When to Call the Doctor About Menopause Symptoms

Patient Expert

Although menopause is a natural part of what I like to call "growing up" (I hate to use the word "aging"), it can be accompanied by medical problems that are anything but natural. Hot flashes are annoying as heck, but they won't kill you. Heart disease can.

I hear from a lot of you asking, "Is this normal?" Undoubtedly menopause can be a confusing time; what's normal for a 30-year-old can be far from normal for a 50-year-old. The most common questions about "normal" usually revolve around:

Spotting and Intermittent Bleeding

WHAT'S NORMAL: As you enter "perimenopause," or the early stages of menopause, it's common for your periods to be different than they have been in the past. You may skip a period, or spot just a bit between periods, or skip three months and then have a normal or heavy period. This goes on for awhile, a few years for some women. So spotting and crazy periods can be "normal."

WHAT ISN'T NORMAL: Such a heavy period that you feel lightheaded, or weak, or one that goes on day after day. I mean HEAVY bleeding for more than 2 days. If this happens, call the doctor.

Racing Heart or a Jittery Feeling, Inability to Sleep

WHAT'S NORMAL: Sleep is elusive when menopause hits in full force. Hormonal changes can cause the jitters, but caffeine from coffee, too many sodas or even (yikes) too much chocolate can cause what feels like a racing heart or the jitters. Maybe you used to be able to drink two cups of coffee in the morning plus two sodas in the afternoon; I don't dispute that. But your body is changing, and you may not be able to eat or drink the way you used to.

WHAT ISN'T NORMAL: Most people cannot "feel" heart disease in the making, so a racing heart might not be life-threatening. But it is worth checking out. Know the warning signs of a heart attack. Cardiac disease is the NUMBER ONE killer of women. If you are overweight, have difficulty breathing and your feet or hands start to swell, see a doctor. If you think you have indigestion (a common sign of heart attack in women), seek medical attention. Know the other signs of heart attack.

Tender or Lumpy Breasts

WHAT'S NORMAL: Hormone changes now cause your breasts to change, just like when you started your journey into womanhood. It's normal for breasts to be tender, maybe even a bit painful or swollen off and on while you're going through the hormonal ups and downs of menopause.

WHAT ISN'T NORMAL: Any lump is worth having checked out. While tenderness is normal, out-and-out pain is not. An inverted nipple is not normal, neither is discharge from the nipple. Have all of these symptoms checked out by a doctor.

Lightheadedness, Forgetfulness

WHAT'S NORMAL:  We all get a little dizzy every once in awhile. We all forget where we put the car keys sometimes. And we all get flustered when we can't remember someone's name or a word we're looking for. That's normal, especially when we're under stress or we're not sleeping well.

WHAT ISN'T NORMAL: Maybe I don't have to tell you this but blacking out is not normal, neither is continued light-headedness, or a dizzy feeling once a day or even once a week Almost all forgetfulness is normal but if you are having trouble stringing together a sentence or get lost (I don't mean forgetting where you parked the car at the mall), then see a doctor.

My best advice on normal/not normal is if it worries you, see someone about it. Most likely it will put your mind at ease. We can all use a little more peace of mind, yes?