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The Practical Guide to Menopause Symptoms

Updated: Apr 29

This article was written for

Awesome Woman philosophy: You can absolutely feel like your vibrant, balanced and, dare we say, awesome self during menopause. With a clever blend of modern science and ancient wisdom, symptom management is possible.

One quick note: While this guide will provide helpful insight, tips, and maybe even some aha moments, setting up a telehealth visit is important if you’re dealing with severe menopause symptoms. Our specially trained providers can collaborate with you, using the right tests and personalized remedies. Once you have all the fact-based info about your unique body, you can feel confident making the best decisions.

Symptoms and Solutions, from A to Z

Aches & Stiff Joints

Since estrogen receptors are all over your body, their decline can lead to aches and stiffness caused by inflammation and decades of wear and tear. However, you don’t have to stay on the pain train. Exercise and formal stretching (like yoga) will pump synovial fluid around your joints, keeping them loose and feeling groovy.

Bone Loss

By now, you’ve probably heard a lot about how essential estrogen is to life, and here’s another reason: it helps keep bones strong. As you get older, your body stops making estrogen, so bone loss is common in menopause—but not inevitable.

Lifting weights, doing resistance exercises, and eating green veggies and dairy products for calcium are ways to support your bones. Your body also needs healthy levels of vitamin D to properly absorb calcium, which you can get by spending about 15 minutes in the sun every day or taking a vitamin D supplement.

Brain Fog

Luckily, brain fog is just a short-term cognitive blip during this phase of life. Here are a few things you can do to bring back clarity:

  • Breath into the present. Train yourself to recognize when you’re distracted or shifting moods. Take a moment to breathe and refocus. When you need to take in new info, create a quiet moment to concentrate and process.

  • Trick and treat. Remember those memory tricks that helped you study in school? Time to dust them off again. Using mnemonic devices, making lists, and grouping things are all cool ways to work that memory muscle. Puzzles and word games are also great brain training tools.

  • Mindfully manage stress. Throughout the day, use the mental health resets on your AW dashboard for simple, quick ways to ease stress.

  • Be your own night in shining armor. Sleep is crucial to brain function. Read the Insomnia section below for tips on how to win the menopause sleep battle.

Frequent Urination

A decrease in estrogen can cause an increase in bathroom trips because it weakens the bladder and the urethra, the tube that carries urine out. This means you can pee your pants from laughing at something that’s just mildly funny—which isn’t fun at all. The medical term for this is “urinary atrophy.” The symptoms can include:

  • Leaking urine from coughing, jumping, or laughing

  • A strong urge to urinate

  • The loss of control before you reach the bathroom door

  • Waking up several times a night to wee

Simple things like reducing caffeine and doing Kegel exercises 3 times a day may help. Talk to a doctor about pessary devices, other bladder-training techniques, or even reconstructive surgery if you need more support. You don’t have to just live with leakage.

Hair Changes

Estrogen promotes hair density and growth. A decrease in estrogen and progesterone can create an increase in androgen hormones, responsible for facial and body hair. In women, androgens can cause the hair follicles on the head to shrink—leading to hair loss.

If your scalp is dry, use a gentle, moisturizing shampoo and wash it less frequently. If your scalp is oily, try washing it every day. Also, get your vitamins on. Vitamins A, B, C, D, iron, selenium, and zinc all help your hair stay healthy. Supplements like FILL IN HERE have also been shown to promote healthy hair.

Hormone shifts can increase the growth of facial hair on the upper lip or chin. The tried-and-true methods you’ve always used still work—tweeze, wax, repeat. You can also look into permanent treatments such as electrolysis and laser hair removal.

Hot Flashes & Night Sweats

While these are typical results of hormonal declines, here are a few tips for keeping your cool:

  • Carry a portable fan

  • Avoid spicy foods and caffeine

  • Dress in layers

  • Drink cold water throughout the day and before bedtime

  • Lower the room temperature if possible

If hot flashes are severe and causing you to avoid social events or other activities, talk to an AW provider. There are some very effective non-hormonal and hormonal medication options.


Sleep and hormones are directly related. During menopause, insomnia can insert its rude self into your night because your hormones are in flux. And insomnia can cause a domino effect, triggering weight gain, daytime fatigue, a weakened immune system, mood swings, and more.

Melatonin, anyone? A little help from our friend melatonin can be just what you need to get those Z's again. Melatonin also helps regulate estrogen levels and provides a powerful antioxidant to boost immunity. Synthetic melatonin comes in pill or gummy form, and your body naturally produces it.

