Symptoms

On this page:
Why symptoms are often more severe
Physical symptoms
Cognitive symptoms
Mood symptoms
Bladder, vulvo-vaginal & sexual symptoms
When symptoms don’t improve
References

Why symptoms are often more severe

Hormone receptors for estrogen, progesterone and testosterone are distributed throughout the body. Because hormone loss in surgical menopause is sudden rather than gradual, symptoms tend to be more immediate and intense than in natural menopause. This is not a reflection of how well you are coping — it is a physiological response to abrupt hormone withdrawal.

Over 10% of women continue to experience symptoms even after ten years.

While many symptoms occur, they vary widely in severity and frequency among women.

In natural (spontaneous) menopause, 20% of women don’t experience any symptoms, 60% have mild to moderate symptoms, and 20% have symptoms severe enough to interfere with daily life.

For women undergoing surgical menopause, some symptoms are significantly worse:

Vasomotor symptoms (hot flushes/night sweats)
Sleep disturbances
Anxiety/depression
Sexual dysfunction (low libido, genitourinary syndrome of menopause)

Over 30 symptoms have been recognised so far.

Track & manage your symptoms
Tracking your symptoms — including frequency, severity, and effect on daily life — is one of the most useful things you can bring to a clinical appointment. Charting information will help you discuss with your doctor what changes you can make to reduce the impact of problematic symptoms.

The free Balance-app by Dr Louise Newson, a GP and menopause specialist (UK), generates reports you can share with your doctor. You can also download our own symptom tracker from the Free Downloads page.

Physical symptoms

Physical symptoms may include:

Allergies
Altered sense of smell
Aches and pains (muscles and joints)
Breast tenderness
Brittle nails
Digestive issues (bloating, heartburn, nausea, constipation, diarrhoea, incontinence)
Dizziness
Eye changes (dry eyes, eyesight)
Fatigue or low energy
Hair thinning
Headaches or migraine
Hearing changes (tinnitus, hearing loss)
Heart palpitations
Hot flushes and/or night sweats (vasomotor symptoms)
Mouth or gum problems
Numbness or tingling in parts of the body
Restless legs syndrome
Skin changes (acne, dryness, itchiness)
Sleep disturbances
Weight gain or loss

Cognitive symptoms

Cognitive symptoms may include:

Brain fog
Memory problems
Difficulty concentrating

These are among the most distressing symptoms for many women, particularly those who are still working, and typically improve with treatment.

Mood symptoms

Mood symptoms may include:

Anxiety/Depression
Panic attacks
Anger and/or irritability
Mood swings
Low mood (crying spells)
Overwhelmed

These are directly linked to hormone loss — not just to the psychological impact of surgery — and both dimensions deserve attention.

Bladder, vulvo-vaginal & sexual symptoms

Bladder, vulvo-vaginal and sexual symptoms can also fall under the category of Genitourinary Syndrome of Menopause (GSM), or what is commonly known as vaginal dryness. These symptoms may include:

Low libido
Painful sex (dyspareunia)
Vaginal/vulval dryness (atrophy)
Urinary changes (frequent urination, incontinence, pain, recurrent UTIs)

These symptoms are very common, very treatable, and nothing to be embarrassed about. You do not have to live with them.

This is not an exhaustive list. If you are experiencing something that feels connected to your surgery and hormone loss, trust your instincts and raise it with your clinical team.

When symptoms don’t improve

If your symptoms are significantly affecting your quality of life, or treatment doesn’t seem to be working, advocate for a review. Symptom management in surgical menopause can take time to get right and you are entitled to ongoing support.

References

Jean Hailes for Women’s Health – Symptoms of Menopause, May 2025.

Australasian Menopause Society, What are the Symptoms?, Apr 2017.

Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024 Jul 30:1-7.

Australasian Menopause Society, Vulvovaginal Symptoms After Menopause, July 2024.

[Updated: April 2026]