Your Ears May Itch — and Other Surprising Things About Menopause
Menopause is far more than hot flashes — it can affect everything from sleep and memory to bone and cardiovascular health. Image: iStock
Menopause has long been sold to us as “the change,” a phrase so vague it could apply equally to a hormonal transition or a questionable haircut. In reality, it is a significant life stage that can affect sleep, mood, periods, skin, sex, memory, and your body’s internal thermostat. Menopause is a natural transition, and the more openly we talk about it, the easier it is to recognize what is happening, seek support, and prepare for it.
Here are a few surprising facts about menopause and perimenopause you might not know.
1. Menopause is finally getting the spotlight it deserves.
If it feels like menopause is suddenly everywhere — on podcasts, in group texts, and at the doctor’s office. You aren’t imagining things. For generations, it was treated as an inevitable private ordeal unless someone was visibly sweating through a meeting.
Now the script is flipping. Because women are living longer, postmenopause can span decades. Researchers are also recognizing that the symptoms go way beyond hot flashes to include brain fog, anxiety, joint pain, and sleep changes, to name a few.
A welcome cultural shift is also underway. Everyone, from public figures to everyday women, is speaking openly about personal experiences, making it easier to recognize symptoms and ask better questions. Thanks to the rise of telehealth, menopause-focused clinicians, online communities, and other easily accessible resources, we are finally giving menopause the attention and seriousness it has always deserved.
2. Menopause symptoms appear in distinct patterns.
Hot flashes are real and often intensely inconvenient — but they are only one part of the picture.
A 2025 systematic review and meta-analysis categorizes the symptoms of perimenopausal and postmenopausal women into four main clusters: somatic (physical), vasomotor (vascular), psychological, and sexual. This means that menopause can affect the body and mind, from temperature regulation and mood and thinking to sexual health — often in overlapping ways.
A large study analyzing more than 145,000 symptom logs found that common perimenopause symptoms range from fatigue and headaches to brain fog, insomnia, dry skin, and low libido. The Scientific Reports study also found that symptoms can appear in distinct patterns rather than as one universal menopause package.
If your ears itch, your skin feels dry, or you have entered a room and forgotten why (again!), you are not imagining it. But you should still mention new or worrying symptoms to your healthcare provider. Menopause can explain many things, but it shouldn’t get automatic credit for everything.
3. Sleep disturbance is a core symptom with no standard care.
Sleep is complicated in multiple ways during perimenopause and menopause, and a form of sleep disturbance is common at this time. Fluctuations in estrogen and progesterone can cause night sweats in some women, which tend to wake them up once they are drenched. That is, if they manage to fall asleep in the first place, since insomnia is another common symptom.
Sleep-related breathing disorders and movement disorders may also occur. Circadian changes, as well as decreased melatonin production, can complicate the matter, too.
Because of the multiple factors contributing to (and disturbing) sleep, the management of sleep disorders — ranging from non-pharmacological to hormone therapy or other pharmacological treatments — needs to take an individualized approach. A study conducted in 2025 found that there is a lack of standards for the appropriate management of sleep disorders in perimenopausal women.
4. The “average age” is just an average.
Contrary to popular belief, your first period is not a predictor of your last. The timing is a complex mix of genetics, health history, lifestyle, and other factors that are not always easy to identify.
The average age of natural menopause in the United States is around 52, but timelines vary wildly. A paper published last year notes that women in high-income settings now have a life expectancy of roughly 80 years. That means menopause and postmenopause can span 30-40 years, or approximately 40% of a woman’s adult life. Women are living longer, making post-menopause health an essential area of study for 51% of the world’s population.
Once a woman is in the post-menopause phase, hormone levels, in particular the level of estrogen, remain low for life. Without the protection that hormones offer, health risks become more similar to those of men of the same age.
5. Menopause has “invisible” health effects.
Your doctor will likely talk to you about declining estrogen being associated with bone loss and shifts in cardiovascular risk, but there is so much more at play. The decline in estradiol levels, together with age-related metabolic changes, leads to a shift in body composition without necessarily increasing body weight. Silent inflammation and insulin resistance increase the risk for metabolic syndrome, type 2 diabetes, and associated heart events.
For some patients, hormone replacement therapy (HRT) may be prescribed to manage symptoms such as hot flashes, sleep disruption, and vaginal discomfort, while playing a broader role in preventative care.
Hormone therapy can offer benefits for eligible patients when started early, but it isn’t a one-size-fits-all solution, and it may not be right for everyone. The decision depends on your health history, symptoms, family history, age, and timing. A conversation with your doctor can help you determine the best course of action for your specific needs. Whether you gain weight or not, staying up to date with checkups and blood tests is crucial at this time.
6. Humans are not the only mammals with a long post-reproductive life.
Menopause is rare in the animal kingdom. Aside from humans, only a small group of mammals — specifically toothed whales like orcas and belugas — experience a significant post-reproductive life.
Why would evolution favor a long life after reproduction? One theory is the “grandmother hypothesis”: older females may improve the survival of younger generations through caregiving, guidance, food knowledge, and leadership. Older female orcas, for instance, have been observed guiding their pods toward food sources.
It is hard not to appreciate the symbolism here. Essentially, the older you get, the more you know where the good snacks are — and how to keep everyone alive.
7. Post-menopause life in humans is a revolutionary puzzle.
Natural selection favors traits that result in reproductive success. After reaching menopause age, female cells become less guarded against mutations and less protected against disease. In the vast majority of animals — including chimpanzees (the primate considered the closest to humans) — this means that the end of fertility leads to the end of life.
We are highly social animals who cannot fend for themselves for more than a decade after birth. And for many years, we depend on members of our society to provide for us. Sharing resources, including wisdom and childcare, may have led to improved survival and interdependence.
8. There can be real upsides to menopause.
Menopause is no walk in the park, but it does have its perks. For starters, you can say goodbye to periods, PMS, and any concerns that might be associated with pregnancy. Migraines often improve, and estrogen-sensitive issues like uterine fibroids, heavy bleeding, and pelvic discomforts finally lessen.
Emotional shifts are also likely. Some women describe a surge in confidence, sharper boundaries, less “people pleasing,” and a renewed sense of ownership over their time and energy.
In some cultures, menopause is recognized not as a woman’s decline, but as her passage into wisdom, experience, and authority. That feels like a much better storyline than viewing the whole thing with shame or embarrassment.
A transition this significant deserves more than simple euphemisms. Menopause is not a single age, a single symptom, or a single experience. It can begin with irregular periods in perimenopause, involve far more than hot flashes, and continue to influence health long after your last period.
The best approach is simple: pay attention to your body, bring questions to your doctor, and do not accept unnecessary discomfort as the price of getting older.
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Miriam Calleja
Miriam Calleja is a Pushcart-nominated poet, writer, workshop leader, artist, and translator. Her work appears in numerous publications including Odyssey, Taos Journal, Modern Poetry in Translation, and more. A retired pharmacist, Miriam is passionate about health and wellness topics. When she's not writing, you can find her cooking, reading, crafting, and traveling.
