1. Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling
2. Bouts of rapid heart beat
3. Irritability
4. Mood swings, sudden tears
5. Trouble sleeping through the night (with or without night sweats)
6. Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles
7. Loss of libido (see note)
8. Dry vagina (see note)
9. Crashing fatigue
10. Anxiety, feeling ill at ease
11. Feelings of dread, apprehension, doom (see note)
12. Difficulty concentrating, disorientation, mental confusion
13. Disturbing memory lapses
14. Incontinence, especially upon sneezing, laughing; urge incontinence (see note)
15. Itchy, crawly skin (see note)
16. Aching, sore joints, muscles and tendons (see note)
17. Increased tension in muscles
18. Breast tenderness
19. Headache change: increase or decrease
20. Gastrointestinal distress, indigestion, flatulence, gas pain, nausea
21. Sudden bouts of bloat
22. Depression (see note)
23. Exacerbation of existing conditions
24. Increase in allergies
25. Weight gain (see note)
26. Hair loss or thinning, head, pubic, or whole body; increase in facial hair
27. Dizziness, light-headedness, episodes of loss of balance
28. Changes in body odor
29. Electric shock sensation under the skin and in the head (see note)
30. Tingling in the extremities, (see note)
31. Gum problems, increased bleeding
32. Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor
33. Osteoporosis (after several years)
34. Changes in fingernails: softer, crack or break easier

NOTES:

Symptom 1 (flashes): Hot flashes are due to the hypothalamic response to declining ovarian estrogen production. The declining estrogen state induces hypophysiotropic neurons in the arcuate nucleas of the hypothalamus to release gonadotropin-releasing hormone (GnRH) in a pulsatile fashion, which in turn stimulates release of luteinizing hormone (LH). Extremely high pulses of LH occur during the period of declining estrogen production. The LH has vasodilatory effects, which leads to flushing.

Symptom 7 (loss of libido): For some women the loss is so great that they actually find sex repulsive, in much the same way as they felt before puberty. What hormones give, loss of hormones can take away.

Symptom 8 (dry vagina): results in painful intercourse

Symptom 11 (doom thoughts): includes thoughts of death, picturing one's own death

Symptom 14 (incontinence): reflects a general loss of smooth muscle tone

Symptom 15 (itchy, crawly skin): feeling of ants crawling under the skin, not just dry itchy skin

Symptom 16 (aching, sore joints): may include such problems as carpal tunnel syndrome

Symptom 22 (depression): different from other depression, the inability to cope is overwhelming. There is a feeling of loss of self. Hormone therapy ameliorates the depression dramatically.

Symptom 25 (weight gain): often around the waist and thighs, resulting in 'the disappearing waistline'

Symptom 29 (shock sensation): "the feeling of a rubber band snapping in the layer of tissue between skin and muscle. It is a precursor to a hot flash"

Symptom 30 (tingling in extremities): can also be a symptom of B-12 deficiency, diabetes, alterations in the flexibility of blood vessels, or a depletion of potassium or calcium