Going through perimenopause and menopause is a unique and personal experience for everyone. It often comes with many changes that can affect daily life. During the 12 Days of Menopause Real Talk, we'll talk about 12 of those changes. We'll hear more from our Ambassadors and experts, learn what's behind these menopause symptoms, and give you (or someone you know) tips to help manage them.
What’s the connection between menopause and trouble sleeping?
The quality of your sleep (or lack thereof) can affect your menopause symptoms and your menopause symptoms can affect your sleep patterns. It’s a bit of a confusing chicken and egg situation trying to figure out which came first. Regardless, research has shown that there’s indeed a complex relationship between menopause symptoms and sleep. Let’s dive into how some menopause symptoms may be making it harder for you to sleep.
- Night sweats are hot flashes that happen while you’re sleeping. Night sweats can cause you to wake up frequently. Some people sweat so much that they have to get up and change clothes/bedding. Once you’re up and moving, it’s harder to fall back asleep.
- Menopause can increase the risk of developing insomnia. Hormonal changes, along with other menopause symptoms like hot flashes and anxiety, can contribute to insomnia. In addition, when progesterone breaks down in the body, it creates a substance called allopregnanolone, that sticks to a part of your brain called the GABA receptor, which makes you feel tired and sleepy. With less progesterone during the menopause transition, you have less of this substance and may have more trouble sleeping.
- Sleep apnea can show up or worsen during menopause. While it’s more common in males, it can occur or worsen for females during menopause. Sleep apnea can lead to frequent wake ups.
What can I do to get better sleep during perimenopause and menopause?
Here are a few things you can do to try and get better sleep during the menopause transition.
- Practice good sleep hygiene (sleep habits). This includes maintaining a consistent sleep schedule, creating a comfortable sleep environment, and keeping electronics out of the bedroom.
- Try cognitive behavioral therapy for insomnia (CBT-I). It’s an evidence-based therapy that focuses on reframing thoughts, feelings, and behaviors that may contribute to insomnia.
- Continue to build on healthy habits. Habits such as regular exercise, a healthy diet, and stress-reducing techniques can improve sleep quality while also helping manage menopause symptoms.
- Ask a healthcare provider about treatment options. For some people, hormone therapy (HT) may be recommended to alleviate severe menopause symptoms and improve sleep.
“I wake up, unable to fall back asleep until just before my alarm goes off. I tried everything — meditation, binaural beats, even mentally cataloging handbag styles. I started scrolling through my phone. Big mistake. I fell down a rabbit hole of random facts — like how octopuses have 3 hearts, 2 of which stop beating when they swim. I thought, why don’t humans have backup hearts? Next thing I know, I was looking up organ redundancy in evolution, convinced I’d unlocked some great biological mystery. And I never fell asleep again that night. Back to handbags....” - Stacy, 48, Versalie Ambassador
Want to learn more about the perimenopause and menopause symptom of trouble sleeping? Read more.
People choose to drink for many reasons — to celebrate, to relax, to socialize, to cope with stress, the list goes on. And about half of us are doing it — 50% of women over age 50 drink a moderate amount of alcohol (1 drink or less per day).
How does alcohol affect us as we go through menopause?
Alcohol has effects on our bodies that can worsen some menopause symptoms you may already be experiencing:
- Trouble sleeping. Drinking alcohol can make it harder to get a good night’s rest.
- Digestive health. In larger amounts, alcohol can inflame your intestines and disturb your gut microbiome.
- Mood changes, depression, and anxiety. Some people drink to manage stress or deal with a negative mood. But alcohol is a depressant and drinking too much can often cause feelings of sadness (depression) and nervousness (anxiety).
- Osteoporosis. Alcohol affects bone-forming cells. Older women who are heavier drinkers have greater bone less than those that have minimal use of alcohol.
- Hot flashes and night sweats. Research suggests that regular alcohol use is strongly connected to an increase in the frequency and severity of hot flashes and night sweats.
How does alcohol affect females different as we age?
There are physical factors related to age and sex that can affect our how bodies process alcohol as we get older.
- Liver enzymes that help metabolism alcohol become less efficient with age.
- Our central nervous system sensitivity increases with age.
- Most females have a lower amount of lean muscle mass. This can make them more susceptible to the effects of alcohol.
