Simply put, menopause is the time that marks the end of a woman’s menstrual cycle. It’s typically diagnosed after you have gone a full 12 months without a cycle. Before actually going into menopause, a woman’s body goes through a transitional period called perimenopause. This process typically occurs in your 40s or 50s. However, if you undergo a surgical removal of your ovaries, menopause will be brought on more suddenly.

Depending on the woman, there are a variety of signs that menopause is approaching. Here is a list of some of the most common symptoms to watch out for:

1. Insomnia

Insomnia is a chronic difficulty in falling and staying asleep, and becomes problematic if it occurs more than four times a week. It’s a very common symptom that many women who are undergoing menopause experience. Sleep disturbances are caused by a menopausal decrease of the hormone estrogen. With lower levels of estrogen, women can experience other symptoms like depression and night sweats, making it even more challenging to sleep well. Progesterone is another hormone that decreases during menopause; this can also cause sleep disturbances, since progesterone has a sleep-inducing effect.

2. Hot Flashes

Hot flashes are the most common sign of perimenopause and menopause. A hot flash is a sudden feeling of heat in the upper body that is usually intense in the face, neck, and chest. Women may experience a red, flushed face and sweating because of these flashes. These feelings of warmth usually happen suddenly and last for a few seconds or minutes. There are no particular causes for hot flashes, but women can prevent them by avoiding triggers like stress, caffeine, spicy foods, tight clothes, and smoking.

3. Decreased libido

As you go through menopause, it is common to experience a decrease in libido. This is caused by the loss of hormones estrogen and testosterone. Women in menopausal and postmenopausal stages might notice that they’re not as easily aroused. A decrease in estrogen can also cause a drop in blood supply to the vaginal area, affecting the vaginal lubrication which is necessary for comfortable sex. It is also common to gain weight during menopause, leading to a lower desire for sex, mood swings, and stress.

4. Anxiety

During menopause, you become more likely to experience anxiety. As changes happen to a woman’s body, it is easy to feel upset or frustrated. As menopause causes a drop in the production of estrogen, changing hormone levels can also contribute to feelings of anxiety. There is also a decline in the production of cortisol, which allows you to cope with stress, also adding to the likelihood that women in menopause will experience anxiousness.

5. Migraines

Headaches are a common symptom that affects many women undergoing menopause. A drop in estrogen is the leading cause of migraines, as changing hormone levels impact the brain. Other factors contributing to headaches during menopause include stress, depression, and hot flashes.

6. Incontinence

During menopause, many women experience urinary incontinence. It is caused by hormonal imbalances that cause the thinning of urethra linings, which pass urine from the bladder out of the body. As a result, women may experience some leakage during this stage of life.