What Are The Worst Menopause Symptoms?

Hot Flushes and Night Sweats

Key Point: Hot flushes and night sweats are two of the most well-known and experienced symptoms of the menopause. Hot flushes are sudden feelings of warmth that unexpectedly surge throughout the body. These can manifest at any time and are frequently responsible for night sweats and disruptions to sleep.

They can vary in severity, frequency and duration, so for some women they happen regularly while others only experience the odd one here and there. Experiencing hot flushes can be an incredibly uncomfortable and often distressing part of many women’s lives. These sensations of intense heat can come without warning, affecting various parts of the body and can significantly disrupt daily activities and sleep patterns.

• It is advisable to wear light, loose and breathable clothing to help manage your body temperature. Natural fibre fabrics such as cotton are recommended because they allow your skin to breathe and thus reduce the intensity of hot flushes.
• Maintaining a cool environment, particularly during nighttime, may help. Consider using a fan or keeping the window slightly open to allow air circulation, which can help in reducing the room temperature and provide relief from night sweats.
• Avoid triggers if you can – alcohol, caffeine, hot drinks and spicy food are the main culprits, but you may notice triggers specific to you. Stopping smoking can help too, as smoking can make hot flushes and night sweats worse. The NHS is a great place to start if you need help quitting.
• Speak to your doctor about whether hormone replacement therapy (HRT) could be right for you. HRT has been found to be effective in treating symptoms associated with menopause, including hot flushes and night sweats. Your doctor can advise on whether this treatment is suitable for you based on your individual health needs and medical history.
• There’s good evidence that cognitive behavioural therapy (CBT) can help decrease the severity and frequency of hot flushes. It can be a good alternative if you have been advised not to take HRT.

By taking these steps, you can better manage the symptoms associated with hot flushes and improve your overall comfort and quality of life.

You can read more about hot flushes and night sweats and ways to manage them here.

Mood Swings and Emotional Changes

During menopause hormone swings, along with the physical and mental symptoms of the menopause, can all trigger mood swings. Many women find that mood swings can be particularly challenging, often experiencing rapid and unpredictable changes in their emotional state. These fluctuations can significantly affect daily life, creating stress and discomfort.

• It’s beneficial to maintain a regular exercise routine, as physical activity can help stabilise mood swings by releasing endorphins, which are natural mood lifters. Even gentle exercise can work wonders to improve mood, increase your sense of wellbeing, self-worth, body image and feelings of happiness, while reducing stress and anxiety.
• Engaging in activities that promote relaxation, such as yoga or meditation, can also be greatly beneficial. These practices not only help in reducing stress but also aid in maintaining emotional balance during this transitional period.
• Consider seeking counselling or therapy to manage mood swings more effectively. Professional guidance can provide strategies to cope with emotional changes and offer support through the menopause transition.
• It’s worth talking to your doctor to find out whether HRT could be suitable for you. If your mood changes are related to the perimenopause or menopause, evidence suggests that HRT may improve mood.
• Antidepressants can have a part to play, particularly if you have clinical depression or premenstrual syndrome. They can lift your mood, help you sleep and help with anxiety. Please talk to your doctor about the risks and benefits for you.

Implementing these strategies can help mitigate the impact of mood swings during menopause, leading to a more balanced and enjoyable life.

You can read more about mood swings and ways to manage them here.

Asking for help

It’s important to talk about how you feel with family and friends, with your doctor, or with a counsellor – someone you trust with a sympathetic ear. Understanding why your mood is low, or why you feel depressed, can go some way to helping find a solution.

If premenstrual syndrome is a particular issue for you, there are other places to look for help and support. The National Association for Premenstrual Syndromes has good information. Other information can be found online through the Royal College of Obstetricians and Gynaecologists.

If you feel suicidal – call your GP practice, the Samaritans 116123, 111 or 999 if you think you are going to harm yourself.

Sleep Disturbances

Key Point: Poor sleep may be linked to hormone changes, but physical symptoms, like hot flushes, mood changes, and stress can contribute too.

Women often talk to us about how difficult they’re finding it to get a decent night’s sleep. The effects of sleep issues can be debilitating and can take their toll on your daily life, affecting your mood, behaviour and even your long-term health.

• It is advisable to steer clear of caffeine and engaging in stimulating activities before going to bed. These can interfere with your ability to fall asleep as they keep the mind and body alert when they should be unwinding.
• Avoid large meals that are rich in heavy or spicy foods before you go to bed.
• Try to limit how much alcohol you drink in the day. Alcohol can get you off to sleep, but the resulting quality of sleep can be poor. You experience a lighter sleep and don’t feel rested when you wake.
• Try to stop smoking as it’s also a stimulant (and not good for your health).
• Establishing a calming bedtime routine can be tremendously beneficial. This might involve activities such as reading a book, taking a warm bath, or practising relaxation exercises. These activities serve as signals to your body, indicating that it is time to relax and prepare for sleep.
• Making sure your sleep environment is geared up for a good night’s sleep is important – for example, ensuring your bedroom is cool and dark, use cooling cotton sheets and a good choice of nightwear can all help.
• Cognitive behavioural therapy (CBT) can help some women. The process works by challenging the negative thought processes surrounding lack of sleep and teaches strategies for turning around your negative thinking.
• If sleep disturbances continue to be a problem, it may be wise to consult with your GP. Persistent sleep issues should not be ignored as they can significantly impact your overall health and wellbeing. Your GP can offer advice on suitable sleep aids or recommend therapies that might help in managing your sleep patterns more effectively.

