Beyond Hot Flashes: 11 Surprising Symptoms of Menopause You Might Not Expect

Women are often educated on the uncomfortable symptoms of menstruation, but being informed on the many facets of menopause often falls through the cracks.

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By Sheramy Tsai

11/30/2023Updated: 5/28/2024

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At 53, Rida Rafiq’s journey through menopause was complex, marred by a misdiagnosis of severe acid reflux. She began suffering from episodes of burning sensations that spread from her abdomen to her neck and arms, accompanied by weight loss, anxiety, and depression. Despite numerous medical interventions, including endoscopies and emergency care, relief remained elusive until a hormonal test revealed the true culprit—menopause.

Ms. Rafiq’s ordeal, shared with The Epoch Times, underlines a broader issue: “I was sure it was my hormones, but my doctor wasn’t convinced. I was so helpless and miserable,” she recalls. Her story is a reminder of the complexities surrounding menopause, spotlighting the difficulties women often encounter in being accurately diagnosed for non-traditional symptoms.

Menstruation’s End: A New Phase Begins

For many women, the thought of ending their monthly menstrual cycle seems like a welcome respite. Picture it—no more searching for a tampon or pad, waving goodbye to cramps, and bidding farewell to the infamous PMS (premenstrual syndrome) mood swings. It’s a vision of liberation—but the reality of menopause is often far more complex.

“Menopause isn’t just the cessation of periods. It’s a significant biological shift,” Dr. Holly Thacker, menopause expert and professor at Cleveland Clinic, told The Epoch Times. While it might mean the end of menstruation, it’s the beginning of something else—a phase where the body redefines itself in the absence of the reproductive hormones it’s relied on for so long. “You never go through it—you just enter it,” she shared.

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Menopause and its precursor, perimenopause, mark significant shifts in a woman’s body, characterized by the ovaries’ reduced production of estrogen and progesterone. These hormones are crucial not only for reproduction but also for overall health.

Dr. Wen Shen, director of the menopause consultation service at Johns Hopkins, emphasizes the extensive impact of estrogen on various bodily systems, including cardiovascular, skeletal, immune, gastrointestinal, and neurological functions.

“During menopause, the reduced production of estrogen and progesterone by the ovaries isn’t just about reproductive changes. It’s a whole-body experience. Estrogen’s decline can significantly affect everything from our heart health to brain function,” Dr. Shen told The Epoch Times.

A Spectrum of Symptoms

Navigating menopause can be a unique experience for every woman. For most, the telltale signs begin in perimenopause, the phase leading up to menopause. Within four to five years of entering menopause, around 80 percent of women notice their symptoms become mild or disappear-however, about 20 percent experience symptoms for a decade or more.

Vasomotor symptoms such as hot flashes, night sweats, and sleep disturbances are the most prevalent symptoms of menopause, impacting up to three-quarters of women. These particular symptoms frequently lead women to seek medical advice, and they typically persist for an average of 7.4 years.

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Beyond hot flashes, close to two-thirds of women report genitourinary syndrome of menopause, which affects the vaginal area and urinary system. Other common symptoms include heart palpitations, headaches, fatigue, insomnia, and breast tenderness.

The psychological impacts are just as varied, including irritability, mood swings, and a decrease in self-confidence. It’s a complex mix that underscores why menopause is more than just the end of a menstrual cycle—it’s a significant change affecting various aspects of health and well-being.

11 Lesser Known Symptoms of Menopause

1. Sensation of Crawling Bugs on Skin

Menopause might make your skin crawl, quite literally for some. In one study, more than 10 percent of women reported experiencing formication during menopause—a peculiar sensation that feels like ants or bugs crawling on or under the skin.

Menopause often brings significant changes in skin health, with 64 percent of women reporting skin changes during this time. A decline in estrogen production means less sebum, the skin’s natural oil, resulting in increased dryness and itchiness. Consequently, skin becomes more fragile, loses elasticity, and grows more sensitive during menopause.

2. Burning Mouth Syndrome

Burning mouth syndrome (BMS) affects up to a third of menopausal women, manifesting as a persistent burn on the tongue, lips, or throughout the mouth. This condition often occurs without any visible oral health problems.

Doctors typically diagnose BMS after ruling out other conditions. Ongoing research suggests that deficiencies in key vitamins such as B12, D, iron, and folic acid may be contributing factors.

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Menopause sometimes introduces other oral health issues. Changes in taste, such as a bitter or metallic flavor, are common, along with increased gum sensitivity and dental discomfort.

3. Hair Loss (and Gain)

Finding hair on your “chinny chin chin?” You’re not alone. Menopause can increase hair growth in unexpected areas, a condition known as hirsutism. This includes hair growth on the chin, upper lip, chest, back, and abdomen. The cause of this is a relative increase in androgens, or male hormones, during this life stage.

While hair may grow in unexpected places, it may thin in others. Research shows that up to half of menopausal women experience hair thinning, a condition medically called female pattern hair loss. Lowered estrogen levels may also lead to hair loss on the legs, arms, and pubic area.

