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Am I menopausal?​

Everybody is different when it comes to perimenopause and menopause, so it’s not always easy to identify what’s happening and what help you need. By learning its language, you can tell your GP how you’re feeling in your own words.

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Symptoms of the menopause

Everyone’s experience is different, but any of these symptoms could indicate perimenopause and menopause. How many do you recognise?

Anxiety

Not everyone will experience anxiety as part of their menopause symptoms.1 Anxiety can make one person feel overwhelmed at work or as though they cannot cope with the number of tasks they feel they need to complete in a day, while someone else may get nervous in another situation, such as a feeling of panic while driving.

Bloating

Bloating during the perimenopause and menopause may be due to changing hormone levels.2 It can also be caused by a build-up of gas in your digestive system.2 There are things you can do to try and relieve bloating, such as being more active and avoiding fizzy drinks. Alcohol may also cause bloating, so try and reduce your alcohol intake and drink plenty of water, as bloating can also be a sign that you are dehydrated.

Changes in taste

When you are going through the perimenopause and menopause, you may notice a change in your sense of taste or have a dry mouth.4

Brain fog

Many women who experience brain fog during the perimenopause or menopause worry that they might be developing dementia. However, in this age group, it’s far more likely that changes to your memory or ability to concentrate are caused by falling hormone levels.3 Eating healthily and being physically active can help, as can getting good quality sleep.3

Depression

During the perimenopause and menopause, people can feel depressed due to changing hormone levels.5 Symptoms can include feeling ‘down’ and less interested in doing things you usually enjoy.

Excessive sweating

As with many perimenopause and menopause symptoms, sweating more can be caused by hormonal changes.6 It may help to wear clothes made of natural fibres, like cotton and linen.

Fatigue

While going through the perimenopause and menopause, changes to sleep patterns are common, with many of us experiencing disturbed sleep or sleeplessness at night. This has a knock-on effect of causing tiredness during the daytime that can feel debilitating.7

Gastrointestinal problems

The perimenopause and menopause can cause changes in your stomach and digestion,8 leading to symptoms including diarrhoea, constipation, and acid reflux. Exercise and a healthy diet may help relieve these symptoms.

Headaches

During the perimenopause and menopause, you may get more headaches,9 but everyone is different. If you’ve always had headaches before and during periods, then when you reach the perimenopause and menopause, you may suffer less, but someone who has not previously had headaches may start to get them during the perimenopause and menopause. Drinking lots of fluids may help and avoiding triggers if you know what yours are. It’s a good idea to talk to your GP if headaches are impacting your wellbeing because they may be able to help.

Hot flushes

Hot flushes can come on suddenly and are very common during the perimenopause and menopause.10 They may continue after the menopause too.

Irritability

It’s common when you are going through the perimenopause or menopause to be more easily irritated than you used to be.5 As well as hormonal changes, lack of sleep – another menopause symptom – can make it worse.

Irregular
periods

Before you reach the end of the menopause and stop having periods altogether, hormonal changes can lead to spotting between periods and heavy bleeding. Blood may also be darker or browner than you’re used to.11

Joint pain

When levels of the hormone oestrogen drop during the perimenopause and menopause, you can get joint pain.12 It can be worse in the morning.

Libido

During perimenopause and menopause, you might notice your interest in sex changes, also known as your libido. It could increase or decrease. A lower libido during menopause is often due to decreased hormone levels, which can cause dryness ‘down below’.13 This can make sex uncomfortable or painful. Other menopause symptoms can also make you less interested in sex, such as weight gain, low mood, and hot flushes.

Night sweats

A night sweat is a common menopause symptom14 and is like having a hot flush at night, which can disturb sleep. It can help to use light bedding – for example, a thin duvet – and to avoid alcohol and spicy foods. Night sweats can vary from light sweating to waking up drenched in sweat.

Osteoporosis

Oestrogen protects our bones, and because this hormone drops during the perimenopause and menopause, the risk of osteoporosis increases.15 Osteoporosis means weak bones. The good news is that there are things you can do to protect your bones, so talk to your GP.

Palpitations

The perimenopause and menopause can cause feelings like your heart is racing or jumping. These are called palpitations.16 If you get these, talk to your GP.

Recurrent UTIs

UTI stands for urinary tract infection, and the symptoms include needing to pee more often than usual, pain or discomfort in the lower stomach, cloudy pee, and sometimes blood in the pee. You may also feel tired and as if you have a temperature.

UTIs can be more common if you’re perimenopausal or menopausal,10 partly because oestrogen can protect this area of the body, and levels of this hormone drop during the menopause. UTIs are usually treated with antibiotics, so if you have symptoms, you should make an appointment
to talk to your GP as soon as possible.

Sleep

There can be a link between trouble sleeping and the perimenopause and menopause. This can make low mood and anxiety worse.18 Having a regular routine around going to bed and getting up in the morning may help, as can exercise. If sleep problems affect your daily life, it’s a good idea to make an appointment to see your GP for help and advice.