To help with natural melanin production, turn off your TV, phone, tablet, and bright lights before bed. Scrolling social media or binging TV shows late at night keeps your mind spinning and messes with circadian rhythms. Tip: Charge your phone in the kitchen so you won't be tempted to look at it in bed.

Add in a little exercise for deep, relaxing sleep. Just 30 minutes of aerobic activity can help you sleep better and increase deep sleep, that time during the night where your brain and body really get a chance to rejuvenate. Bonus: Exercise also releases endorphins, making you feel calmer and happier during the day.

Irregular Periods

Once you stop having periods around the same time every month due to decreasing progesterone, you could be entering into perimenopause or the "menopause transition" stage. This marks the end of your reproductive years. It usually happens in your 40s, but some experience it as early as their late-30s. During this time, the level of estrogen falls and rises unevenly. This causes your cycles to shorten or lengthen as you stop ovulating (releasing an egg) every month on the reg like you used to.

During this time, you may experience some of the other menopausal systems mentioned in this guide, such as vaginal dryness and hot flashes. Once you have gone without a period for 12 consecutive months, you officially are in menopause. Any period-like bleeding after menopause is considered abnormal and should be discussed with a provider.

Low Sex Drive

Vaginal dryness, elevated risk of UTIs, and insomnia can make anyone say meh to sex, but don’t give up. Everyone, no matter your age, deserves a satisfying sex life.

During menopause, your estrogen and testosterone levels can take a nosedive, causing your arousal and interest in sex to drop with your hormones. However, similar to many other symptoms described, balancing out your hormones can result in you feeling hot again—in all the right places.

The vaginal microbiome test can point to imbalances that are linked to libido. If you suspect a hormonal imbalance is at play, talk to an AW provider about hormone testing. Additionally, supplements such as maca root have been shown to help with vaginal dryness and libido.

Our mind and body are intimately connected, mental health plays a big role in our sex lives. Have you stopped doing or wearing something that makes you feel sensual and beautiful? If so, start doing it again. Just because you hit a certain age doesn’t mean you have to stop doing what makes you feel voluptuous. Also, be open with your partner about the changes in your body and what feels good and doesn’t. It is time to mix it up. Adding in a water-based lube can help, and so can open and beautiful conversation. As always, we are here for you—just as you are. If you are feeling down, consider talking to an AW provider to create an action plan for shaking off the blues.


Female hormones and migraine headaches are linked, making women three times more likely to get migraines than men. Argh. Do you remember getting migraines right before your period? This is because your estrogen levels are at the lowest during the month. Once your body stops creating estrogen, your migraines will likely cycle out when your period ends for good. But you got important things to do today and a late-night ahead.

To mitigate migraines, it is time to play detective. Are they triggered by a lack of sleep, a particular type of food, stress, a strong candle? Still haven't found any clues? There are also several different prevention medicines and pain relievers during a migraine episode. These can be common OTC such as Tylenol or prescriptions like antidepressants or triptans.

All of this making giving you a headache from just thinking about it? Reach out to an AW provider today to collaborate and create solutions.

Mood Swings

Like you, we are all about honoring and holding space for our authentic feelings and emotions. However, menopause-induced mood swings are not always representations of what you really are feeling. Instead, expressions of rapid changes in hormones and all of the exasperating symptoms that could tag along. Hot flashes, itchy vaginas and vulvas, insomnia, brain fog can all make anyone at any time moody. No need for a longer explanation there.

However, it is important to talk with your doctor or one of our providers to help you determine if the emotions like irritability and sadness you are experiencing are linked strictly to menopause or a mix of depression and other mental health conditions. From menstruation to menopause and everything in between and beyond, you never have to do it all by yourself. You now have a community of awesome providers and women to help you through every step of the way throughout your whole vibrant life.

It may be easy to give into morning your pre-menopausal body or fear the changes ahead. In those moments, always remember your powerful highs, happy mediums, painful lows, and moments when you know life may not always be pretty, but it is absolutely beautiful. This is the same for every stage your body will naturally experience. Embrace all of your beauty.

Recurrent UTIs, Yeast & Bacterial Infections

A decrease in estrogen can alter the acidity of the vulva and vagina, making them more prone to infection from bacteria or yeast overgrowth. The thinning, dryness, and irritation of vaginal tissue, as well as incontinence (involuntary leakage) and difficulty emptying the bladder, can all elevate the risk of infections.

