain, shortness of breath, or dizziness, it’s a good idea to see your doctor for a check-up.²⁸

Tingling and Numbness

Tingling, pins and needles, or a crawling sensation in your feet, legs, arms, or hands can be another menopausal symptom.³⁰

They're caused by declining estrogen levels, which can affect your nervous system and circulation, leading to these sensations.30 While unsettling, they are often harmless and temporary.³⁰

But if the tingling gets worse, or it happens mainly on one side of the body, it’s a good idea to book a doctor’s appointment to find out what's causing this.³⁰

Changes in Hearing

This lesser-known symptom of menopause includes tinnitus (a ringing, buzzing, or roaring sound in the ears) or increased sensitivity to certain sounds.^31,32

While research is ongoing, it’s thought to happen because of hormonal changes affecting how your brain processes sound.³¹

A hearing assessment is recommended if the tinnitus is ongoing or affecting your quality of life.³³

Cholesterol Shifts

Estrogen protects your heart and regulates cholesterol levels by maintaining good cholesterol and lowering the bad.³⁴

When estrogen levels drop, this balance can tip, causing bad cholesterol to increase and raising the risk of heart disease.³⁴

High cholesterol often has no symptoms, making it easy to overlook.³⁴

To support healthy cholesterol levels, try to manage menopausal weight gain by eating healthy and staying active. Some other tips are:³⁴

• Avoiding foods high in saturated and trans fats
• Quitting smoking
• Exercising regularly 
• Getting your cholesterol checked regularly

Sometimes, the most frustrating menopause symptoms are the ones no one warns you about. But many of these changes are manageable, and experienced by more women than you think, even if they’re not talking about them.

Paying attention to new symptoms and giving your body the support it needs is part of self-care, and how you can navigate this transition with confidence.

FAQ

What Are the Exact Side Effects of Menopause?

Some symptoms of menopause are well known, like hot flashes, while others are less talked about, like dry eyes.^1,2

Here’s a simple breakdown of common and lesser-known symptoms:

• Well-known symptoms of menopause
• Irregular periods¹
• Night sweats¹
• Vaginal dryness¹
• Low libido²
• Mood changes²
• Sleep disturbances¹
• Weight changes⁴

Lesser-known menopause symptoms

• Brain fog¹²
• Joint pain⁶
• Anxiety and low mood¹⁴
• Facial hair ²²
• Hair loss²⁴
• Dry mouth²⁷
• Heart palpitations²⁸

These symptoms happen because estrogen plays a role throughout the body, affecting your skin, bladder, brain, mood, and many other systems.³

You can explore each of these symptoms in more detail in the article sections above.

Do You Feel Better After Menopause?

Perimenopause and menopause often come with symptoms that could feel intense and unpredictable. While some symptoms may linger, many fade away as your hormones settle over time.³⁵

Some symptoms that start or persist after menopause include:

• Vaginal dryness³⁶
• Joint pain³⁷
• Urinary changes, such as incontinence^6,11

But you don’t have to simply put up with these changes; there are ways to manage them with your doctor’s help and simple lifestyle adjustments.

What Are the Three Stages of Menopause?

Perimenopause is the phase leading up to menopause, and it often begins in your 40s.³⁷

Once you’ve gone 12 consecutive months without a period, usually around the age of 51- 52, menopause begins.^{37,38 39} After menopause, the next stage is post-menopause, which lasts for the rest of your life.³⁷

Symptoms often start in perimenopause and can continue through the transition, with each stage bringing different changes to understand and manage.³⁸

What's the Worst Stage of Menopause?

Most women might find perimenopause more challenging because symptoms can be unexpected and unpredictable.³⁹

But it varies from woman to woman.³⁸ Some may find post-menopause more difficult, especially with changes like incontinence.^6,11

While any stage can feel challenging, the right treatment and some lifestyle measures can really make a difference.³⁸

What Are the Biggest Symptoms of Menopause?

Many women find symptoms like hot flashes, night sweats, vaginal dryness, sleep disturbances, mood changes, and brain fog the most difficult to deal with.¹

But the biggest symptom depends on the person. For some women, it might be joint pain or bladder changes that affect their daily life the most.

Estrogen plays a role throughout your body, which is why some of the most disruptive symptoms are not always the ones most widely talked about.³

Can Menopause Cause Bladder Problems?

Yes, when estrogen levels decline, it could affect your bladder and urethra,⁶ causing bladder changes like:

• Urinary urgency⁹
• Recurrent UTIs⁹
• Bladder leaks¹⁰
• Needing to pee more often, including at night¹⁰

These changes are part of a group of symptoms called genitourinary syndrome of menopause (GSM) and are common during and after menopause.⁹ Management includes pelvic floor exercises, bladder training, and products to keep you comfortable and confident like incontinence liners for women.¹¹

Can Menopause Cause Anxiety Even If You've Never Had It Before?

Yes, it can. Declining estrogen levels can affect brain chemicals like serotonin, triggering anxiety.¹⁵

Anxiety is a common symptom of menopause¹⁴ but it tends to be unexpected.

It’s also easy to dismiss it as stress, but speaking with your doctor can help you understand what’s really going on.

References

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