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10 surprising menopause symptoms

From cold flushes to burning mouth, all about lesser-known menopause symptoms

Most of us will have heard of hot flushes – in fact, hot flushes and night sweats affect around 80% of women during the perimenopause and menopause.

But what other symptoms can falling hormones during the perimenopause and menopause bring?

Here we look at 10 surprising symptoms of the menopause – and the science behind why they happen.

And don’t forget, you can download the balance menopause support app to find out more about symptoms, and access a symptom tracker. For more information, click here

Cold flushes

A cold flush is a sudden chilly, tingling feeling that can come out of nowhere, or happen straight after a hot flush.

Like hot flushes, they can last for a few seconds or for several minutes.

The exact cause of hot and cold flushes isn’t known, but it is thought to be related to changing estrogen levels impacting on the areas of the brain involved in maintaining temperature.

Search for menopause symptoms and treatments in the balance menopause library 

Dry Eyes

Noticed that your eyes are feeling drier and grittier lately? It could be dry eye syndrome.

Every time you blink, your eyes release a tear film made up of water, oil and mucous that covers and lubricates your eyes.

When you don’t produce enough of this substance, your eyes can feel dry, as well as stinging, a gritty feeling (like you have something in your eye) or blurry vision.

This symptom can be a real nuisance, particularly if you spend a lot of time in front of a computer screen.

But why does it happen in the perimenopause and menopause?

As you get older, tear production decreases, but estrogen also plays a part in tear-film production.

Recent research also suggests that testosterone can help to manage the delicate balance of tear production, so fluctuating levels can also contribute to dry eyes [1].

Cold weather and wind can cause tears to evaporate too quickly and can make dry eyes worse.

You could try wraparound sunglasses to protect your eyes from the elements, particularly if you are out running or cycling.

Brittle nails

Take a look at your fingernails for a moment. Notice anything different?

Has their condition changed? Have they been more prone to breakage than before?

During the perimenopause and menopause, nails can become thin or soft, meaning they can split, crack or break more easily.

Why does this happen?

Your nails are made of a protein called keratin, which gives them structure and helps keep them hard and strong. The hormone estrogen helps to produce keratin, so when levels are lower, your nails may be more susceptible to breaking.

RELATED: Mental health and emotional wellbeing in the perimenopause and menopause booklet


Also known as acid reflux, heartburn is that horrible burning feeling in your chest and throat where stomach acid travels up into your oesophagus. This can leave an unpleasant taste in your mouth, give you bad breath and make you feel bloated and nauseous.

Common causes of heartburn include stress and being overweight, while alcohol and eating spicy and fatty foods can make symptoms worse or be the cause of heartburn in the first place.

But it can also occur during the perimenopause and menopause.

Fluctuating estrogen levels can alter the amount of acid the stomach produces. In addition, when you are feeling stressed, the body produces more of the hormone cortisol which can affect your digestion.

One study of 497 women found that 42% per cent of perimenopausal and 47% per cent of menopausal women suffered from heartburn [2].


You may have noticed intermittent periods of feeling dizzy, or light-headed, such as feeling a bit wobbly in the shower.

But why does it happen during the perimenopause and menopause?

Estrogen, progesterone and testosterone have an effect on the way your blood vessels widen and narrow, so when hormone levels fluctuate, this can trigger feelings of light-headedness, pressure and dizziness. These hormones can also affect the function of the balance areas of the brain and also the inner ear.

To be on the safe side, however, see a healthcare professional if you’ve had episodes of severe dizziness, fainting or palpitations to rule out any other underlying causes.

Altered sense of smell

During the perimenopause and menopause, you might find you can’t smell things as keenly as you used to, this sense might be heightened or there may even be certain smells – such as perfumes and cleaning products – you just can’t stand any more. This can then affect your sense of taste, too.

This is because fluctuating estrogen levels can affect the pathways in your brain that control your sense of smell and taste.

You might find that the changes only last for a few days, or longer.


Tinnitus is a constant ringing or humming sound in the ears. It is a complex condition involving many different parts of the auditory pathways and can be exacerbated by psychological events such as mood disorders, depression and stress.

Severity can really differ from person to person; I’ve had patients who are unable to sleep well or socialise because of tinnitus.

So why can it happen during the perimenopause and menopause?

There hasn’t been a lot of research on the impact of menopause on tinnitus and hearing loss.

You have estrogen receptors in the cells in your ear and along the auditory pathway, and low estrogen can affect the pathways from the ears to the brain.

RELATED: Hearing loss and tinnitus in the perimenopause and menopause

Burning mouth

Burning mouth is an uncomfortable sensation that can affect your tongue, gums, lips, inside of your cheeks, roof of your mouth – or even your whole mouth.

The burning sensation can be severe; patients have likened it to when you burn your tongue or palate on hot food or a hot drink.

So why can burning mouth happen during the perimenopause and menopause?

Estrogen is crucial in the healthy functioning of the supporting structures of your teeth, bones and ligaments, as well as the mucous membranes inside the mouth.

When hormone levels fall, this can have a direct impact on your oral health, triggering a range of issues, including burning mouth, dryness, gum disease and bad breath.

RELATED: Oral health and the menopause factsheet

Skin crawling and itchy skin

Have an itch that just won’t resolve itself?

It could be down to your perimenopause or menopause.

You might find yourself noticing more wrinkles and fine lines when you look in the mirror, or that the skin all over your body feels rougher, dry and even itchy.

As estrogen levels fall during the perimenopause and menopause, your skin becomes thinner and more water is lost, leading to more lines, a drier texture and, for some women, an itchy, uncomfortable feeling.

Another symptom that can occur in menopause is formication, which is the sensation of insects crawling on your skin.

RELATED: Skin changes during the menopause

Heart palpitations

A palpitation is a feeling that your heart is beating more intensely than usual, or irregularly.

Palpitations may last for a few seconds or a couple of minutes. They can coincide with a hot flush or a night sweat, a dizzy spell or happen on their own.

RELATED: Heart disease, perimenopause and menopause factsheet

Palpitations can be due to changing or declining levels of estrogen, which can affect the pathways in your heart through which electrical impulses travel.

They can feel quite alarming, but in most cases they aren’t a sign of a serious cardiac issue. However, you should see a healthcare professional if you are worried, or if your palpitations last for several minutes, are accompanied by shortness of breath or chest pain, or you notice they are becoming more severe and/or regular, or if they haven’t resolved within three months of starting HRT.


1. Peck, T. et al. (2017), ‘Dry eye syndrome in menopause and perimenopausal age group’, Journal of Mid – life Health, 8(2), pp. 51–4. doi:10.4103/jmh.JMH_41_17

Infantino, M, (2008), ‘The prevalence and pattern of gastroesophageal reflux symptoms in perimenopausal and menopausal women’, Journal of the American Academy of Nurse Practitioners, 20 (5), pp.266-72,

10 surprising menopause symptoms

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