Abnormal Bleeding During Menopause 

What’s going on?
Hormonal rollercoasters during perimenopause and menopause can mess with your cycle. As your ovaries slow down, your lining (endometrium) can thicken or shed wildly—leading to heavy periods, spotting out of the blue, or bleeding after sex. Less commonly, things like fibroids, polyps, or in very rare cases, endometrial cancer can be the culprit. And any bleeding after a year of no periods definitely isn’t normal 

Feeling Anxious During Menopause 

What’s going on?
Anxiety during perimenopause or menopause is super common—it can hit you like a sudden wave of nervousness or build slowly until you're feeling edgy all the time. It might be from hormone changes, like falling oestrogen messing with your serotonin and stress hormones, or simply from sleepless nights and pesky hot flushes making everything feel ten times worse 

Bleeding After Sex During Menopause 

Why it might happen:
A bit of bleeding during or after sex isn’t your period—but it shouldn’t happen often. During perimenopause or menopause, falling oestrogen can thin and dry out the vaginal tissue (a bit like atrophic vaginitis), making it more fragile. That means it might tear or bleed a little, especially during sex—even if you don’t really feel dry or sore. 

Feeling Bloated or Gassy Through Menopause

What’s happening?
During perimenopause and menopause, your hormones (especially oestrogen and progesterone) start doing a funky dance, which can slow down digestion and make you retain water—hello bloating and puffiness!

Plus, as we get older, our metabolism and gut muscles ease off, stress creeps in, and our diet might change—it all adds up to a bit of bloat.

Burning‑Tongue Syndrome during Menopause

What’s happening?

Burning‑tongue syndrome, often classified under the broader term burning mouth syndrome (BMS), is commonly encountered in perimenopausal and postmenopausal women. It is characterised by a persistent burning, tingling or scalding sensation on the tongue—and sometimes the lips, gums, palate or throat—without visible oral abnormalities or underlying dental causes.

Chronic Pruritus or Itchy Skin in Menopause

What’s happening?

Itchy skin—medically termed pruritus—is a frequently overlooked yet distressing feature of the perimenopausal and postmenopausal transition. Declining oestrogen levels lead to diminished collagen and sebum production, weakening the skin barrier, increasing water loss, and rendering the skin dry, thin, fragile, and hypersensitive

Changes in Vaginal Discharge During Perimenopause and Menopause

What’s happening?
As women transition through perimenopause into menopause, declining oestrogen levels can cause notable alterations in vaginal discharge. Oestrogen supports the health and lubrication of vaginal tissues; as its levels fall, the tissues may become thinner, drier and less elastic, and the vaginal pH may rise—thus increasing susceptibility to irritation or infection.

Labial Changes in Perimenopause and Menopause

What’s happening?

As oestrogen levels decline during the menopause transition, the tissues of the vulva—including the labia majora and labia minora—may undergo noticeable changes. Reduced oestrogen leads to thinning, decreased elasticity, and loss of collagen and fatty tissue, resulting in tissue shrinkage, increased sensitivity, dryness, and altered appearance.

Loss of Confidence & Self‑Esteem in Menopause

What’s happening?

Many women experience a decline in confidence and self-esteem during perimenopause and menopause. This often arises from hormonal shifts—particularly falling oestrogen and, in some cases, testosterone—that affect mood, cognition, and emotional resilience. Concurrent life stressors such as career transitions, ageing, relational changes or caregiving responsibilities may amplify the impact

Loss of Energy & Fatigue During Perimenopause and Menopause

What’s happening?
Loss of energy and fatigue are among the most persistent and debilitating symptoms during perimenopause and menopause. They result from hormonal shifts—particularly declining oestrogen and progesterone—that disrupt sleep, metabolism and mood. Secondary symptoms such as hot flushes, night sweats, mood swings, brain fog and reduced muscle mass often compound tiredness. 

Low Mood in Perimenopause and Menopause

What's happening?

Low mood—including sadness, irritability, anxiety, and emotional instability—is a prevalent experience during perimenopause and menopause. These mood changes stem from fluctuating and falling oestrogen and progesterone levels, which affect neurotransmitters like serotonin and increase stress hormone (cortisol) levels, all of which may impair emotional regulation. 

Mood Swings in Menopause

What’s happening?

Women experiencing mood swings during menopause may notice:

• Sudden and unpredictable shifts in mood, such as feeling happy one moment and tearful or irritable the next
• Increased irritability or sensitivity to stress
• Feelings of sadness or depression that come and go
• Heightened anxiety or nervousness
• Low motivation or lack of interest in activities that once brought joy
• Emotional outbursts or a tendency to feel overwhelmed easily

Pain During Sex During Perimenopause and Menopause

What’s happening?
Several factors contribute to this condition:

• Vaginal Dryness: Decreased oestrogen levels can lead to reduced natural lubrication, causing friction and discomfort during intercourse.
• Vaginal Atrophy (Genitourinary Syndrome of Menopause): Thinning and inflammation of the vaginal walls can make sexual activity painful .
• Decreased Blood Flow: Reduced circulation to the vaginal area can affect tissue health and sensitivity.
• Psychological Factors: Anxiety, stress, or previous painful experiences can exacerbate discomfort.
• Pelvic Floor Dysfunction: Weak or tight pelvic floor muscles can contribute to pain during sex .

Night Sweats in Perimenopause and Menopause

What's happening?

Night sweats are characterized by:

• Sudden, intense sweating during sleep
• Soaking of clothing and bed sheets
• Waking up feeling hot and uncomfortable
• Chills or feeling cold after the sweating episode
• Difficulty falling back asleep due to discomfort
• Accompanying symptoms like flushing or increased heart rate
  

Memory Changes in Menopause

What’s happening?

Many women experience memory lapses, concentration difficulties, verbal retrieval problems, and a general slowing of thought—commonly referred to as “brain fog.” These cognitive symptoms often emerge during perimenopause due to declining oestrogen levels, disrupted sleep, stress, and metabolic shifts affecting brain function. Although distressing, these changes are usually temporary, with improvement often occurring post-menopause.