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November 2023

Beyond Hot Flashes: Other Symptoms of Menopause

The time leading up to a woman’s last period, called perimenopause, is filled with many changes. Some, like hot flashes, are well-known. Others may surprise you. Learn how to manage these lesser-known symptoms and feel better.

Bathroom blues

Do you find yourself racing to the restroom? Feel a little leak when laughing with friends? You are not alone. During perimenopause, estrogen levels begin to drop, weakening the urethra and leading to urinary incontinence in some women.

Self-care strategies.

To combat incontinence, strengthen the pelvic floor muscles, which support your bladder and uterus. Start by performing Kegel exercises—squeezing and relaxing the muscles you use to stop the stream of urine while peeing. In addition, avoid food and drinks high in acid or caffeine (think coffee, grapefruit, or tomatoes), which can irritate the bladder. If you are struggling with incontinence problems, a physical therapist who specializes in the pelvic floor can help.

Sabotaged sleep

Whether you wake up in the middle of the night or struggle to fall asleep, sleep problems are all too common in menopausal years. Yes, the stress and responsibilities of aging into the sandwich generation can sideline slumber. But shifting hormones also play a role. Other menopause symptoms (hello, hot flashes!) can interrupt sleep, too.

Self-care strategies.

To increase your z’s, take a walk or bike ride during the day. Exercise is one of the best things you can do for better sleep. Bonus: It may also help curb hot flashes. Then, focus on good sleep hygiene. Make sure your bedroom is dark and cool. Avoid looking at your phone or other screens close to bedtime. And create a relaxing nighttime routine, such as taking a bath or reading.

Tummy troubles

Feeling bloated or crampy? Hormonal changes related to menopause may be the cause. Decreases in estrogen and progesterone raise our body’s cortisol hormones. High cortisol levels can result in bloating, constipation, abdominal pain, and indigestion.

Self-care strategies.

Take steps to reduce your stress. Work with your healthcare provider to identify foods that trigger your digestive issues. See your provider right away if you experience unexplained weight loss or rectal bleeding.

Ringing in the ears

Whether it is ringing, roaring, hissing, or buzzing, if you hear a constant noise in one or both ears, you may have tinnitus. The condition is often associated with hearing loss or exposure to loud noises, but menopause may raise risk as well. Some experts point to changes in reproductive hormones that may affect the inner ear. Sleep issues common during menopause could also contribute.

Self-care strategies.

While tinnitus typically does not pose a danger to your health, it can be distressing and annoying. To help, focus on good sleep habits and talk with your provider about low-dose hormone replacement therapy, which has been shown to improve symptoms.


Up to 40% of women in perimenopause—and more than half of postmenopausal women—experience heart palpitations. The correlation between these fluttering, racing, or pounding feelings in the chest and menopause needs to be studied more, experts say.

Self-care strategies.

You can reduce heart palpitations by cutting back on caffeine and taking steps to manage stress. If you are concerned about palpitations, talk with your healthcare provider.

Moody matters

Studies show that a whopping 2 in every 3 women going through perimenopause may deal with cognitive issues such as memory problems and difficulty concentrating. Emotional issues like mood changes and anxiety are common, too. These symptoms can be caused by hormone fluctuations, other menopause symptoms, or a combination of both.

Self-care strategies.

Focus on self-care. In addition to eating a healthy diet, getting quality sleep, and exercising regularly, engage in activities like yoga, meditation, listening to music, reading or spending quiet time outside, which can reduce stress. Stay connected with family and friends.

Most important, be sure to share any new or troubling symptoms with your healthcare provider. They may recommend treatments or recognize signs of a more serious problem.


Date Last Reviewed: 8/1/2023
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