Hot flushes, night sweats, insomnia and mood swings are the most well-known symptoms of menopause. But did you know that officially there are 42 symptoms in all?

Some of the symptoms you may already know about:

• hot flushes
• irregular periods
• night sweats
• problems sleeping
• weight gain
• mood changes

The hormonal upheaval can also cause everything from:

• thinning hair
• dry eyes
• tinnitus
• thyroid problems
• gut disorders such as bloating and diarrhoea
• joint and muscle pain
• urinary tract infections
• incontinence
• heart palpitations
• loss of sex drive
• a creepy crawly sensation under the skin (known as formication)
• anxiety
• brain fog, and memory problems. Other symptoms can include toothache and gum problems, burning tongue, vulval pain, painful sex
• constipation
• a change in body odour
• thyroid problems

No wonder women often feel they are falling apart or losing it. 

“What often happens is that because the symptoms are so wide ranging,” Dr Arif explains, “women don’t connect them with the menopause and don’t seek medical help. Or if they do, some GPs don’t make the connection with the menopause either, and they’ll end up being referred to multiple specialists for individual symptoms.”

Will I recognise menopause symptoms? Well…

Haitham Hamoda, a consultant gynecologist, clinical lead for London King’s College Hospital menopause service, and chairman of the British Menopause Society, agrees. “If a woman has hot flushes and night sweats she will recognise them as menopause symptoms,” he says. Other symptoms, however, might slip under the radar or be misdiagnosed: “if she is forgetting things and doesn’t have other menopause symptoms, she may worry she is developing dementia.” Sadly, he says, he hears this day in and day out.  

“Those symptoms may be caused by other medical conditions , of course, but hormone deficiencies may also be an explanation,” added Dr Arif. Oestrogen, the main female sex hormone, is a lubricant: it lubricates the brain, the backs of our eyes, blood vessels, the skin and everywhere else in the body that has oestrogen receptors. It is also needed to make collagen, the scaffolding structure that keeps the skin plump, and promotes the activity of bone-building cells called osteoclasts. When levels start to drop this can cause symptoms such as brain fog and memory problems, itchy eyes, dry skin and vagina, and the fragile bone condition osteoporosis. 

Low levels of testosterone may also cause loss of sex drive, and a drop in progesterone may cause headaches or migraines, vaginal dryness, and sore breasts as well as mood swings and anxiety. “Testosterone also drives energy, brain function, mental sharpness and muscle strength, so when levels fall this can have a dramatic effect,” says Tania Adib.