What are the early signs of menopause?

May 9, 2025

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What are the early signs of menopause?

Premature menopause symptoms—often part of perimenopause—can be quite heterogeneous but most characteristically include:

Unpredictable menstrual periods: Irregularities in the duration of menstrual cycles, bleeding, or skipped periods.

Hot flashes: Episodes of fleeting heat, usually with accompanying perspiration and flushing, often nocturnal.

Nocturnal sweats: Intense perspiration at night, which may interfere with sleep.

Mood disturbance: Increasing irritability, nervousness, or depression.

Sleep problems: Inability to sleep or sleep disturbances.

Vaginal dryness: Sex discomfort or overall dryness resulting from low estrogen level.

Loss of libido: Decreased interest in sex.

Urinary changes: Frequent urination or urinary tract problems.

Memory and concentration issues: “Foggy brain” or forgetfulness.

Tenderness or breast changes.

Weight gain or slow metabolism, especially around the midriff.

These symptoms can begin years before menopause occurs in fact (a 12-month consecutive period with no period). Would you prefer advice on how to deal with early symptoms without medication or using medical help?

There isn’t a hard-and-fast rule for how often women are to be screened for menopause symptoms specifically, but physicians typically monitor for this during their annual check-ins—most notably for women 45 and older, or earlier if symptoms are being noticed.

A general standard is as follows:

1. Routine Checkups
Once a year: During a woman’s annual physical or gynecologic exam, physicians typically ask about menstrual cycle, mood, sleep, and other menopause symptom patterns.

2. Symptom-Based Evaluation
Screening or assessment should be performed at any time a woman reports symptoms such as:

Irregular or missed menstrual cycles

Hot flashes or night sweats

Vaginal dryness or pain during sex

Sleep disturbances

Changes in mood or depression

Memory issues or “brain fog”

3. Transition of Perimenopause
Women typically begin perimenopause at their 40s, and thus discussion and follow-up typically begin in that decade unless sooner.

4. Testing
Routine laboratory work up at menopause (e.g., FSH level) is not routinely necessary unless symptoms are unusual or diagnosis is uncertain.

Recommendation:
Women should have a discussion of menopause with their physician at least annually after age 40, or earlier if symptoms appear. More frequent follow-up is warranted if symptoms severely affect quality of life.

Would you like a checklist of common menopause symptoms to bring in on a doctor’s visit?

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