Her older sisters told her that her symptoms were just part of perimenopause. 

But she knew her excessive nighttime sweating, severe fatigue, and especially her unexplained weight loss were signs of something more serious. She persisted and eventually received a diagnosis: a rare form of cancer. 

After several rounds of chemo and a stem cell transplant, she’s back to thriving—because she knew her body and her symptoms.

Midlife can be as confusing and full of changes as adolescence. Your body is going to do things that don’t feel normal to you but are a natural part of perimenopause and menopause

Unless they aren’t.

Chances are, what you're experiencing is due to hormonal changes in perimenopause/menopause or to aging. But you know your body best, and if something feels more urgent, don't hesitate to take it to a qualified medical professional. Pay attention to what and how you’re feeling; you may want to take extra precautions with some menopause symptoms if you have a personal or family history of certain conditions or symptoms that come with other discomforts.

Talk to your doctor if you notice any of these red flags.

  1. Fractures before menopause.  If you’ve broken a few bones, or even just one, after age 50 and before menopause, you’re at greater risk for osteoporotic fractures after menopause, even after all other reasons for osteoporotic fractures (like maternal fracture history, bone mineral density, diet, and drug use) are ruled out. Talk to your doctor about preventative measures.
  2. Post-menopausal bleeding or discharge. Irregular, inconsistent bleeding or unusual or foul-smelling discharge should raise a red flag for people with uteruses at any point in their lives, but any bleeding or discharge after your periods stop in menopause is a major red flag; it could be a sign of uterine cancer. Your doctor may order some testing for you, including an ultrasound and biopsy.
  3. Weight gain, brain fog, fatigue, temperature regulation, and irregular periods if you have an autoimmune disease or family history of thyroid problems. Many of the symptoms of hypothyroidism can mimic the symptoms of perimenopause. The most common cause of hypothyroidism is Hashimoto’s disease, an autoimmune disorder that attacks the thyroid, which is why people with Type 1 diabetes or celiac disease especially should rule out Hashimoto’s. And, of course, if hypothyroidism runs in your family, you might want to talk to your doctor.
  4. You’ve had a major depressive episode prior to perimenopause. Fluctuating estrogen is enough to make anyone in menopause moody. But if you’ve had a major depressive episode in the past, you are 59% more likely to have another as you enter perimenopause. And if you haven’t, but are experiencing fatigue, headache, and a sense of prevailing sadness now that you’re in midlife, you may be depressed and not even realize it. Mental illness is no joke; talk to your doctor about your options before your mental health takes a downturn. There's no shame in it, and no shame in seeking help.
  5. Excessive sweating. Hot flashes are a normal part of menopause, but excessive sweating, especially nighttime sweating, can be a sign of something more serious, along the lines of heart attack or lymphoma. If you’re soaking through the bed sheets every night, especially if you also have unexpected and unintended weight loss, and/or a lump in your armpit, neck, or groin, talk to your doctor.
  6. Incontinence. 30-40% of women experience midlife incontinence, but feeling pressure on your bladder or sudden urges to urinate when you haven’t had them before could be a sign of ovarian cancer. Ovarian cancer in its early stages has few to no symptoms, and in the later stages can easily be mistaken for menopause symptoms. If you have just incontinence, chances are you're experiencing the normal issue that comes with estrogen withdrawal. However, if you're also experiencing bloating, quickly feeling full when eating, unintended weight loss, pelvic pain, changes in elimination (like constipation), and incontinence, make an appointment with your doctor. 
  7. Cognitive challenges that go beyond brain fog. Brain fog is a normal symptom of menopause. Mood fluctuations are a normal part of menopause. It’s not uncommon to forget where you put your keys every now and again or have a word right on the tip of your tongue. However, if you have trouble maintaining a conversation, regularly forget the month, year, or where you are, or can’t remember how to pay the bills, or if your friends and family begin to notice changes in your personality, see a doctor. It could be a sign of something more serious such as early-onset Alzheimer’s or dementia
  8. Headaches. If you’re someone who regularly suffers from headaches, the good news is that the prevalence of headaches tends to decrease in your 40s. The bad news is that headaches after menopause could be a sign of something more serious. If you didn’t have headaches before menopause or your headache is accompanied by fevers, chills, muscle aches, nausea, or weight loss, gets progressively worse, or hurts more when you stand up, call your doctor. But don’t let this stress you out: migraines and tension headaches are still the most common form of headache in midlife and beyond.
  9. Back pain. Pain is never a good thing, though we often see back pain as a normal part of getting older. Sitting too much, poor posture during exercise, and even your mattress can all contribute to spinal aches. But when the pain is localized or acute, you might want to get it checked out, especially if you have osteoporosis or a family history of cancer. If your pain gets worse at night, while you lie in bed, or when you take a deep breath, or occurs without activity, talk to your doctor—especially if you have a cough, unexplained weight loss, fatigue, or begin to cough up blood. 25% of lung cancer patients report mid to upper back pain before being diagnosed. Lower back pain, when combined with constipation, bloating, pelvic pain, loss of appetite or urinary issues, can be a warning sign of ovarian cancer. Best to talk to your doctor and get yourself checked out.
  10. Your doctor dismisses your concerns. If you can’t have an open conversation with your OB/GYN about your menopause symptoms or feel like he or she dismisses your concerns, find a new doctor. Seriously. Here’s more on what to look for when selecting an OB/GYN in menopause.

Know what’s normal and what isn’t.

Read up on what to expect in perimenopause and menopause.  

And always trust your gut. Talk to your doctor or one of ours if you have any concerns about your health, your body, and your journey through menopause.

Come talk with our Health Coaches and other women in our Community. We discuss symptoms, solutions, and similar experiences. We’re all on the path together. Jump on into the conversation!