Menopause & Perimenopause

Understanding perimenopause and menopause

Perimenopause is the transition leading up to menopause, when hormone levels fluctuate and symptoms may begin. Menopause is usually identified after 12 consecutive months without a period, where there is no other cause. This definition does not apply in the same way to everyone, including people using certain hormonal contraception or who have had surgery.

Menopause often occurs between ages 45 and 55, but can happen earlier. Experiences vary widely, and symptoms can begin before periods stop.

Common experiences

• Hot flushes, night sweats and disrupted sleep
• Changes to periods, including irregular bleeding
• Mood changes, anxiety, irritability and difficulties concentrating or remembering things (“brain fog”)
• Joint or muscle discomfort, headaches and fatigue
• Vaginal dryness, discomfort during sex and urinary symptoms
• Changes in sexual desire

These symptoms can have other causes. Speak to a healthcare professional if you are unsure, symptoms affect your life or you notice unusual bleeding. Bleeding after menopause should always be assessed by a clinician.

Getting help and discussing treatment

A GP, nurse or menopause specialist can help you understand symptoms and treatment choices. Options may include hormone replacement therapy (HRT), non-hormonal medicines, treatments for vaginal symptoms and lifestyle or psychological support. Benefits and risks depend on your medical history and circumstances, so discuss them with a qualified professional rather than starting or stopping treatment based on online advice.

For reliable information see NHS menopause guidance and NICE menopause guidance. If symptoms begin before age 45, seek medical advice; menopause before 40 needs particular assessment.

Supporting yourself day to day

• Try to protect sleep and rest where possible, especially if night sweats affect you.
• Choose movement and strength-building activities appropriate to your health and ability.
• Eat regularly and discuss bone-health concerns or nutritional needs with a professional.
• Notice personal triggers for hot flushes without assuming everyone has the same triggers.
• Talk with trusted people about what support would help.

You do not need to buy expensive supplements or follow influencer routines. Check claims and discuss supplements with a pharmacist or clinician, especially if you take medicines.

Menopause at work, home and in the community

Menopause symptoms can affect concentration, comfort and confidence at work. It may help to discuss practical adjustments such as access to water, ventilation, breaks or flexibility with a manager or occupational health team. Share only what you feel comfortable sharing.

In some families and cultures menopause is rarely discussed. It is a normal life transition, not something shameful. Partners, relatives and friends can offer practical help and listen without dismissing symptoms.

Prepare for your appointment

Consider noting:

• What symptoms you experience and how often
• Any changes in bleeding or periods
• How sleep, mood, work and daily life are affected
• Current medicines, contraception and relevant health history
• Questions about HRT, non-hormonal options and follow-up

If language is a barrier, ask the service whether interpreting support is available.

My menopause reflection

What changes have I noticed in my body or wellbeing?

What would make everyday life easier right now?

What would I like to ask a healthcare professional?

Feeling unwell? Seek help and stay connected

Do not ignore symptoms that concern you. Contact your GP practice if you feel unwell, especially when symptoms are persistent, worsening or affecting daily life. If you need urgent help and cannot wait for a GP appointment, use the appropriate urgent care service. In England, NHS 111 can advise on urgent but non-life-threatening concerns. For a life-threatening emergency, call 999.

Keep someone you trust informed, if it is safe and you wish to. A family member or friend can check on you, help with appointments, collect essentials or offer emotional support. You decide what personal health information to share. If family contact is unsafe or difficult, choose another trusted person or professional service.

If you live alone, consider arranging a simple check-in with someone you trust when you are unwell.