Reduced
muscle mass

Because we lose oestrogen when we approach and go through menopause, we tend to lose muscle mass. Activity levels can affect how much muscle mass we have, so getting a good amount of exercise can help. Another way we can help our bodies maintain muscle mass is through our diet; protein can help and vitamin D can also help our muscle health.17

Vaginal pain

Once again, we can blame dropping oestrogen levels for this perimenopause and menopause symptom: vaginal pain.18 Oestrogen helps to keep the area lubricated, and when our bodies produce less of this hormone, it can lead to vaginal dryness, which can make sex painful or uncomfortable. Not the easiest subject in the world to talk openly about, so watch our video about pain during sex to help with conversations about this symptom.

Weight gain

It can be easier to gain weight, when you’re perimenopausal or menopausal,10 but it doesn’t have to be this way. If you can, exercise regularly, eat a healthy diet, and aim for good quality sleep every night. If you’re struggling with your weight, talk to your GP for help and advice.

What is the menopause?

woman sitting on a sofa reading
You have two main hormones related to your reproductive cycle: oestrogen and progesterone. These hormones have controlled your periods from puberty and throughout your adult life.19 Although they fluctuate month-to-month, the overall levels remain stable.19,20 At around the age of 45, your ovaries will only have a few remaining eggs, so they start to produce less oestrogen and progesterone.21​ It’s this decline in hormone levels that causes the symptoms related to perimenopause and menopause.19​

Once the levels become really low, your periods will stop. Twelve months after your last period, you officially enter the menopause.22​

The three stages of menopause

Perimenopause

Menopause

Postmenopause

Download our information leaflet

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Learn more about the symptoms of menopause and how to manage them.

FAQs about menopause

You may have many questions about menopause or feel curious about how it could affect your health and lifestyle. Here are answers to some commonly-asked questions:

Menopause happens to anyone who menstruates. In the UK, the average age for the menopause to start (your final period) is around 51 years and is usually between the ages of 45 and 55.24 If you go through the menopause before you’re 45, this is known as early menopause. Before the age of 40, it’s classed as premature menopause.27
There are three stages of menopause.28 Perimenopause is the first stage, and this is when your hormone levels begin to drop and you may experience a range of symptoms. At the middle phase, menopause, your periods stop, and you could continue to experience symptoms. Menopause is diagnosed when you’ve not had a period for 12 months running.22 The final phase, postmenopause happens right after menopause and lasts for the rest of your life.29
Menopause is unique to every person. Symptoms during perimenopause can start years before menopause, while menopause itself can take anywhere from 7 to 14 years to complete.25 You may still experience some symptoms in the years after the menopause.30

Is it coming up to a year since you last had your period? It could be a sign that menopause has nearly completed and you’ll be moving on to the next phase, postmenopause. You might start to notice that the symptoms you were experiencing in perimenopause and menopause are easing or have stopped.26

