The transition into menopause can come with a range of symptoms that may mimic or overlap with those of other medical conditions or diseases, potentially leading to confusion in diagnosis. E.g., while hot flushes and night sweats are common symptoms of menopause, they can also be signs of other serious health issues.
Which are the most commonly misinterpreted symptoms?
The decline of estrogen during menopause can have a significant impact on mood and sleep quality and lead to fatigue and irritability. However, these symptoms are also indicative for depressions, systemic inflammatory diseases such as rheumatoid arthritis, and sleep apnea.
Changes in menstrual cycle, fatigue and weight changes are common menopausal symptoms but might also be caused by thyroid diseases such as hyperthyroidism or hypothyroidism. Moreover, various types of cancer can present with these symptoms.
Especially fatigue is associated with multiple medical conditions and sometimes it is difficult to dissect the underlying cause. In combination with a feeling of weakness or palpitations, fatigue could also be a sign of anemia. Besides that, and the previously mentioned conditions, metabolic disorders such as diabetes and certain infectious diseases can lead to fatigue.
What is needed for a correct diagnosis?
To avoid misinterpretation of menopausal symptoms, it is important to do a comprehensive anamnesis, assessing the woman’s symptoms and medical history. In some cases, hormone tests might help to rule out underlying medical conditions, as explained in more detail in this previous blog post.
The basis of the diagnosis of menopause is the assessment of the symptoms. It is important that physicians understand which menopausal symptoms have the biggest impact on women´s daily life. However, some women may struggle to describe the severity of their symptoms since different women tolerate the discomfort to various extent, and many can tolerate quite severe symptoms before considering medication.
The Menopause Rating Scale
In Switzerland, the questionnaire “Menopause Rating Scale” is often used to evaluate symptoms. It can be completed by a person themselves and afterwards discussed and evaluated in a consultation with a healthcare professional. In the questionnaire a person will judge the severity of their own symptoms by scores starting with 0 (no symptoms), 1 (mild), 2 (moderate), 3 (severe) and 4 (extremely severe). These symptoms include hot flushes and sweating, heart troubles, sleep disorders, depressive mood, irritability, anxiety, physical and mental exhaustion, sexual and urinary problems, vaginal dryness, and joint and muscle complaints. In addition, the rate and severity of weight and skin changes and headaches can be rated.
The healthcare professional may use this questionnaire at subsequent follow-up visits to decide whether the symptoms alleviated or worsened. Based on this, they can adapt the therapy or advise some lifestyle changes.
