10 surprising menopause symptoms

From cold flushes to burning mouth, we uncover the lesser-known menopause symptoms

Most people will have heard of hot flushes and night sweats but while these common symptoms can affect an estimated 70% of women during perimenopause and menopause, they are not the defining nor most common symptoms. A survey of 5,744 women by Newson Health found that 98 different symptoms were reported by women, impacting various areas of their bodies, including brain function, mood, digestion, bladder control, skin, hair, muscles, and bones [1].

Hormone receptors are present throughout your body, so when levels of oestradiol (oestrogen), progesterone and testosterone fluctuate and fall during perimenopause and menopause, this can trigger a whole host of symptoms. 

The survey found that hot flushes were the 18th most common symptom, and that almost three quarters (74%) of respondents experienced symptoms they found surprising or unexpected [1].

Here we look at 10 surprising symptoms of menopause and the reason why they happen. Don’t forget, you can download the balance app to find out more about symptoms and log your own on a symptom tracker.  

Cold flushes

A cold flush is a sudden chilly, tingling feeling that can come out of nowhere, or happen straight after a hot flush. Like hot flushes, they can last for a few seconds or for several minutes.

The exact cause of hot and cold flushes isn’t known, but it is likely to be related to changing hormone levels impacting on areas of your brain involved in maintaining temperature (the hypothalamus gland). This often becomes more sensitive to changes in body temperature, which cause it to overcompensate by having a cold flush.

RELATED: Surprising menopause symptoms

Dry eyes

If you’ve noticed that your eyes are feeling drier and grittier lately, you could have dry eye syndrome.

Every time you blink, your eyes release a tear film made up of water, oil and mucous that covers and lubricates your eyes. When you don’t produce enough of this substance, your eyes can feel dry and you can have a stinging, gritty feeling (like you have something in your eye) or blurry vision. This symptom can be a real nuisance, particularly if you spend a lot of time in front of a computer screen.

Although some women can be surprised by this symptom, it is quite common – 50% of women in the Newson Health survey reported experiencing it [1]. As you get older, tear production decreases, but oestradiol and testosterone also have important roles in tear-film production. Research also suggests that testosterone in particular can help to manage the delicate balance of tear production, so fluctuating levels can also contribute to dry eyes [2].

Cold weather and wind can cause tears to evaporate too quickly and can make dry eyes worse. You could try wraparound sunglasses to protect your eyes from the elements, particularly if you are out running or cycling.

RELATED: Dry eyes and menopause: what’s the link?

Brittle nails

Take a look at your fingernails for a moment. Notice anything different? Has their condition changed? Have they been more prone to breakage than before? During perimenopause and menopause, nails can become thin or soft, meaning they can split, crack or break more easily.

Your nails are made of a protein called keratin, which gives them structure and helps keep them hard and strong. Oestradiol, progesterone and testosterone help to produce keratin, so when levels are lower, your nails may be more susceptible to breaking.

RELATED: Skin, hair and nail changes in menopause: a dermatologist’s guide

Heartburn

Also known as acid reflux, heartburn is that unpleasant burning feeling in your chest and throat where stomach acid travels up into your oesophagus. This can leave an unpleasant taste in your mouth, give you bad breath and make you feel bloated and nauseous.

Common causes of heartburn include stress and being overweight, while alcohol and eating spicy and fatty foods can make symptoms worse or be the cause of heartburn in the first place. But it can also occur during perimenopause and menopause.

Fluctuating and reduced hormone levels can alter the amount of acid your stomach produces. In addition, when you are feeling stressed, your body produces more of the hormone cortisol, which can affect your digestion as well as your hormone levels. One study of 497 women found that 42% per cent of perimenopausal and 47% per cent of menopausal women suffered from heartburn [3].

RELATED: Heartburn and the menopause: what’s the link?

Dizziness

You may have noticed intermittent periods of feeling dizzy, or lightheaded, such as feeling a bit wobbly in the shower. Oestradiol, progesterone and testosterone have an effect on the way your blood vessels widen and narrow, so when hormone levels fluctuate, this can trigger feelings of light-headedness, pressure and dizziness. These hormones can also affect the function of the balance areas of your brain and your inner ear.