VMS stands for vasomotor symptoms, and these include hot flushes/flashes and night sweats. Many people experience these symptoms, and they typically occur around the head, neck, chest, and upper back.31
  1. Albooshi S, et al. Does menopause elevate the risk for developing depression and anxiety? Results from a systematic review. Australas Psychiatry. 2023;31:165–173.
  2. Eun-Ok I, et al. Gastrointestinal symptoms in four major racial/ethnic groups of midlife women: race/ethnicity and menopausal status. Menopause. 2022;29:156–163.
  3. Liverpool Women’s NHS Foundation Trust. Decision making, concentration and memory changes/problems during menopause Information Leaflet. Available at: https://www.liverpoolwomens.nhs.uk/media/3536/decision-making-concentration-and-memory-changes-during-menopause.pdf Accessed October 2023.
  4. Saluja P, et al. Comparative evaluation of the effect of menstruation, pregnancy and menopause on salivary flow rate, pH and gustatory function. J Clin Diagn Res. 2014;8:ZC81–ZC85.
  5. NHS Inform. Menopause and your mental wellbeing. Available at: https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause-and-your-mental-wellbeing. Accessed October 2023.
  6. Hao S, et al. The effect of diet and exercise on climacteric symptomatology. Asia Pac J Clin Nutr. 2022;31:362–370.
  7. Sherwood Forest Hospitals NHS Foundation Trust. Menopause-why do I feel fatigued? Available at: https://www.nhsemployers.org/system/files/2022-03/Fatigue%20%26%20Menopause%20Leaflet.pdf Accessed October 2023.
  8. Heitkemper MM and Chang L. Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome? Gend Med. 2009;6(Suppl 2):152–167.
  9. NHS. Hormone headaches. Available at: https://www.nhs.uk/conditions/hormone-headaches/ Accessed October 2023.
  10. NHS. Menopause symptoms. Available at: https://www.nhs.uk/conditions/menopause/symptoms/ Accessed October 2023.
  11. NHS. Irregular periods. Available at: https://www.nhs.uk/conditions/irregular-periods/ Accessed October 2023.
  12. Makara-Studzińśka MT, et al. Epidemiology of the symptoms of menopause – an intercontinental review. Prz Menopauzalny. 2014;13:203–211.
  13. NHS. Low sex drive (loss of libido). Available at: https://www.nhs.uk/conditions/loss-of-libido/ Accessed October 2023.
  14. NHS. Night sweats. Available at: https://www.nhs.uk/conditions/night-sweats/ Accessed October 2023.
  15. NHS. Osteoporosis causes. Available at: https://www.nhs.uk/conditions/osteoporosis/causes/ Accessed October 2023.
  16. NHS. Heart palpitations. Available at: https://www.nhs.uk/conditions/heart-palpitations/ Accessed October 2023.
  17. Maltais ML, Deroches J, Dionne IJ. Changes in muscle mass and strength after menopause. J Musculoskelet Neuronal Interact. 2009; 9:186–197.
  18. Tandon VR, et al. Menopause and sleep disorders. J Mid-life Health. 2022;13:26–33.
  19. Endocrine Society. Reproductive hormones. Available at: https://www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/reproductive-hormones Accessed October 2023.
  20. Reed BG and Carr BR. The normal menstrual cycle and the control of ovulation. Available at: https://www.ncbi.nlm.nih.gov/books/NBK279054/?report=reader Accessed October 2023.
  21. Harvard Health. Perimenopause: rocky road to menopause. Available at https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause Accessed August 2023.
  22. Lloyds Pharmacy. Difference between perimenopause and menopause. Available at: https://onlinedoctor.lloydspharmacy.com/uk/womens-health-advice/difference-between-perimenopause-menopause Accessed October 2023.
  23. NHS. Menopause. Overview. Available at: https://www.nhs.uk/conditions/menopause/ Accessed October 2023.
  24. NHS Inform. Menopause. Available at: https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause Accessed October 2023.
  25. National Institute on Aging. What is menopause? Available at: https://www.nia.nih.gov/health/what-menopause Accessed October 2023.
  26. NHS Inform. After the menopause. Available at: https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/after-the-menopause Accessed October 2023.
  27. NHS Inform. Early and premature menopause. Available at: https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/early-and-premature-menopause Accessed October 2023.
  28. Bridgewater Community Healthcare NHS Foundation Trust. The menopause. Available at: http://www.bridgewater.nhs.uk/wp-content/uploads/2014/02/The-Menopause-what-to-expect-when-you-are-expecting-the-menopause.pdf Accessed October 2023
  29. Soules MR, et al. Executive summary: stages of reproductive aging workshop (STRAW). Fertil. Steril. 2001;76:874–878.
  30. Dalal PK and Agarwal M. Postmenopausal syndrome. Indian J Psychiatry. 2015;57(Suppl 2): S222–232.
  31. Thuston RC and Joffe H. Vasomotor Symptoms and Menopause: Findings from the Study of Women’s Health Across the Nation. Obstet Gynecol Clin North Am. 2011;38:489–501.

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How do I start talking about menopause?

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Perimenopause

Perimenopause means ‘around menopause’ and is the first natural transition to the menopause. Most of us will start noticing symptoms around the age of 45, although some may find they start earlier or even later than that.

If you’re having symptoms before the age of 45, you might need a blood test to check your hormone levels.23 Otherwise, a diagnosis of perimenopause or menopause can be reached by discussing your symptoms with your doctor.

Symptoms could start months or years before menopause, and they can change over time.10 The perimenopause is when your hormone levels start to change, but before your periods stop completely. It can cause a wide range of symptoms. Your periods may become lighter or heavier, or they may become irregular. These changes are usually (but not always) the first sign10 of the perimenopause.10

You may also experience some of the physical and mental symptoms listed above. It’s not always the obvious ones like hot flushes and night sweats!

Menopause

Menopause is when your periods stop due to lower hormone levels. It affects anyone who has periods.22 The average age of natural menopause is 51,24 but it can happen when you’re younger or older. ​This stage usually lasts about seven years but can be as long as 14 years.25

While the perimenopause involves changes to your periods, menopause can only be diagnosed once your periods have stopped for 12 months. Additional symptoms, like those listed above, typically last for four years after your last period.

The menopausal transition affects each of us uniquely and in various ways. The body begins to use energy differently, fat cells change, bone and heart health is affected, body shape, and your physical function.25 This can be a daunting time, impacting your work, your life, and your self-esteem, but it’s a natural process, and support is available to help you navigate these years with confidence. Visit how do I start talking to my GP to help you get started.

Postmenopause

Postmenopause begins at the start of the menopause when you haven’t experienced a period for over a year and are therefore extremely unlikely to ever have another period. This stage lasts for the rest of your life.26

Some of us look forward to a time with no periods, no worries about contraception, or having to buy sanitary products. However, symptoms related to menopause can still affect you during this time, so be sure to speak to your doctor about managing these.

Now that your hormones have changed, be mindful to listen to your body and adopt a healthy diet and lifestyle. Low hormone levels can bring health concerns such as increased risk of osteoporosis (weak bones), cardiovascular (heart) disease, and urinary tract infections. That’s why it’s still important to keep up with your GP health checks, including your regular cancer screenings, such as cervical (smear test) and breast.26

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