Menopause symptoms

Common mental health and physical symptoms of menopause and perimenopause include:

• changes to your mood, like low mood, anxiety, mood swings and low self-esteem
• problems with memory or concentration (brain fog)
• hot flushes, when you have sudden feelings of hot or cold in your face, neck and chest, which can make you dizzy
• difficulty sleeping, which may be a result of night sweats and make you feel tired and irritable during the day
• palpitations, when your heartbeat suddenly becomes more noticeable
• headaches and migraines that are worse than usual
• muscle aches and joint pains
• changed body shape and weight gain
• skin changes, including dry and itchy skin
• reduced sex drive
• vaginal dryness and pain, itching or discomfort during sex
• recurrent urinary tract infections (UTIs)
• sensitive teeth, painful gums or other mouth problems

Peri-menopause

Understanding Perimenopause

Peri-menopause marks the time leading up to menopause when hormone levels begin to change.

Perimenopause is the time when you start to have symptoms of the menopause, but your periods haven’t stopped yet. It’s a natural part of ageing and happens as your ovaries gradually produce less of the hormone oestrogen.

Symptoms can start for some women in their late 30s, but it’s more common in the early to mid-40s. Perimenopause can last for several years until your periods stop completely, which is when you reach menopause.

Read more about common menopause and perimenopause symptoms

Early or premature menopause

Early menopause is when you stop having regular periods before the age of 45. Premature menopause is when it occurs before age 40. It can happen naturally or be caused by treatment for other conditions.

Read more about menopausal symptoms.

Causes of early or premature menopause

You have a higher chance of early or premature menopause if it runs in your family.

It’s also more likely if you:

• started your periods early
• smoke
• are underweight

Early or premature menopause can also be caused by treatment for other conditions.

This includes treatments such as:

• radiotherapy or chemotherapy
• certain hormone medicines
• surgery to remove your ovaries

Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) is a treatment used to help menopause symptoms. It replaces the hormones oestrogen and progesterone, which fall to low levels as you approach the menopause.

Who can take HRT

You can usually take HRT if you’re having menopause symptoms.

But HRT may not be suitable if you:

• have a history of breast cancer, ovarian cancer or womb cancer
• have a history of blood clots – you may need to use patches or gels rather than tablets
• have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
• have liver disease
• are pregnant – it’s still possible to get pregnant while taking HRT, so it’s important to use contraception until 2 years after your last period if you’re under 50, or for 1 year after the age of 50

If any of these apply to you, alternatives to HRT may be recommended instead.

Types of hormone replacement therapy (HRT)

There are different types of hormone replacement therapy (HRT) available.

They can:

• contain different hormones – oestrogen, progestogen or both (a specialist doctor may also sometimes prescribe testosterone)
• be taken or used in different ways – tablets, patches, gel, spray or vaginal rings, pessaries or cream
• be taken or used at different times – routines can be cyclical (sequential) or continuous

The type of HRT that’s best for you depends on different factors, like if you’ve had a hysterectomy, what stage of menopause you’re at, and your personal preferences.

Read more about types of hormone replacement therapy (HRT)

• Oestrogen tablets, patches, gel and spray
• Vaginal oestrogen
• Utrogestan (micronised progesterone)
• Continuous combined HRT tablets, capsules and patches

• Sequential combined HRT tablets and patches

• Tibolone

Alternatives

If you’re unable to take hormone replacement therapy (HRT) or decide not to, you may want to consider alternative ways of controlling your perimenopause and menopause symptoms.

Alternatives to hormone replacement therapy (HRT)

Lifestyle changes –

• regular exercise – regular physical activity can reduce hot flushes and improve sleep

• have a healthy diet – a balanced diet can help make sure you do not put on weight and can keep your bones healthy

• wear loose clothes and sleep in a cool, well-ventilated room if you get hot flushes and night sweats – this can help you to stay cool

• cut down on caffeine, alcohol and spicy food – they have all been known to trigger hot flushes

• quit smoking – giving up can help reduce hot flushes

• try a vaginal lubricant or moisturiser if you have vaginal dryness – several different types are available to buy from shops and pharmacies

• Other medicines for menopause symptoms
• Herbal remedies and complementary medicines for menopause symptoms