How alcohol affects each person will vary. But in general, the more you consumer, the more likely you are to experience negative side effects.
“I can’t have more than 2 drinks without having a hangover. Which makes celebrating with friends hard, especially if they haven't had any perimenopause symptoms.” - Tula, 47, Versalie Ambassador
Want to learn more about the relationship between alcohol and menopause? Read more.
It’s totally normal for body odor to change during perimenopause. It might seem strange and even a bit embarrassing, but it’s a normal part of the journey.
Why does menopause cause body odor changes?
Estrogens and androgens are the main hormones involved in a changing body odor during the menopause transition. They can impact how much you sweat, the body odor you produce, and even your perception of the way it smells. Changes in estrogen levels can cause you to sweat more often than you used to (think, hot flashes), and androgens play a part in the body odor that results. When androgens interact with your sweat glands, it often causes a body odor that some people find more intense and/or musky.
“Sweat itself doesn’t smell! Odor comes from sweat mixing with the normal, healthy bacteria on your skin. Hormone changes during perimenopause can sometimes alter this natural scent, but it’s part of the normal variation we all experience.” - Dr. Liss, OB-GYN, Versalie Advisor
How do I manage body odor changes during perimenopause?
Changes in body odor are normal as you age, but there are ways to manage it if they bother you:
- Keep clean! The foundation of staying fresh is keeping clean. Shower regularly, use soap, especially in the underarm and external parts of the groin area, where the bacteria that causes odor like to hang out.
- Reboot your routine. If you’ve always showered before bed, but now experience night sweats, you may need to switch your showers to the morning (or start showering twice a day).
- Use antiperspirants and deodorants. Antiperspirants help reduce sweat, while deodorants can cover up and neutralize bad smells.
Want to understand more about the connection between menopause and body odor? Read more.
“Brain fog” is a term used to describe the feeling of mental confusion, forgetfulness, and difficulty concentrating that often accompanies menopause. While it’s not a medical term, many people going through menopause can relate to this feeling.
What’s the connection between menopause and brain fog?
We know that estrogen plays an important role in the brain and nervous system, but the exact reasons behind brain fog are still being studied. Changes in hormone levels, difficulty sleeping, and stress can all contribute.
How can I improve memory and concentration?
- Get regular exercise. It’s been shown to have positive effects on the ability to stay focused and concentrate.
- Eat a diet that supports brain health. Focus on antioxidants (berries, tomatoes, spinach, dark chocolate) and omega-3 fatty acids (eggs, walnuts, salmon, tuna) to help support brain health.
- Practice mindfulness. This can help you manage stress and anxiety and improve concentration by focusing on the present moment.
- Use external aids. Tools like to-do lists, calendars, and reminders can help with forgetfulness and help you remember tasks and appointments without using too much extra brain power.
- Break larger/complex tasks into smaller, manageable tasks. This can make it easier to focus and accomplish each component.
"Let’s not forget about the brain fog. Baby, it gets cloudy in there. Forget what I was saying mid-sentence.” - Sandra, 50, Versalie Ambassador
Looking for information on brain fog and menopause? Check out this article.
Stress is a normal part of life. While some stress can be helpful (pushes us to try our best and work harder), some stress can be bad for us if we don’t handle it well.
When our body feels stressed, whether it’s “good” or “bad”, our adrenal glands release cortisol into the bloodstream to help us deal with the stress. This is often referred to as the "fight or flight" response.
How does menopause impact stress?
During menopause, our body regulates cortisol (stress hormone) differently than it used to. This might result in higher baseline cortisol levels or a prolonged cortisol response to stress. Your body may react in different ways. You may see:
- Increases in hot flashes, mood swings, and trouble sleeping.
- Changes in metabolism, immune function, weight, and cognitive function.
How can I better manage stress during perimenopause and menopause?
There are lots of different ways to manage stress. Try a few to see if they work for you:
- Learn your body’s signs of stress. Stress can show up in our bodies as physical, emotional, cognitive, or behavioral symptoms.
- Get regular exercise. It’s a powerful stress reducer. Exercise release endorphins, which are natural mood lifters.
- Avoid too much caffeine, sugar, and processed foods. They can contribute to mood swings and energy crashes.
- Do your best to improve sleep quantity and quality. We know this is a tough one, but small changes in your sleep habits can add up.
