Women entering the menopause report sleep disruption as the most common and severest symptom, according to a study.
Research published in the Journal of Clinical Nursing shows 95% of those surveyed reported difficulties in sleeping.
Forgetfulness was cited by 92% as the second most common symptom, with hot flashes or flushes as third at 91%.
And irritability featured highly at 87%, the study from the University of Arizona College of Nursing, USA, found.
Problems sleeping were also found to be the most severe symptom, followed by nights sweats and irritability.
Lead researcher and associate professor Dr Judith Berg said: "We also talked to the women about how frequently they experienced symptoms.
"Women who reported problems with day sweats and hot flashes or flushes experienced an average of six a day and women who had problems with nights sweats average just under three a night."
The study found that some menopausal symptoms changed in frequency as women moved further into menopause, but sleep disturbance remained constant.
"This contradicts earlier research which sought to link sleep difficulties with night sweats and problems like hot flashes", Dr Berg said.
"Although the severity of these problems changed as the women progressed through the early stage of the menopause, the sleep difficulties the women reported remained fairly constant."
University of Arizona College of Nursing
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"Unquestionably. I slept like a baby until menopause. I started menopause at 48 and now at 54 I still cannot sleep and I developed fibromyalgia on top of it all. Unbeliveable pain, I would wish it on no one. Thanks for listening." - Geneva, WV
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