A few happy vagina practices can help you say bye to UTIs include:

  • Wiping front to back—wipes the bad away instead of back in

  • Peeing after sex—this may help flush harmful bacteria from the urethra

  • Ditching the douche—these can actually cause all sorts of infections

  • Let it breathe—wear loose clothing and go commando whenever possible since tight underwear and clothes trap discharge, sweat, and dead skin, leading to infections and odors

  • Take a probiotic to support a healthy, balanced vaginal microbiome

  • Only use plain water or a pH-balanced intimate cleanser for the skin outside your vagina, and never clean inside your vagina

Sagging & Dried Skin

Your strength and personal assistant collagen are literally holding it all together. Collagen is a protein that holds your body’s tissues together, and this protein decreases with estrogen. Massaging in your favorite facial oil or moisturizer stimulates your skin’s collagen production, so does taking collagen supplements or eating foods like bone broth.

Say bye to the dry because supple skin is still possible. During menopause, just make sure to amp up your home care routine. Moisturize-more-more-more! Use moisturizers that contain hyaluronic acid because they hold in water, keeping your skin supple. Serums and creams with antioxidants like vitamin C fight off free radicals and help with the aging game. To combat extra dry skin, take short and warm showers. Hot and long showers can strip your skin of natural oils, leaving your skin feeling parched and itchy. Lastly, lather up the lotions and potions when your skin is damp to better absorb the ingredients.

Vaginal Dryness, Pain & Itchiness

First, you are never too old to have sex, and it should never be painful. We are here to make your vagina feel aww-some again as sex helps you live a healthier and happier life. And we are talking about real happiness—from the oxytocin and DHEA released from orgasms.

As estrogen and ovarian hormones drop, the vulva tissues and the lining of the vagina become thinner, less elastic, and drier. All of which can result in saying boo to sex and awkward itchiness. Ekk! But have no fear—rejuvenation is here!

Just like you feel better after drinking iced tea to quiche your thirst on a hot day, a vaginal lubricant can do the same. Lube is a great fix for in the moment, but it does not address the root cause. Make sure to use only water-soluble products because oil-based, warming and flavored may actually increase irritation.

Need a longer-lasting solution? Vaginal moisturizers can bring longer-lasting moisture down there. You might have a special moisturizer for your face, hands, and legs…so give your vulva the same refreshing love.

Stayed tuned for the AW purpose-built vaginal moisturizer! No need for any type of dry spells in your life.

Weight Gain & Slowed Metabolism

Weight is something you do not have to gain during menopause or throughout the next chapters of your life. It isn’t inevitable—you are the captain of your ship. Maintaining a healthy weight will even decrease a multitude of other medical issues and menopause symptoms. Your body is scared—fuel it with purpose and love.

After menopause, your fat is stored differently than in your childbearing years. It switches from your thighs and hips to the abdomen. While hormonal changes play a small part in this, lifestyle changes mainly determine weight gain. For example, if you don’t get enough sleep, you are more likely to snack between meals for extra energy.

A Homage to Hormones

Before we get to specific symptoms, let’s talk hormones—special chemicals made by your glands that tell other parts of the body how and when to work. Bosses, like you. When your hormones are balanced—you are balanced. You’re at a decreased risk for many illnesses, and your vagina is happy. Inflammation levels are stabilized, hot flashes aren’t attacking you at the most inconvenient times, and your moods are manageable and pleasant. Life is good. And then menopause comes sweeping through, and your hormones go haywire. Luckily, there are biologically efficacious supplements that can provide balance to your body, mind, and soul—awesome.

We want to clearly state that you should never take any hormones before reviewing your hormone test results and creating a plan with one of our providers or a trusted doctor. Suggested tests include:

  • Estrogen (E1-estrone, E2-estradiol, and E3-estriol)

  • Progesterone

  • Vaginal microbiome

The Tale of Two Bioidentical Hormones

“Bioidentical” means the hormones in the product are chemically identical to those your body produces. They gently stimulate and replicate your body’s unique hormone balance. Currently, there are two types of bioidentical hormones: plant-based bioidentical hormone replacement therapy (BHRT) and traditional/synthetic hormone replacement therapy (HRT). They can come in pill, skin patch, vaginal inserts, cream, gel, or spray form and have helped millions of women restore balance during and post menopause.

Again, if you’re interested in BHRT or HRT, set up a visit with an AW provider.

It’s Only Temporary

Just think of all the obstacles you’ve overcome this far, all the seasons you’ve powered through. You are stronger, braver, and smarter than you may even know. Like the others you’ve gracefully conquered, the season of menopause symptoms is only temporary. Keep learning, respecting yourself, growing, and moving forward. You got this. And when you need a hand, AW is here to help.

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