Women’s experiences of symptoms of early menopause – Part 1

Early menopause (EM) is marked by the absence of menstrual periods, which may or may not be associated with menopausal symptoms such as hot flushes and/or night sweats (vasomotor symptoms), vaginal dryness, loss of libido and/or incontinence (genitourinary symptoms), mood changes, sleep disturbance, fatigue, and cognitive difficulties. Symptoms vary between women, by cause of EM, and over time. Women who experience surgical menopause (bilateral oophorectomy or hysterectomy with oophorectomy) often experience more severe symptoms (see also Symptoms of early menopause (Health Practitioners’ perspectives)). To learn about treatments that have been shown to be effective for EM symptoms (including Hormone Replacement Therapy (HRT) and selected non-hormonal medications), and complementary medicines and alternative therapies or lifestyle changes that some women find helpful, see ‘Further Information’ at the end of this Talking Point.

This Talking Point covers women’s experiences of vasomotor and genitourinary symptoms. For information on mood changes, sleep disturbance, fatigue, cognitive difficulties, and the absence of menstrual periods please see Women’s experiences of symptoms of early menopause – Part 2.

Hot flushes and night sweats

Most of the women we talked with described experiencing ‘vasomotor symptoms’ – hot flushes and/or night sweats. Together with their menstrual periods changing or stopping, hot flushes and/or night sweats were often one of the first ‘signs’ of spontaneous EM (see Early signs and symptoms of spontaneous early menopause) or symptoms of medically-induced EM. Some women experienced both hot flushes during the day and at night (night sweats), while for others hot flushes during the day were worse than night sweats or vice versa.

Maree compared the night sweats and daytime hot flushes she experienced as a result of medically-induced EM.

Women varied in how severe they found hot flushes and/or night sweats. Some found them very challenging, describing them as ‘debilitating’, ‘out of control’, or ‘terrible’. Other women who found them less intense described them as ‘manageable’, ‘annoying’ or ‘tedious.’ One woman, Tracey, began taking HRT the day after having a risk-reducing BSO and didn’t have ‘any issues with any menopause-type symptoms.’

Naomi’s night sweats and hot flushes weren’t ‘too bad’.

Several women talked about the emotional aspects of hot flushes. On the one hand, feeling stressed or upset could make hot flushes worse; on the other, hot flushes could trigger distressing emotions such as anxiety or sadness. As Alex said, ‘hot flushes remind me that I’m in menopause and not a fertile 32-year-old woman anymore. So there’s a little bit of an emotional sadness sometimes with a hot flush.’

Lydia found that stress or anxiety could trigger a hot flush. 

Vaginal dryness, loss of libido, and bladder problems

Vaginal dryness was mentioned by many women as a symptom of EM, along with a loss of interest in sex, or problems with continence. Health practitioners have grouped these symptoms under the title ‘genitourinary syndrome of menopause’ (GSM). Some women saw vaginal dryness as a problem mainly in the context of heterosexual relationships, including Linda: ‘I was celibate for so long [before meeting my partner], so vaginal dryness wasn’t an issue really then.’ However, others found vaginal dryness difficult whether or not they were sexually active.

Jenni, who experienced spontaneous EM, suffered from vaginal dryness and incontinence.

Night sweats and bladder control problems were the first symptoms of spontaneous early menopause for Maddy.

For women in relationships, loss of libido and vaginal dryness could be very challenging (see Intimacy, sex and dating after early menopause). Sylvia, who was in a heterosexual relationship, described her experience of the impacts of surgical menopause: ‘My relationship has definitely suffered. My confidence as a female has suffered. From a sexual perspective there is just no drive at all.’ Some women had, as Anna said, opted for ‘less sex overall,’ while others were trying to work through this with their partners.

Maree described the impact of vaginal dryness on intimacy with her partner.

Further information:

Talking Points (Women)

Talking Points (Health Practitioners)

Other resources