Menopause FAQs

The menopause 101: phases, symptoms, periods, support and HRT.

What is the difference between menopause and perimenopause?

There are three phases of menopause: perimenopause, menopause and post-menopause, but all three are usually caught by the umbrella term ‘menopause’.

Perimenopause is the initial onset phase of menopause. This is the hormonal rollercoaster bit where everything’s in flux and the ‘classic’ symptoms can kick in.

Technically, a woman is in ‘menopause’ when her periods have stopped and things start to calm down.

If a woman has not had a period for a year (if she’s 50+) or two (if she’s aged 45 – 50) then she is ‘post-menopausal’.

 

What are symptoms of menopause?

Every woman is different so every individual experience will vary. The most common symptoms are:

• Hot flushes
• Night sweats
• Irregular periods
• Sleep problems
• Brain fog
• Low mood
• Anxiety
• Joint pains
• Vaginal dryness

Each woman is likely to experience a range of symptoms but medication and lifestyle changes can help significantly.

Menopausal symptoms should be manageable but if they start impacting a woman’s quality of life she should seek further help.

 

What are the early symptoms of menopause?

They range from subtle symptoms – like being more sensitive to wine – through to disrupted sleep, insomnia and the odd hot flush. Period cycles may alter, becoming shorter, longer or more generally unpredictable. Some women notice they’re more emotional – suddenly crying or suddenly feeling intense anger. This may be subtle to start with and become more pronounced.

Where can I get menopause help and support?

You can see our support resources here.

The British Menopause Society also has some great resources.

Most importantly, if you haven’t already then talk to your GP.

What can be done about vaginal dryness?

Go to your GP and mention it to them. It is very common and they can help through some of the following (and others):

1) Vaginal oestrogen in the form of pessaries, cream or a vaginal ring. The pessaries are twice weekly and the ring is for three months. 

2) Vaginal lubricant for sex.

3) Vaginal moisturisers such as Sylk or Yes! can be used in addition to the oestrogen on a daily basis if needed.

How can I prevent hot flushes?

There are several ways to help prevent hot flushes:

1) HRT

2) Improve/ change your lifestyle

3) Review your bedroom temperature and look at specialist menopause clothing

4) Non-hormonal meds such as antidepressants

5) CBT and talking therapies

6) Exercise, particularly yoga

 

How long does menopause last?

Menopause ranges from months up to 10 years, or even longer in some cases.

 

Does menopause cause weight gain?

Many women report weight creeping on and / or being harder to shift during midlife.

Basically, changing hormone patterns mean fat is now more likely to be stored around a woman’s midsection; hence midlife women often notice their body shape changes. A different body shape might not mean actual weight gain, but fat’s different distribution (typically around the waist and bum) can give that appearance. 

At this stage in life, it’s important not to focus too much on maintaining a target weight, shape or size, or to see body parts in isolation. We always recommend a holistic approach to lifestyle and exercise that promotes a healthy overall wellbeing.

Can I be perimenopausal and still have regular periods?

Yes. You can still have hot flushes, night sweats, brain fog and regular periods. If this is you then it’s OK to ask your GP for support.

 

Can I be perimenopausal and still get pregnant?

Yes. You need to consider contraception until you are post menopausal.

Is HRT a contraception?

No, but some kinds of contraception can act as HRT.

Am I too young to be going through the menopause?

Not necessarily – women can go through it at any age. Under 40 is known as early menopause, or Premature Ovarian Insufficiency. The most common age in the UK go through the menopause is 51 but perimenopause symptoms commonly start in the mid 40s.

 

Am I too old for HRT?

Not necessarily. Traditionally, the window of opportunity for HRT was any time within 10 years of a woman’s last period.

But nowadays it isn’t so black and white. A GP or specialist will take into account an individual’s health, circumstances and risk profile and make a personalised judgement. You may be 11 years (or more) after your last period but a doctor could still recommend HRT.

 

Can I take HRT for ever?

As long as the benefits continue to outweigh the risks then you can take HRT for as long as you like. You should have an annual check up with the doctor to continue to monitor your risks.

 

Are my symptoms severe enough for HRT?

It is a very personal choice but just having symptoms suggests you may benefit from hormone treatment.

Will hot flushes stop after I have been through the menopause?

For the majority of women, yes. While some women find that flushes persist these they are generally less severe. 

 

Is the menopause as horrific as people say?

Some women sail through the menopause with no symptoms. Of those who develop symptoms, 25% have mild symptoms, 50% moderate symptoms, and 25% severe symptoms. If your symptoms are severe then lots of help and many treatment options are available.

Conversely, many women out there have tremendously difficult periods and conditions which can be excruciatingly painful – such as endometriosis or PCOS. So for some women, menopause (when periods end) is actually a massive relief and an empowering stage of life.

In fact, as we get to know more about menopause, and how to treat and relieve its symptoms, more and more women find that there’s nothing to fear and this it can be a particularly liberating stage of life.

Why do women experience these symptoms during menopause?

All symptoms are caused by fluctuations in hormone levels. During the perimenopause, ovulation does not always occur and this causes an imbalance of hormones – causing/ exacerbating symptoms such as hot flushes and night sweats.

After the menopause, oestrogen and progesterone reduce right down and most women then find that their symptoms settle. Only 7% of women have ongoing symptoms after the menopause and these tend to be mild.

 

What if my periods start again after menopause?

Once a woman has been through the menopause then she should never bleed again. If there is vaginal bleeding after the menopause then immediately contact a GP.

Where to go for help?

See my “Talking to your GP” and “Dear Doctor – menopause symptoms” videos for advice when going to your GP for support.

 

Recommended reading

Perimenopause Power by Maisie Hill

Hormonal Repair Manual; Every woman’s guide to healthy hormones after 40 by Lara Briden

Managing the Perimenopause and Menopause by Dr.Louise Newson