4. Electric Shock Sensations

Feeling zapped? Menopause might be to blame. Some women undergoing menopause report experiencing electric shock sensations in their bodies. These sudden, sharp zaps, primarily felt in the head or extremities, are thought to be connected to the hormonal rollercoaster that is menopause. These shock sensations may either accompany a hot flash or occur independently.

“These are part of the vasomotor phenomenon that affects the central and peripheral nervous system. Some women have skin hypersensitivity and don’t like to be touched. Others describe electric-like shocks before flashing,” explains Dr. Thacker.

5. Aches and Pains

Research indicates that up to 71 percent of women post-menopause suffer from muscle aches and joint pain, often misidentified as a sign of aging. This discomfort is linked to declining estrogen levels, which have a protective role in joint health and bone density. Lower estrogen can lead to swollen, painful joints and an increased risk of osteoporosis, characterized by weakened, brittle bones.

Additionally, fluctuations in estrogen can exacerbate joint inflammation, often resulting in osteoarthritis. Given the complexity of these conditions, experts advise menopausal women to seek medical guidance for tailored treatment options.

6. Changes in Body Odor

As menopause approaches, many women experience a subtle yet noticeable change in body odor. This shift is partly due to altered olfactory senses during perimenopause, making one’s own scent seem more intense.

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More notably, increased sweating from hot flashes and night sweats can intensify underarm odor by promoting bacterial growth. The hormonal changes of menopause, especially reduced estrogen and increased testosterone, also affect sweat production and its composition, further altering body odor.

7. Phantom Periods

As if the menopausal journey wasn’t perplexing enough, many women encounter what are known as “phantom periods.” Imagine the usual suspects of a menstrual cycle—abdominal cramps, fatigue, breast tenderness—but without any actual bleeding.

This occurrence is tied to the erratic hormonal fluctuations during menopause. Even though the menstrual cycle ceases, the body still reacts to changing levels of estrogen and progesterone, often mimicking premenstrual symptoms.

8. Cold Flashes

While hot flashes are a well-known hallmark of menopause, their less discussed counterpart, cold flashes, can be just as impactful. Cold flashes are a surprising symptom that many women experience during menopause, characterized by sudden chills or feelings of intense coldness, often accompanied by shivering.

These episodes, occurring alone or alongside hot flashes, introduce unpredictability to menopause. Hormonal fluctuations, particularly the decline in estrogen, disrupt the body’s internal thermostat, causing these dramatic temperature shifts. Cold flashes can significantly impact sleep and daily routines, extending beyond mere physical discomfort.

9. Visual changes

If you find yourself squinting a bit more at the fine print, it may be more than aging eyes. Menopause often ushers in vision and eye health changes. Dry eyes, a common complaint, emerge as estrogen levels, which influence tear production, wane. This can lead to discomfort, a gritty sensation in the eyes, and sometimes even blurred vision.

But it’s not just dryness. Many women report temporary shifts in their vision clarity, experiencing moments of blurriness that can come and go unpredictably. While often temporary, these changes can be a source of frustration, affecting everyday tasks like reading or computer work. Eye care professionals emphasize the importance of regular check-ups during this time, as timely interventions can help manage these symptoms effectively.

10. Feeling Off Balance

Menopause can unexpectedly tip the scales on a woman’s sense of balance, introducing sensations of dizziness or equilibrium-related challenges. Women may feel unsteady or dizzy, symptoms that can arise without warning and disrupt daily life.

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The root of these balance issues is believed to be the hormonal fluctuations that can impact the inner ear—a key player in maintaining balance. Additionally, other menopausal symptoms like hot flashes, sleep disturbances, and vision changes can indirectly contribute to a sense of dizziness or instability.

11. Forgetfulness

If you’ve recently forgotten Uncle Joe’s birthday or where you left your keys, menopause might be playing a role. Alongside the well-known physical symptoms, menopause often ushers in subtle yet significant cognitive changes. Women traversing this life stage frequently report moments of forgetfulness, challenges in maintaining focus, and a general feeling of being less mentally sharp.

The fluctuation and eventual decrease in estrogen levels during menopause are thought to play a key role in these mental changes. Estrogen influences brain functions, including memory and concentration. Therefore, a decline in this hormone can have a tangible impact on cognitive abilities.

The Educational Void in Menopause Awareness

Ms. Rafiq’s experience highlights a significant gap in menopause education, revealing a lack of comprehensive understanding among both health care providers and women themselves.

Dr. Thacker highlights this oversight, noting, “Most women are educated on menstruation, contraception, childbearing, and lactation but then just stop investigating the female lifecycle. Not sure if it’s cultural or the focus only on younger women. It’s still a mystery to me why more women aren’t interested and proactive about this part of their life.”

Health experts also warn against the common oversimplification that attributes all health issues during menopause solely to this phase. Menopause is not necessarily the root cause of every symptom, as hormonal changes can vary widely. This understanding calls for a careful evaluation of health concerns in menopausal women to ensure they are not hastily labeled as menopause-related without proper investigation.

Menopause represents not just a phase of coping with symptoms but an opportunity for education and empowerment. By filling the knowledge gap and providing comprehensive information about menopause, we can transform its perception and management, enabling women to make more informed decisions about their health during this pivotal stage of life.