- Spend time in nature. It’s been linked to stress reduction and improved mood.
- Do things that bring you joy and satisfaction. They can have a positive impact on mood and overall happiness.
- Do deep breathing exercises. They can activate the body’s relaxation response, reducing feelings of anxiety and stress.
"Before I had kids I was stressed. After having kids, I was more stressed. During the menopause transition, I feel like stress is my first, middle, and last name. Is it due to menopause stages, or just a fact of life?” - Suzan, 53, Versalie Ambassador
Curious to know more about stress, cortisol, and menopause? Read more.
Have you been feeling a roller coaster of emotions lately? Do you find yourself getting angry, happy, and then depressed without much notice? If so, you might be part of the 33% of people going through menopause that experience sudden changes in mood (mood swings). Changes in mood is one of the first symptoms that someone may start experiencing during perimenopause.
Why are mood swings part of perimenopause and menopause?
Serotonin is a type of neurotransmitter (the body’s chemical messengers) that’s thought to help naturally regulate mood, happiness, and anxiety. Estrogen affects how much serotonin is “sent” throughout the nervous system.
Fluctuating estrogen levels change the levels of serotonin, which can cause changes in mood that can feel erratic and like they’re coming out of nowhere. In addition to estrogen, fluctuating progesterone levels during menopause can disrupt serotonin production, leading to more changes in mood. During menopause, as levels of estrogen change, how happy, anxious, or sad we feel will also change.
How do I manage menopause mood swings?
There’s no magic pill for helping prevent or manage changes in your mood. But here are a few things you can do to help boost your mood.
- Try to get enough sleep. Not getting enough quality sleep can make irritability and mood swings worse. We all know it’s harder to deal with challenges when you haven’t slept well.
- Get regular physical activity. It’s good for our mental and physical health. It can help relieve stress, improve mood, and give us the time to either process our problems or take a break from them.
- Find (and make time to do) hobbies and activities you enjoy. This can help us feel better physically and mentally and make it feel easier to manage changing moods.
- Try some mind-body practices. Practices like tai chi, yoga, and meditation can help many people feel more relaxed.
- Talk to a counselor/therapist. Many people find it helpful to talk to a professional about what they’re going through.
- Ask a healthcare provider if medications might be right for you. Some options they may recommend can include menopause hormone therapy or medications to help with anxiety and depression.
“Some days I’m happy, sad, crying, and then mad. The mood swings feel like I’m in a revolving door full of people.” - Sandra, 50, Versalie Ambassador
Ready to learn more about mood swings and menopause? Read more.
You may not associate thinning hair or brittle nails with menopause, but the decreasing levels of estrogen can also affect hair and nails. Estrogen plays an important role in maintaining healthy hair and nails.
Why is my hair thinner during perimenopause and menopause?
Hair is made of layers of a protein called keratin that helps make hair stronger and more resilient. As estrogen decreases, our bodies make less keratin, making hair grow more slowly and become thinner.
Less estrogen can trigger an increase in androgens, which shrink hair follicles, resulting in female pattern hair loss.
In addition to hormonal changes, factors like genetic predisposition and stress can contribute to hair loss during menopause.
What should I do to help my thinning hair?
Thinning hair may make you feel more self-conscious about your appearance and possibly more aware of the changes your body is going through. But there are steps you can take to help strengthen and improve the quality and health of your hair.
- Eat foods with high levels of protein and essential fatty acids (omega-3 and omega-6). These nutrients are especially important to include for hair health.
- Use special shampoos and conditions to help strengthen hair. Use anti-dandruff shampoos to help promote hair growth.
- Find healthy ways to manage stress that work for you. Higher stress levels can cause hair loss or make it worse.
- Talk to a doctor or dermatologist. Thinning hair is a symptom of menopause but may have other causes. Medications are available that may help, depending on the cause. Dermatologists can help treat thinning hair.
"When my hair started falling out, I started collecting it in envelopes to show the doctor each day how much hair I was losing.” - Christina, 52, Versalie Ambassador
Learn more about menopause and thinning hair by checking out our Symptom Guide on the topic.
Issues with your mouth and teeth are yet another set of symptoms associated with the menopause transition — and ones that you don’t hear much about. One of the most common oral symptoms that happens during menopause is dry mouth, also known as xerostomia (zeer-oh-STOE-me-uh).
