The Science Behind the Side Effects of Menopause

Most of us have some idea of what menopause entails, whether we've seen women going through mood swings and hot flashes or heard horror stories of more serious health ramifications.

But a lot of us still don't know about the science behind menopause.

We spoke to an expert to find out more about the side effects of menopause so you can know what to expect—and when—as your body prepares to slow down and stop its reproductive cycle.

An overview of menopause

Menopause is the process that occurs in people who menstruate when their reproductive cycle stops. Menopause is marked a year after the final period. Perimenopause refers to the period of time before menopause when the reproductive cycle slows down and hormone levels begin to lower. Postmenopause refers to the period that follows menopause.

The process of menopause can certainly take its toll on the body.

"Menopause can have a significant impact on a woman's quality of life and her ability to live and feel well," said Mahmud Kara, M.D., an internist and the founder of KaraMD, based in Cleveland.

Common side effects of menopause

Perimenopause brings with it a reduction in progesterone and estrogen levels.

"These changes in the body lead to some of the most common symptoms and issues that women struggle with during menopausal years," Kara said.

Hormones impact almost every system in the body, so these symptoms can appear almost anywhere in the body.

"Hormones impact just about everything in our body, including but not limited to metabolism, sleep, sex drive, blood sugar, energy levels and more," Kara said. "This means that any fluctuations in hormones, especially key hormones like estrogen, can interfere with just about every aspect of life."

Here are some of the main side effects that typically occur during perimenopause and menopause:

Sleep

As your hormone levels drop, you may experience changes in your sleep cycle. Some women experience difficulty sleeping or insomnia. According to the National Institute on Aging, menopausal symptoms such as mood changes and body temperature changes can contribute to sleep problems.

Sex drive

Many women notice changes in their sex drive during perimenopause, menopause and postmenopause.

As a 2000 review in the Permanente Journal noted, a reduced sex drive may be caused by changes to nerve response that lead to a slower orgasmic response, painful uterine contractions, decreased vaginal lubrication and mood changes, including depression.

According to a 2008 study, 26.7 percent of premenopausal women and 52.4 percent of menopausal women experience reduced libido.

Mood changes

As the hormone levels change during menopause, you may notice a wide range of emotional changes. As a 2019 paper reported, menopause and perimenopause can lead to higher levels of depression, stress, anxiety and emotional distress.

Moods can also become more erratic, also known as mood swings. According to the North American Menopause Society, roughly 23 percent of women experience mood swings during perimenopause or postmenopause.

Bladder issues

During the menopausal transition and menopause, some women find that their bladders change. According to a 2021 study, women in postmenopause are more likely to experience overactive bladder syndrome, while urinary incontinence symptoms also typically worsen with age.

Blood sugar levels

As your hormone levels change, your blood sugar levels also become more variable, which in turn makes diabetes and hot flashes more likely in women with menopause. This can also lead to changes and issues with metabolism and weight loss or weight gain.

Physical and mental fatigue

If you find your energy levels dropping after you hit menopause, you're not alone. In fact, over 85 percent of women report experiencing physical and/or mental fatigue after going through menopause. Fatigue is much less common in the lead-up to menopause, at only 19.7 percent. Many women even report cases of menopausal brain fog.

Heart disease

In some cases, menopause can put women at a higher risk of cardiovascular disease. As a 2021 review explained, this is due to the potential changes in weight and metabolism along with the changes in how fat is distributed in the body.

Osteoporosis and osteoarthritis

Many women experience joint pain during menopause, which may be caused by stress on the joints after weight gain. According to HSS (Hospital for Special Surgery), an academic medical center in New York City, there is a significant rise in cases of osteoarthritis in women older than 55. It has also been shown that 20 percent of bone loss occurs during menopause and postmenopause, increasing the likelihood of osteoporosis. By the age of 60, 1 in 10 women around the world have osteoporosis.

Managing the side effects of menopause

Menopause can cause a wide variety of unpredictable symptoms that range from being mildly frustrating to severe and debilitating.

"Certain issues, like bone loss and osteoporosis, can be dangerous when it comes to aging, falling and fractures," Kara said. "Furthermore, heart disease can be dangerous if certain lifestyle factors, like smoking or poor diet, are not addressed as women start to reach menopause."

Even the mild side effects should never simply be ignored or dismissed as "normal."

"In general, while some of the side effects or symptoms of menopause may not be considered dangerous, they are still important areas of health to address when it comes to treatment," Kara said.

While some symptoms of menopause can be treated or even avoided by making a few small lifestyle and diet changes, other side effects are typically treated with medication. However, each plan for managing the side effects of menopause looks slightly different, as everyone experiences the side effects slightly differently.

If you're experiencing symptoms as a result of menopause, speak to your doctor to find the best course of action for your unique case.