You can read more about sleep issues and ways to manage them here.

Vaginal Dryness and Discomfort

Vaginal dryness, itching, and irritation are common menopause symptoms that impact over a third of menopausal women.  This can result in significant discomfort, including itching and pain during sexual intercourse.

Many women find that they only feel dry during sex, while others experience it daily. Dryness comes with other sensations, such as ‘prickliness,’ itching, irritation, and even pain in the vagina.

Vaginal dryness can make you more prone to yeast infections (thrush), as the tissue is delicate and loses its natural defences. Discharge can decrease or increase as the balance of bacteria that are naturally found in the vagina changes.

You may also be more prone to bacterial vaginosis, where there is an imbalance of the normal bacteria that usually live happily in the vagina. If you have excessive vaginal discharge, this can sometimes cause further irritation.

• For immediate relief, over-the-counter lubricants and moisturisers are widely available and can be quite effective. These products help to alleviate the dryness by providing the necessary moisture. You should avoid the lubricants with added extras (like a tingle, or heat) as they can cause more irritation. For the same reason it’s best to avoid anything perfumed, because, again, vaginal moisturisers containing these can cause further vaginal irritation. You’ll most likely find it best to avoid all soap when it comes to washing, as it often dries out already delicate and sensitive skin. Instead, try using a soap-free wash, or even over-the-counter emollient creams and ointments. If you ask the pharmacist, they will be able to point you in the right direction.
• Systemic HRT (patches, tablets, gels and sprays) helps some women, but not everyone and up to one-quarter of women using HRT will also need a vaginal oestrogen. More on that below. You can find more detailed information about the benefits and risks of HRT here.
• Speak to your GP about the possibility of using vaginal oestrogens.  These are oestrogen pessaries, creams and gels that are inserted directly into the vagina. These treatments can help replenish oestrogen levels, thereby reducing the symptoms associated with vaginal dryness.

You can read more about vaginal dryness, itching and irritation and ways to manage it here.

Physical Changes

For many women, the menopause transition brings with it a variety of physical changes, including bladder symptoms and infections, an increase in weight, hair and skin changes. These changes can have a significant impact on one’s well-being and self-esteem.

The good news is that there are immediate ways to tackle menopause symptoms through self-help lifestyle changes.

Diet

There isn’t one best menopause diet. But what we eat is central to how we feel and our general health.

Caffeine, alcohol, and spicy food can make hot flushes worse. Caffeine can also have a negative impact on your bladder. Some find the switch to decaffeinated tea and coffee makes a huge difference.

The Mediterranean diet is associated with lower risks of heart disease (which can increase after menopause). A diet rich in calcium and vitamin D will help keep bones healthy as well.

Menopause can change the way your gut functions. To figure out which foods affect you, it can be a good idea to keep a diary. Bloating can be uncomfortable, so you may decide to avoid fizzy drinks, chewing gum, and gas-inducing foods including cabbage and sprouts (but make sure you’re still getting your five fruit and veg a day).

Many women drink alcohol in an attempt to help them through the menopause, especially to deal with sleep and anxiety. Although it may help you feel better at the time, it’s only temporary, as alcohol acts as a depressant on the brain. In the long run, cutting down can really help you feel better and support weight loss.

Weight gain is something that troubles lots of women, and losing weight can be a real challenge during the menopause. That’s because of changes to how your body handles carbohydrates and processes calories. Small changes to your diet can turn into dramatic and positive changes.

Exercise

Even the smallest amount of exercise can have a positive impact on your health and wellbeing during the menopause. If you aren’t exercising regularly, then squeezing in a small amount is a start. No marathon running is required!

Regular exercise helps mood and sleep (and even hot flushes for some). It can also help beat the weight gain often associated with menopause.

One of the most important types of exercise for women during menopause is a regular weight-bearing or muscle-strengthening activity, like brisk walking or running. This will help to keep muscles and bones strong.

By adopting these healthful practices, women can better manage the physical changes that accompany menopause and maintain their quality of life.

Managing Menopause

Menopause marks a significant transition in a woman’s life and, while a natural process, the symptoms can sometimes be challenging. Effectively managing these symptoms can notably enhance your quality of life.

• Consider making lifestyle adjustments that can alleviate menopause symptoms. These might include dietary modifications, regular exercise, and stress-reduction techniques such as yoga or meditation.
• Speak to your GP  about whether hormone replacement therapy (HRT) could be right for you.
• Keep abreast of the latest research and alternative options available for managing the symptoms of menopause. New treatments and findings are continually emerging, offering a range of options to suit different needs and preferences.

By taking proactive steps and consulting healthcare professionals, you can navigate through menopause more comfortably and maintain your wellbeing.

If you’d like to learn more about over 40 menopause symptoms and a range of ways to manage them, head to our symptom checker here.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.