What’s the connection between menopause and dry mouth?
Saliva helps keep our mouth healthy by neutralizing acids, washing away leftover food particles, and preventing excess bacteria from growing. And estrogen is involved in saliva production. When estrogen levels drop during menopause, so does the amount of saliva. Without enough saliva, you may have a higher risk of bad breath, cavities, and gum disease.
What should I do to manage dry mouth during menopause?
Let’s explore a few ways you can manage dry mouth and care for your oral health during menopause.
- Schedule regular dental checkups. Dentists can provide advice on how to manage dry mouth and other oral health problems.
- Stay hydrated. Drink water throughout the day when you feel thirsty.
- Look for products like mouth washes, sugar-free chewing gum, and sugar-free lozenges that can help with dry mouth. They can help you produce the proper amount of saliva.
“Estrogen helps maintain moisture in many tissues, including your mouth. During menopause, lower estrogen levels can reduce saliva production, leading to dry mouth. Stay hydrated and consider saliva substitute products to ease discomfort.” - Dr. Liss, OB-GYN, Versalie Advisor
Got more questions about oral health and menopause? Learn more.
It may be surprising to learn that sore and painful breasts can be an unexpected symptom during perimenopause. There are 2 types of breast pain — cyclical and non-cyclical.
- Cyclical breast pain is connected to your menstrual cycle, even when it’s irregular during perimenopause. When you reach menopause and your periods stop, cyclical breast pain usually goes away.
- Non-cyclical breast pain can be caused by changes in anatomy, hormone changes, medications, or wearing ill-fitting bras.
What can I do to manage breast pain?
Sore breasts during menopause can be hard to deal with. But when you find the right approach and support (pun intended), you can feel much better and be more comfortable. If you have breast pain, it’s best to talk to your doctor to figure out the cause and ask any questions or share any concerns.
- Get more supportive bras. A good, supportive bra can help you feel better if your breasts are sore. A sports bra or a bra with extra support may provide added relief, especially when you’re working out or doing something active. If your bra isn’t supportive enough, it can cause your breasts to feel tender and uncomfortable. Most people wear bras that don’t fit well.
- Use heat. Warm compresses can help breast tissue relax and provide relief from pain and tenderness.
- Try OTC pain relievers. Pain reliever that don't need a prescription, like ibuprofen or acetaminophen, can help with breast pain. Follow the directions on the bottle carefully and talk to your doctor if the pain doesn't go away.
- Talk to a healthcare professional about any concerns. If breast pain doesn't go away, or you have other symptoms that worry you, go see your doctor. They might suggest more tests, like mammograms or breast ultrasounds, to make sure there are no other problems.
"One unexpected symptom during perimenopause is sore or painful breasts. Tenderness or discomfort may come and go due to fluctuating estrogen levels. For many, this resolves as hormone levels stabilize post-menopause.” - Dr. Liss, OB-GYN, Versalie Advisor
Want to dive into more information about breast pain during perimenopause and menopause? Read more.
Menopause can cause different types of joint and muscle pain. One common one is myalgia, which is characterized by general muscle aches and pains. There’s a complex connection between your musculoskeletal system and menopause. Let’s break it down a little more to understand menopause muscle pain.
Why does menopause cause muscle pain?
Estrogen is important for keeping bones and muscles healthy. It helps make a protein called collagen and helps support blood flow to the muscles. Collagen helps keep muscles and connective tissues strong and flexible.
During menopause, when estrogen levels drop, the body makes less collagen. Without enough collagen, muscles can get hurt more easily and feel stiff. With less estrogen, there’s also less blood flow to the muscles. Less blood flow makes it harder to recover after exercise or daily activities.
So, as estrogen levels start to fluctuate significantly during perimenopause, you may notice an increase in muscle stiffness, soreness, and general discomfort. Both changes make muscles feel sore and uncomfortable.
How can I get muscle pain relief?
While hormonal changes are a main factor in menopausal muscle pain, did you know that our daily habits can also affect how bad the pain is? With an integrated approach, you can effectively manage your pain and not let it get in the way of living your life.
