Menopause: what do I need to know?

What is menopause?

Menopause is when your period stops due to lower hormone levels. It usually affects women between the ages of 45 and 55, but it can happen earlier. 

Menopause can happen naturally, or for reasons such as surgery to remove the ovaries (oophorectomy) or the uterus (hysterectomy), cancer treatments like chemotherapy, or a genetic reason. 

What is perimenopause?

Perimenopause is when you have symptoms of menopause but your periods have not stopped. Perimenopause ends and you reach menopause when you have not had a period for 12 months.

What are the common symptoms of menopause and perimenopause?

Menopause and perimenopause symptoms can feel different for everyone. You may have a number of symptoms or none. 

Changes to your periods

The first sign of the perimenopause is usually, but not always, a change in the normal pattern of your periods, for example they become irregular.

Eventually you'll stop having periods altogether.

Mental health symptoms

Common mental health 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)

Physical symptoms

Common physical symptoms of menopause and perimenopause include:

• 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 heartbeats suddenly become 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

See a GP or Nurse if: 

• You think you have perimenopause or menopause symptoms.

You can also speak to a pharmacist for advice about treatments and things you can do.

How long symptoms last

Symptoms can last for months or years, and can change with time.

For example, hot flushes and night sweats may improve, and then you may develop low mood and anxiety.

Some symptoms, such as joint pain and vaginal dryness, can carry on after your periods stop.

Treatment for menopause and perimenopause

The main medicine treatment for menopause and perimenopause symptoms is hormone replacement therapy (HRT), which replaces the hormones that are at low levels.

There are other treatments if you cannot, or choose not to, have HRT.

Find out more about hormone replacement therapy (HRT).

Non-hormone medicines

There are non-hormone treatments if your symptoms are having a big impact on your life and you cannot, or choose not to, have HRT.

Hot flushes and night sweats

There are some medicines that can help with hot flushes and night sweats.

These include:

• a blood pressure medicine called clonidine
• an epilepsy medicine called gabapentin

Talk with a GP about these medicines and their side effects, and if they might be suitable for you.

Mood symptoms

Antidepressants can help with mood symptoms if you've been diagnosed with depression or anxiety.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a talking therapy which can help with:

• low mood and anxiety caused by menopause and perimenopause
• some physical symptoms like hot flushes and joint pain

You can get NHS talking therapy without going to a GP first.

Greenwich Time to Talk: NHS Talking Therapies

Follow-up Appointments

If you're having treatment for your symptoms of menopause or perimenopause, you'll need to return to the doctor or nurse who is prescribing your HRT for a follow-up review after 3 months.

When you and your doctor or nurse agree your treatment is working well for you, you'll need to see them once a year.

During your reviews, your doctor or nurse may:

• make sure your symptoms are under control
• ask about any side effects and vaginal bleeding
• check your weight and blood pressure
• review the type of HRT you're taking and make any necessary changes

You may need treatment for a few years, until most of your menopause and perimenopause symptoms have passed.

You can choose to continue taking HRT. The doctor or nurse prescribing your HRT can discuss with you the benefits and risks, so you can decide what’s right for you.

You can take HRT for as long as you need it. You can discuss this with your doctor or nurse at your yearly review.