What are the first signs of menopause?

October 31, 2023

What are the first symptoms to expect when you start menopause?

Signs and symptoms of menopause in women and how to treat them.

Menopause typically starts between 45 and 55 for most women. The average age is around 51 when most women start but this can vary significantly from one person to the next. Women who start menopause before the age of 45 are referred to as having early or premature menopause, while other may experience it after their mid-50’s. What triggers this change in women can be based on genetics, lifestyle and other factors. Perimenopause which is the transition that includes irregular periods and other symptoms may being several years prior to menopause itself.

Menopause usually involves a variety of physical and emotional changes in women. Some of the more common signs/side effects may include:

Irregular menstrual cycles. A woman may notice her. Becoming unpredictable even after years of it being on an extremely predictable cycle.  

Hot flashes. The onset of intense waves of heat and sweating. Is another tell tale sign.  

Night sweats.  These are hot flashes that will occur during sleep and can cause an individual to wake up soaking wet.

Vaginal dryness.  A reduction and natural lubrication of the vaginal wall may cause discomfort during sex.

Reduced sex drive.   A lower libido and interest in sex is often seen in women starting menopause.

Sudden mood changes.  Emotional fluctuation and irritability, as well as depression may occur during perimenopause and menopause.

Disruption in sleep cycles. Disturbances in sleep, insomnia, and difficulty falling asleep are all common occurrences during menopause.

Lack of energy.  Often women complain of feeling tired, being fatigued, and just overall feeling g run down.

Unwanted weight gain. Often hormone fluctuations can lead to changes in metabolism, and lead to weight fluctuations in women.  Losing weight MAY help to alleviate the other symptoms somewhat but this can be a cycle that influences and exacerbates the other symptoms.

Changes in skin and hair. Skin changes and thinning hair in both volume and thickness of hair. Strands may occur.

Concentration and memory loss.  Some women complain of having difficulty with cognitive functioning. It’s often referred to as brain fog in men and is a similar symptom for women starting menopause  

Granted, not every woman will experience every single sign and symptom listed, and the severity will vary from one patient to the next. It’s extremely important to consult an experienced healthcare provider for guidance and help in managing when undergoing menopause.   This change can be confusing and scary for women, but it is completely normal, and something that can potentially be managed.

Options for treating menopausal symptoms will vary, depending on the individuals needs and desires. There are lots of approaches that one can take. Here are some of the more common ones.

Hormone replacement therapy, or HRT.  Some women will choose bio, identical, hormone replacement therapy, which can involve taking testosterone, estrogen or progesterone to replace hormones lost during menopause.  Depending on your symptoms, these medications often distributed by pharmacies in capsule or gel/cream form may be able to help alleviate some of the unwanted signs and symptoms like hot flashes, vaginal, dryness, etc. It’s important to know that HRT is not suitable for all females, and there may be associated risks involved, so it’s extremely important to discuss all of the Benefits as well as potential side effects of HRT with a licensed and experienced healthcare provider.

Non-hormonal medication. Some non-hormone based prescription medication, like SSRI’s, which are selective serotonin, reuptake, inhibitors, or SNRI’s which are serotonin-norepinephrine reuptake inhibitors, may be able to help manage. Both mood swings and hot flashes for women suffering from menopause symptoms.  

Vaginal estrogen. When women are experiencing vaginal dryness and discomfort during sex, topical estrogen treatment in the form of creams/gels, rings, tablets are available and present a lower risk of systemic effects compared with oral HRT treatments.  

Modification of lifestyle. Clearly, it’s important and maintaining a healthy lifestyle and doing so during menopause may help manage the signs and symptoms. This may include regular exercise, a well, balanced, healthy diet, learning techniques to reduce stress and making sure to get enough sleep every night.  

Herbal supplementation.  Some women may find relief from herbal remedies. Some examples are black, cohosh, evening, primrose, oil, or soy isoflavones.  It should be mentioned that most of the statements made by the manufacturer of these supplements on the market will have not been evaluated by the FDA, so proceed with extreme caution, and obviously speak with your physician before starting any type of treatment.

CBT or cognitive behavioral therapy may also help to manage mood swings and emotional symptoms that can often come with menopause.  It’s extremely difficult in maintaining composure and managing mood, anger and stress however, there’s plenty of evidence that suggests having a positive approach when these situations arise may help to battle the symptoms in a healthy, non-medicinal way.

Supportive therapy.  Activities like yoga, exercise or meditation may help alleviate some symptoms and help to improve a patient overall health and well-being. Some patients have even reported like massage and acupuncture has been beneficial.  

Everyone is unique, and it’s important to have an individualized approach that works best for you.

It’s extremely important to consult with the healthcare provider to talk about your unique signs and symptoms. Discussing your past medical history, individual preferences are important when considering the various treatment options available for menopause relief. An experienced physician will be able to provide personalized recommendations, as well as guidance, and the necessary follow-up to help you get through what may be considered a difficult stage in your life.


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This subsequent lab panel is necessary for males undergoing Testosterone Replacement Therapy (TRT) through NovaGenix Health and Wellness. It allows physicians to assess the patient's response to prescribed medications, covering sex hormone levels, thyroid function, adrenal health, hematocrit, and liver and kidney function. The panel includes tests such as:

  • Complete Blood Count
  • Comprehensive Metabolic Panel
  • Testosterone (Free and Total)
  • Estradiol Sensitive
  • Thyroid Stimulating Hormone
  • Prostate Specific Antigen

Each test serves a specific purpose in monitoring overall health and treatment effectiveness. When required, Dr Mackey may require LH and FSH (Luteinizing hormone, follicle stimulating hormone) SHBG (Sex hormone binding globulin) or any other tests which may be important for your health and optimizing your hormones.

The Comprehensive Hormone and Wellness Panel for Women offers a foundational assessment of sex hormones, thyroid function, adrenal health, metabolic activity, and overall well-being. This panel serves as a diagnostic tool for identifying testosterone and estrogen deficiencies, assessing health risks, and detecting potential thyroid issues before considering hormone replacement therapy. Additionally, it includes insights into hematocrit (red blood cell volume), as well as liver and kidney function. The panel encompasses various tests such as:

  • Complete Blood Count (CBC)
  • Complete Metabolic Panel
  • Testosterone (free and total)
  • Estradiol
  • Thyroid Stimulating Hormone (TSH)
  • Progesterone

When indicated, Dr. Mackey may require additional tests such as Follicle Stimulating Hormone (FSH), and IGF-1 and Cortisol.

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