ABDOMINAL FAT

Overview: As they get older, women may notice that staying at their usual weight becomes harder. It's common for weight gain to start a few years before menopause, during the time known as perimenopause.
Symptoms:  Increase in waist measurement, bulging in the upper and lower abdomen (extending to the sides), fat resistance to exercise, and other lifestyle changes.
Causes: The hormonal changes of menopause tend to make it more likely that women will gain weight around the abdomen, rather than the hips and thighs. 

*Reference: Mayo Clinic 

DEPRESSION

Overview: Depression is common during perimenopause. Most studies agree that the risk of depression increases during the menopause transition. 
Symptoms: Crying a lot, feeling hopeless or worthless, feeling numb, and losing interest in your normal activities.
Causes: The same hormones that control your menstrual cycle also influence serotonin, a brain chemical that promotes feelings of well-being and happiness. When hormone levels drop, serotonin levels also fall, which contributes to depression. 
*Reference: Hopkins Medicine 

MUSCLE PAIN

Overview: Musculoskeletal pain (MSP) is one of the most severe complaints in women undergoing menopause. Muscle aches can occur at any stage of menopause, including perimenopause. Although muscle aches are one of the salient symptoms that occur during menopausal phases, their prevalence varies among midlife women in different menopausal states, especially in the transition between the perimenopausal and postmenopausal states. 
Symptoms: Muscle stiffness, muscle soreness, sharp pains.
Causes: Loss of estrogen can affect joints and the connective tissue that 'glues' your skeleton together. This can result in general muscle aches, pains, and stiffness.
*Reference: National Library of Medicine

HOT FLASHES

Overview: A hot flash is the sudden feeling of warmth in the upper body, which is usually most intense over the face, neck, and chest.
Symptoms: A sudden feeling of warmth spreading through your chest, neck, and face; A flushed appearance with red, blotchy skin; rapid heartbeat; perspiration, mostly on your upper body; A chilled feeling as the hot flash lets up.
Causes: Commonly caused by decreasing hormone levels. There is no exact explanation as to the connection between fluctuating hormones and the occurrence of hot flashes. However, research suggests that hot flashes occur when decreased estrogen levels cause your body's thermostat (hypothalamus) to become more sensitive to slight changes in body temperature. When the hypothalamus thinks your body is too warm, it starts a chain of events — a hot flash — to cool you down.
*Women have reported occurrences of cold flash (opposite of hot flash) - Reference: Mayo Clinic (2022)

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ABDOMINAL PAIN

Overview: As a woman’s body prepares to end her fertile stage, she experiences different hormonal changes that can affect the digestive system and cause abdominal pain. 
Symptoms: Pinching pain, movements in the abdomen, sharp pain, constipation, indigestion, diarrhea, pressure related to fibroids, inflamed ovaries, flatulence (accumulation of gas) 
Causes: At menopause, estrogen and progesterone production fluctuate and gradually decline, and both hormones regulate the functions of the digestive system. 
*Reference: Women's Midlife Health

BREAST PAIN

Overview: Breast pain is more common in perimenopause than in the later stages of the menopause transition, where estrogen levels stabilize. 
Symptoms: Soreness, discomfort, burning, tenderness to the touch or sensitivity to clothing, sharp, stabbing, or throbbing pain.
Causes: Sore/painful breasts, also known as mastalgia, are also very common during menstruation. This is because hormonal changes cause fluid to build up in the breasts, making them feel swollen and tender. During perimenopause, the hormonal fluctuations are more dramatic. It is also common for breasts to get bigger or smaller or to change in shape during this period. Breast pain around menopause may also feel different. Instead of a dull ache, people may experience burning or throbbing pain. 
*Reference: My Menopause Center

PANIC ATTACKS

Overview: Panic attacks can feel terrifying – you can’t breathe, feel sick, shake, and lose control. They can last for just seconds at a time or up to an hour. 
Symptoms:  feeling of dread/death, sweating, chest pain, trembling, shaky limbs, dizziness, feeling like you’re not connected to your body, choking sensation, nausea, dry mouth, tingling in the fingers. 
Causes: The hormones estrogen and progesterone work together to regulate mood. The declining levels of these hormones during menopause mean that a woman at this stage of life is more susceptible to anxiety and panic attacks. Menopausal hot flushes may also bring on panic attacks, as women can worry and feel self-conscious about sweating in public.
*Reference: Stella UK

INCONTINENCE

Overview: Stress incontinence, which is caused by weak pelvic floor muscles. The most common symptoms are leakage of urine with coughing, laughing, sneezing, or lifting objects. Stress incontinence is common during perimenopause but typically doesn’t worsen because of menopause.
Urge incontinence (also called "overactive bladder"), which is caused by overly active or irritated bladder muscles.
Symptoms: Nocturia: the urge to pee several times in the middle of the night, painful urination, peeing on yourself while laughing or coughing, and the frequent and sudden urge to urinate. 
Causes: Reduced levels of estrogen starting around menopause can cause thinning of the lining of the urethra, The surrounding pelvic muscles also may weaken with aging, a process known as "pelvic relaxation." As a result, women at midlife and beyond are at increased risk for urinary incontinence, or the involuntary leakage of urine.
*Reference: National Association for Continence

BODY ODOR

Overview: Changes in the nutrient content of your sweat and in the skin microbiome can both lead to different body odors.
Symptoms: Increased sweat, pungent smell, night sweats, hot flushes. 
Causes: Hormonal balance shifts, stress, dehydration, .
*Women have reported occurrences of cold flash (opposite of hot flash) - Reference: Evernow (2022)

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