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Your Guide to Menopause

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6 Symptoms Never to Ignore During Menopause

Medically Reviewed By William C. Lloyd III, MD, FACS
  • Menopause, when women produce less of the hormone estrogen and monthly periods stop as a normal part of aging, can be accompanied by an array of symptoms and signs. Some of them can be treated with home remedies, lifestyle changes, or prescription hormone therapy. However, menopausal changes increase your risk of some serious health conditions, so it’s important to know when it’s time to contact your gynecologist or healthcare provider about menopausal symptoms.

  • 1
    Pelvic pain during menopause
    woman with lower abdominal pain is holding her aching belly

    Menstrual cramps should stop with menopause. If you have not had a period in more than 12 months and experience cramping, talk to your gynecologist or healthcare provider. Endometriosis or fibroid tumors can cause pelvic pain after menopause, though they are more typically found in younger women. Cramping can also be due to gastrointestinal concerns, which your doctor can help you address. In some cases, pelvic pain may be a sign of uterine cancer, which is more common in older women. It is usually accompanied by other symptoms including bloating, bleeding or fatigue.

  • 2
    Painful intercourse after menopause
    senior woman with head pain

    After menopause, vaginal tissues become less elastic. During sex, you may initially feel sharp or burning pain at penetration followed by deeper pain. Infrequent sex can increase the discomfort. Over-the-counter vaginal lubricants can be used as often as needed, or you can try vaginal moisturizers, which you use every few days. If these remedies aren’t sufficient, ask your gynecologist about vaginal estrogen therapy, which comes in a cream, tablet or ring. There are also oral prescription medications including ospemifene (Osphena) that can help but may cause hot flashes and increase the risk of stroke, blood clots and uterine cancer.

  • 3
    Disruptive hot flashes and night sweats
    woman having night sweats and wearing tank top with sweat marks

    Researchers don’t know what causes hot flashes, but think they may be the result of changes to the area of the brain that regulates body temperature. The frequency and intensity vary from woman to woman. If hot flashes make daily life difficult, call your healthcare provider. Hormone replacement therapy can help, but make sure you understand the increased health risks, including heart attack or breast cancer. Certain antidepressants, high blood pressure drugs, and the drug gabapentin are also options. A supplement called S-equol may help, but if you have a family history of breast cancer, do not take it without consulting your doctor.

  • 4
    Vaginal bleeding after menopause
    woman handing sanitary pad to other woman in public toilet stall

    There are many reasons for vaginal bleeding after menopause, but it is always a signal to call your doctor. It may be from tears in the vaginal or uterine tissue, which thins and becomes more fragile after menopause, or it could be caused by uterine fibroids or polyps. Infections, medications including hormone therapy and tamoxifen, or endometriosis can also cause vaginal bleeding. It can also be a symptom of uterine cancer or, less commonly, cervical cancer, so don’t ignore vaginal bleeding after menopause. See your doctor to determine the cause and recommended treatment.

  • 5
    woman in public bathroom

    Lower estrogen levels can thin the lining of the urethra, the tube that carries urine from your body. Pelvic muscles also weaken with aging, so menopausal women may experience urinary incontinence. It may be just a few drops when you laugh, exercise, or cough, or it can be an urgent need to urinate. Talk to your doctor about lifestyle changes and treatments, including limiting alcohol and caffeine and strengthening your pelvic floor muscles with Kegel exercises. If these remedies don’t work, devices called pessaries can support your bladder, or various prescription medications treat incontinence. If necessary, surgery is also an option.

  • 6
    Vaginal itching, burning or irritation
    Woman indicating genital distress

    Menopause increases the chance of developing vulvovaginitis, inflammation of both the vagina and vulva. Before menopause, the vaginal tissues are acidic, but after menopause they become more alkaline, which makes women more likely to develop urinary tract infections. If you think you may have a UTI, call your doctor. Cool compresses dampened with a mild solution of baking soda and water can ease discomfort and itching. Use soft cloths and pat the area dry after applying compresses. Vaginal moisturizers and lubricants may help, as well as oral or topical vitamin E. Follow directions closely. Your doctor can also prescribe vaginal estrogen or, if necessary, hormone replacement therapy.

Was this helpful?
  1. Menopause Symptoms and Relief. Office on Women’s Health.
  2. Treatments and Solutions for Menopause Symptoms. North American Menopause Society.
  3. After Menopause, Vulvovaginal Troubles Are Common And Linked With Other Pelvic Problems. Bladder and Bowel Community.
  4. Bleeding after menopause: is it normal? Mayo Clinic.
  5. Women’s Wellness: Painful sex after menopause. Mayo Clinic.
  6. Menopause FAQs: Hot Flashes. The North American Menopause Society.
  7. What is S-Equol? Does It Really Work for Menopausal Symptoms? MGH Center for Women’s Mental Health.
  8. Urinary Incontinence. The North American Menopause Society.

Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 4
View All Your Guide to Menopause Articles
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