Hot flashes, flushes, or power surges- sense of warmth that starts suddenly, usually over your face, neck, and chestRelated to fluctuations in estrogen, occurs only during peri-menopause when estrogen levels are decreasingFluctuating estrogen levels may cause an imbalance in the hypothalamus. The body is tricked into thinking it is too hot. To cool itself blood is rushed to the surface of the skin, therefore resulting in a flushed appearanceNight sweats - when hot flashes interfere with sleepVaginal dryness, itching, and irritationThinning of the vaginal lining may cause painful intercourseUrinary tract infections, need to urinate frequently, burning on urination, itching in the urethra areaUrinary incontinence if the uterus and bladder slip lower into the pelvisOsteoporosis – or bone density loss occurs when estrogen diminishes to a low level. The most rapid bone loss occurs during the first 10 years of menopause.Heart rate rises after menopause. Estrogen helped to dilate the arteries. Menopausal women are at greater risk of heart attacks.Skin changes with an increase in wrinkles. The decreasing estrogen levels makes the skin less elastic.