To be on the safe side, however, see a healthcare professional if you’ve had episodes of severe dizziness, fainting or palpitations to rule out any other underlying causes.

RELATED: Dizziness and the menopause

Altered sense of smell

During perimenopause and menopause, you might find you can’t smell things as keenly as you used to, this sense might be heightened or there may even be certain smells – such as perfumes and cleaning products – you just can’t stand any more. This can then affect your sense of taste, too.

This is because fluctuating hormone levels can affect the pathways in your brain that control your sense of smell and taste.

RELATED: Altered taste and the menopause

Tinnitus

Tinnitus is a ringing or humming sound in your ears. It is a complex condition involving many different parts of the auditory pathways as well as your nerves and can be exacerbated by mood disorders, depression and anxiety. Severity can differ from person to person; some women are unable to sleep well, work or socialise because of tinnitus negatively affecting the quality of their lives.

Of the women surveyed by Newson Health who reported having surprising perimenopause or menopause symptoms, 19% experienced tinnitus [1]. There are receptors for oestradiol, progesterone and testosterone in the cells in your ears and along your auditory pathway, and low hormones can affect the pathways from your ears to your brain.

RELATED: Hearing loss and tinnitus in the perimenopause and menopause

Burning mouth

Burning mouth is an uncomfortable sensation that can affect your tongue, gums, lips, inside of your cheeks, roof of your mouth – or even your whole mouth. The burning sensation can be severe; some women have likened it to when you burn your tongue or palate on hot food or a hot drink.

Oestradiol, progesterone and testosterone are important hormones for the healthy functioning of the supporting structures of your teeth, bones and ligaments, as well as the mucous membranes inside your mouth. When hormone levels fall, this can have a direct impact on your oral health, triggering a range of issues, including burning mouth, dryness, gum disease and bad breath.

RELATED: Burning mouth syndrome and the menopause

Skin crawling and itchy skin

Have an itch that just won’t resolve itself? It could be down to your perimenopause or menopause. You might notice more wrinkles and fine lines when you look in the mirror, or that the skin all over your body feels rougher, dry and even itchy.

As hormone levels fall during perimenopause and menopause, your skin can become thinner and more moisture and collagen are lost, which can lead to more lines, a drier texture and, for some women, an itchy, uncomfortable feeling. Another symptom that can occur during perimenopause and menopause is formication, which is the sensation of insects crawling over your skin. Other causes of itching are iron deficiency and thyroid disorders so it may be worth reviewing the possible causes with a healthcare professional.

RELATED: The impact of hormones on our skin, hair and nails

Heart palpitations

A palpitation is a feeling that your heart is beating more intensely than usual, or irregularly. Palpitations may last for a few seconds or a couple of minutes. They can coincide with a hot flush or a night sweat, a dizzy spell or happen on their own.

Palpitations can be due to changing or declining levels of hormones, which can affect the pathways in your heart through which electrical impulses travel. They can feel quite alarming, but in most cases they aren’t a sign of a serious cardiac issue. However, you should see a healthcare professional if you are worried, or if your palpitations last for several minutes, are accompanied by shortness of breath or chest pain, or you notice they are becoming more severe and/or regular, or if they haven’t resolved within a few months of starting HRT.

RELATED: Heart palpitations and menopause: what you need to know

It is worth remembering that perimenopausal and menopausal symptoms – whether surprising or not – can be treated, you don’t have to put up with them.

Many women find that replacing their missing hormones, by taking the right dose and type of HRT and testosterone, can alleviate all these symptoms discussed above. Speak to your healthcare professional regarding the right treatment for you.

References

1. Newson Health, Experiences of Perimenopause and Menopause (2022)
2. Peck, T. et al. (2017), ‘Dry eye syndrome in menopause and perimenopausal age group’, Journal of Mid – life Health, 8(2), pp. 51–4. doi:10.4103/jmh.JMH_41_17
3. Infantino, M, (2008), ‘The prevalence and pattern of gastroesophageal reflux symptoms in perimenopausal and menopausal women’, Journal of the American Academy of Nurse Practitioners, 20 (5), pp.266-72, https://doi.org/10.1111/j.1745-7599.2008.00316.x