Menopause Support: Frequently Asked Questions

Perimenopause is the period leading up to menopause, when hormone levels begin to fluctuate and gradually change. It can last for several years, although the length of time varies from person to person.

For many women, changes to their menstrual cycle are one of the first signs. Periods may become irregular, heavier or lighter, or you may notice that the time between periods changes. You may also begin to experience symptoms that weren't typical for you before.

Things to look out for can include:

• Changes in your periods or menstrual cycle 
• Hot flushes or night sweats 
• Changes in sleep or feeling more tired than usual 
• Mood changes, irritability or feeling more anxious 
• Brain fog or difficulty concentrating 
• Headaches or migraines 
• Changes in libido 
• Vaginal or urinary symptoms 
• Joint and muscle aches 
• Changes in weight, skin or hair 

You don't have to experience all of these symptoms, and some women have few or no symptoms. Symptoms can also change over time, which can make perimenopause difficult to recognise.

Once you have gone 12 consecutive months without a menstrual period, you have reached menopause.

Menopause is a natural stage of life that usually occurs between the ages of 45 and 55, as the ovaries gradually produce less oestrogen and other reproductive hormones. 

In natural menopause, it is defined as having gone 12 consecutive months without a menstrual period. The average age of menopause in the UK is 51.

Not every woman will experience menopause in the same way, and it does not always happen naturally.

• Natural menopause: For most women, menopause happens naturally, usually between 45 and 55. 
• Early menopause: Menopause that occurs before the age of 45 is considered early menopause. 
• Premature ovarian insufficiency (POI): When the ovaries stop working normally before the age of 40. POI is different from early menopause and can have a number of causes. 
• Induced menopause: Menopause can result from medical treatment, such as surgery, chemotherapy or radiotherapy. Symptoms may begin suddenly and can be particularly intense. 

Menopause is one point in the wider transition from perimenopause to post-menopause. 

During perimenopause, changing hormone levels can cause menstrual changes and other symptoms. 

These may include hot flushes, night sweats, sleep problems, mood changes, anxiety, brain fog, headaches, joint and muscle aches, changes in libido and vaginal or urinary symptoms.

The experience of menopause varies considerably. Some women have few symptoms, while others experience symptoms that significantly affect their physical health, emotional wellbeing, relationships or everyday life.

For most women aged 45 or over, menopause and perimenopause can usually be identified from changes to your periods and symptoms, without the need for a blood test.

Changes to your menstrual cycle are often one of the first signs of perimenopause. Your periods may become irregular, occur more or less often, or become heavier or lighter than usual. You may also notice symptoms such as hot flushes, night sweats, changes in sleep, mood changes, anxiety, brain fog, headaches or joint and muscle aches. 

Menopause itself is reached when you have not had a period for at least 12 consecutive months, provided you are not using hormonal contraception that affects your periods. 

If you are unsure whether your symptoms could be related to perimenopause or menopause, speak to your GP or another qualified healthcare professional. They can consider your symptoms, menstrual history and overall health and advise whether you need further assessment or treatment.

If you are under 45 and experiencing symptoms or changes to your periods, it is particularly important to speak to a healthcare professional. Early menopause or Premature Ovarian Insufficiency (POI) may need to be considered, and blood tests may be appropriate depending on your age and circumstances.

Menopause and perimenopause can affect everyone differently. 

Some women experience very few symptoms, while others experience symptoms that have a significant impact on their health, wellbeing, relationships, work and everyday life. Symptoms can also change over time. 

Changes to your periods are often one of the first signs of perimenopause. You may notice that your periods become more or less frequent, or that bleeding becomes heavier or lighter than usual.

Other symptoms can include:

• Hot flushes and night sweats: Sudden feelings of heat, sometimes accompanied by sweating, palpitations, anxiety or dizziness. Night sweats can also disrupt sleep. 
• Sleep problems and fatigue: You may find it harder to fall asleep or stay asleep, or feel tired during the day. 
• Mood changes: Some women experience mood swings, irritability, anxiety or low mood. 
• Brain fog and memory changes: You may notice difficulty concentrating, remembering things or finding the right words. 
• Headaches and migraines: Existing migraines may become more frequent or severe for some women. 
• Joint and muscle aches: Joint and muscle pain or stiffness are common menopause-associated symptoms. 
• Changes in sexual wellbeing: Some women experience a reduced sex drive or changes in sexual function. 
• Vaginal symptoms: Vaginal dryness, irritation, itching or discomfort during sex can occur as oestrogen levels fall. 
• Urinary symptoms: Some women experience needing to urinate more often, urinary incontinence or recurrent urinary tract infections. 
• Skin and hair changes: You may notice drier or itchier skin, thinning hair or other changes to your skin and hair. 
• Palpitations: Some women notice their heartbeat becoming faster or more noticeable. 

You do not need to experience all of these symptoms, and having one or more of them does not necessarily mean you are going through menopause. If symptoms are affecting your everyday life, speak to your GP or another qualified healthcare professional about your symptoms and the support available.

Menopause itself is a point in time, rather than a period that lasts for a set number of years. It is reached when you have gone 12 consecutive months without a menstrual period.

The transition leading up to menopause, known as perimenopause, can last for several years. The length of time varies from woman to woman, and some women experience changes for only a short period while others experience them for much longer.

Menopausal symptoms can also continue after your final period. For some women, symptoms settle within a few years, while others may experience certain symptoms for longer. Symptoms can change over time, so there is no fixed length of time that menopause symptoms will last.

If your symptoms are affecting your everyday life, work or wellbeing, speak to your GP or another qualified healthcare professional about the support and treatment options available.

Yes. Menopause and perimenopause can affect your mental and emotional wellbeing. Changes in hormone levels, alongside symptoms such as poor sleep and hot flushes, can affect mood, concentration and how you feel day to day.

Some women experience increased anxiety, low mood, irritability, mood changes, reduced confidence or difficulty concentrating. Brain fog and memory difficulties are also commonly reported during perimenopause and menopause.

These changes can affect relationships, work and everyday life. If you are experiencing persistent low mood, anxiety or other changes that are affecting your wellbeing, speak to your GP or another healthcare professional. Support and treatment options are available.

Yes. Menopause and perimenopause can affect how you experience work, although the impact varies considerably from person to person. Symptoms such as poor sleep, fatigue, hot flushes, anxiety, low mood, brain fog and difficulty concentrating can make some aspects of working life more challenging.

For some women, symptoms may affect confidence, attendance, performance, relationships with colleagues or their ability to manage particular working conditions. This does not mean that menopause will affect everyone's ability to work, but having appropriate support can make a significant difference.

Workplace support might include supportive conversations with managers, reasonable workplace adjustments where appropriate, access to relevant information and a workplace culture where people feel able to talk about menopause without embarrassment or stigma.

Employers can play an important role in making sure employees know where to go for information and support.

There is a lot of information about menopause online, but not all of it is accurate or evidence-based.

The following organisations provide reliable information about menopause, symptoms, treatment and support:

• NHS – Menopause and perimenopause — clear information about symptoms, diagnosis, treatment and support. 
• NICE – Menopause: identification and management — national clinical guidance on the identification and management of menopause. 
• British Menopause Society (BMS) — evidence-based menopause information and guidance. The BMS is the UK specialist authority for menopause and post-reproductive health.  
• Women's Health Concern — the patient arm of the British Menopause Society, providing evidence-based, regularly reviewed information and resources for women and their partners.  

If you have concerns about your symptoms or treatment options, speak to your GP or another appropriately qualified healthcare professional.