New research shows how women are affected during perimenopause and menopause, and why treatment is so badly needed

• Fatigue, brain fog and mood issues are the most common symptoms

• Loss of interest in sex is the most severely experienced symptom

• Women worldwide report similar symptoms

If you’ve ever wondered why so many parts of you seem to be “going wrong” during perimenopause and menopause, you’re in good company. For many years, it was thought flushes and sweats, and vaginal dryness were the tell-tale symptoms of menopause, and that was about it. Now, we know that the fluctuations then drop in hormone levels (oestradiol, progesterone and testosterone) affect every cell in your body, so it’s no surprise you can be affected in many different ways.

To gain a deeper understanding of the range and types of symptoms, let’s look at the results of two recent reports.

What are the most common symptoms?

Firstly, 1,352 new patients at Newson Clinic completed our new symptom questionnaire, recording the symptoms they experienced and the severity [1]. In total, 84 symptoms were recorded, and the symptom that was most frequently reported – by an overwhelming 95% of women – was fatigue or low energy.

Brain-fog type symptoms featured heavily in the top 10 symptoms: memory problems was the second most common symptom (experienced by 94% of women); while difficulty in concentrating (92%) and word-finding difficulty (90%) also featured.

Mood issues also featured heavily in the top 10 symptoms: irritability was the third most common symptom (experienced by 93% of women); while feeling anxious (92%), mood swings (90%), low motivation (89%) and feeling tense/nervous (88%) also featured.

Which symptom is the most severe?

The questionnaire also looked at severity of symptoms and found that loss of interest in sex, which was experienced by 90% of respondents, was the most severely affected symptom.

The experiences of the women questioned challenges the notion that menopause is mostly about hot flushes and sweats – night sweats were the 43rd most common symptom (experienced by 62% of women), while hot flushes were the 47th most common symptom (55%).

Do symptoms vary across the world?

These reported symptoms have come from women attending Newson Clinic, so it is interesting to see how they compare to a wider population. The free Balance app allows women all over the world to log their symptoms in its Journal section, and to date 477,840 women – across 238 countries and territories – have logged their symptoms [2].

Brain fog has been recorded by 443,097 women, making it the most common symptom experienced during perimenopause or menopause. In fact, like in the Newson Clinic report, many of the top 10 symptoms reported worldwide on the Balance app are related to brain fog or mood issues. Brain fog, anxiety, low mood or depression and memory problems all feature.

Tiredness or low energy is also in the top 10 most reported symptom, as is low libido. Interestingly, more physical symptoms also make it into the top 10 recorded in Balance, including joint pain, headaches and hot flushes (the 10th most reported symptom).

Balance also asked women about the severity of their symptoms and found that feeling tired or having low energy was the most severe symptom, followed by low libido, tinnitus, dry skin and muscle pain.

How common are more unusual symptoms?

Misconceptions surround perimenopause and menopause, which means many women can be surprised that symptoms they experience can be associated with menopause. These symptoms, while unexpected, can be common, and severe. For instance, 82% of patients who completed the Newson Clinic symptom questionnaire experienced dry skin, 72% experienced frequent urination, 70% had dry hair, 66% had heart palpitations, and 63% had dry eyes.

This information is so important as it shows that women are experiencing so many symptoms – which are often ignored or dismissed. Too many women are told that menopause is just about hot flushes and night sweats, which is clearly wrong. The mental health symptoms are common, and women should not be misdiagnosed with a mental health condition when the underlying cause is changing hormone levels or low hormones. We need to urgently improve education about hormones so less women needlessly suffer.

How can I manage my symptoms?

No-one should have to put up with their symptoms. NICE guidance recommends HRT as the first-line treatment for perimenopause or menopause symptoms. Contact your healthcare provider or an expert in hormone health.

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