- Develop a consistent exercise routine. Include a mix of aerobic exercises (cardio), strength training, and stretching. This can help you maintain muscle strength, flexibility, and overall joint health.
- Eat a balanced diet. Be sure to get enough protein and omega-3 fatty acids. Protein is important for building and keeping muscles and omega-3 fatty acids can help reduce chronic muscle pain.
- Find a daily stress management technique that works for you. Practices such as meditation, deep breathing exercises, and progressive muscle relaxation can help manage stress and ease muscle discomfort.
- Talk to a doctor about medications or therapies that may help you.
“Perimenopause can bring an increase in muscle stiffness, soreness, and discomfort. This often affects areas like the back, neck, and joints.” - Dr. Liss, OB-GYN, Versalie Advisor
Need a few more time on how to manage muscle pain? Read more.
Ever find yourself saying, “Not tonight dear, I just don’t have the sex drive?” If this rings a bell, know that you’re not the only one. One frustrating symptom of menopause is what the medical calls hypoactive sexual desire disorder (HSDD). You and I can call it low sex drive, low libido, or just not feeling in the mood.
Why is my sex drive lower during menopause?
The three main hormones involved in your sex drive are estrogen, progesterone, and testosterone. They’re important for your sexual health, keeping your vagina lubricated and contributing to interest in sex. All 3 also influence sensory perception and blood flow to the pelvic area, which both drive motivation for sex.
Lower estrogen levels cause vaginal tissue to thin, dry out, and become inflamed. This can cause pain during sex (and make you less interested in doing it). Your ovaries produce small amounts of testosterone. These levels may decrease during menopause and contribute to a lower sex drive and reduced response to sexual activity.
Vaginal symptoms and less blood flow to the area can affect orgasm intensity or whether you’re able to have an orgasm. Other factors that affect sex drive include night sweats (that can lead to a lack of sleep), mood changes, relationship dynamics, and body image concerns.
How can I increase my sex drive?
While a lower sex drive is common, it doesn’t mean you just have to live with it. There are strategies and treatments that can help you reignite the spark and get back in the mood.
- Talk to a doctor about menopause hormone therapy. Specifically, localized estrogen therapy can be used to alleviate some of the physical symptoms of menopause related to low sex drive.
- Research lubricants. Lubricants are available without a prescription and can provide relief from vaginal dryness and discomfort during sex. Research the different kinds to see why might work for you.
- Seek counseling and therapy. Sometimes a lower sex drive isn’t just about the physical symptoms. Talking to a mental health professional can help you address relationship-related issues or body image concerns that may be getting in the way of connecting with your partner.
“My sex drive went on a looong drive downhill! Someone turned off that switch.” Wanda, 54, Versalie Ambassador
Have you struggled with lower libido? Read more.
Urinary incontinence, or leaking urine that you can’t control, isn’t the “sexiest” topic. But it’s one that needs attention because it can be uncomfortable and sometimes embarrassing. There are many factors that can contribute to bladder leakage. But menopause hormone changes can be one of the most significant facts as we age.
Why does menopause cause incontinence?
Estrogen has lots of jobs in the body and one of them is to facilitate healthy blood flow to the urinary system. It also supports the health of the bladder, urethra, pelvic floor muscles, and tissues in the vaginal wall. Postmenopause, the muscles and tissues important for bladder function become thinner, less flexible, and weaker. This can lead to problems with bladder control.
What can I do to strengthen my pelvic floor muscles and control my bladder?
Here are a few things you can try:
- Pelvic floor exercises (e.g., Kegels). They help strengthen the muscles that support the bladder and urethra.
- Hydrate. It may seem counterintuitive, but staying well hydrated can help reduce bladder irritation.
- Avoid certain foods. Work towards avoiding caffeine, alcohol, spicy foods, and acidic foods because they can irritate the bladder.
- Stress management. Find ways that work for you to manage stress. High stress levels can worsen bladder issues.
- Talk to a doctor. A healthcare provider can work with you to understand the type and severity of your bladder issue. They can also discuss treatment options. Your gynecologist is a good place to start the discussion.
"While walking with my husband, my toe hit a curb, and I began to trip. I recovered, avoiding a faceplant. However, my bladder and pelvic floor didn’t cooperate & while tripping, golden showers ensued leaving me soaking wet!” - Sherry, 61, Versalie Ambassador
