2. Symptoms

Decreased estrogen levels generate various symptoms associated with pre-menopause and menopause. Certainly, all women do not necessarily experience the same symptoms, and the intensity of these symptoms can vary. But they can be annoying, to the point of interfering with quality of life.
Hot flushes and night sweats
These are the unpleasant symptoms most often mentioned by women. Hot flushes sometimes start during the premenopause.
About 70% of menopausal women complain of them. They consist of a feeling of heat occurring quickly, spreading through the whole or part of the body, often with perspiration. They may occur during the day or night and, in the latter case, they disturb sleep. They can sometimes be seen by people in the vicinity, which is extremely embarrassing.
They occur entirely at random and vary from one woman to another. Some women experience one or two hot flushes per week. In others, they occur several times an hour, becoming a real handicap.
On average, this goes on for 3 years, then diminishes and disappears in 5 to 8 years. Unfortunately, some women have to endure these hot flushes for several decades. This is often the reason for first seeing a doctor about the menopause. Several factors, including stress, fatigue, drinking alcohol and coffee, and smoking, aggravate the condition.
Why do hot flushes occur?

The hypothalamus, a small area of the brain that controls body temperature, reacts to the decrease of estrogens by a mechanism that is not wholly understood. The hypothalamus reacts as if the body were overheating : it orders the central nervous system to disperse the assumed excess heat by dilating the peripheral vessels and activating the sebaceous glands. These measures may increase skin temperature by 2.5°C.

Vaginal Dryness
For every one in two women, the problem of vaginal dryness arises in menopause. As well as making sexual relations painful, vaginal dryness can also promote mycoses, infections linked to fungi.

Irritability and Sleep Problems
40% of menopausal women complain of insomnia, fatigue, and stress. Even though hormonal changes do have a role to play in disturbing mood and sleep, social context should not be ignored. Actually, in a woman's fifties, numerous events take place that can disrupt emotional balance. For example, children leave the family home, just as their parents begin to have more and more health problems.

Less supple skin
Several factors are involved in skin quality. The decrease in estrogens leaves the field open to the male hormones secreted by the suprarenal glands. This explains the possible hair loss from the forehead and the appearance of hairs, especially on the upper lip. The skin itself loses its elasticity. Lines and wrinkles form. Darker or white patches appear.

Information on menopause is taken from the book The New Menopause by Dr Michèle Serrand, published by Éditions Alpen.