You have probably spent your earlier adult life with the vague notion that menopause is something that happens to women’s bodies when they get older and that’s about the extent of it. But now is the time you need to know more, so what actually is it? How does it feel? And what can you do about it?
What is menopause?
In medical terms, menopause is when a woman hasn’t had a period for 12 consecutive months.
Periods are no longer happening because the ovaries are no longer releasing any eggs so the lining of the womb doesn’t need to build up and break down as it does in the menstrual cycle. And this is all because of a transition in hormone levels.
In the UK, the average age of menopause is 51 but it is common for it to happen anytime between 45-55 years.
Menopause that occurs age 40-45 is called an Early Menopause and if it happens younger than 40 years, it may be diagnosed as Premature Ovarian Insufficiency or POI.
You can read more about Early menopause and POI our early menopause and POI guide.
For the majority of women, menopause occurs naturally. For some women, medical intervention affecting their ovaries causes a surgical (or medically induced) menopause earlier or more severely than if it had occurred naturally.
You can read more about Surgical Menopause our surgical menopause guide.
What is perimenopause?
Signs that your hormones are changing can occur for many years before your periods stop altogether. This the time is called perimenopause.
During these months and years, you may notice a change in your periods such as lighter or heavier blood loss, a shorter or longer cycle, or missing periods for a month or two and then getting one. It is also common to notice changes relating to some of the symptoms listed below, especially anxiety, brain fog and mood swings.
How is menopause diagnosed?
For women aged 45 or over with one or more symptoms, no blood tests are required to diagnose perimenopause or menopause.
Blood tests may be suggested to rule out other common conditions at this age, such as anaemia, an underactive thyroid gland or iron deficiency. Blood tests may also be recommended as part of a general health check to assess cholesterol and check for pre-diabetes.
For women younger than 45, hormone blood tests are usually advised but be aware that results can be unreliable in perimenopause due to hormone levels changing so much from day to day or even hour to hour. Blood results are usually normal in perimenopause.
How will I feel?
This is different for everyone. Some women sail through with hardly any symptoms and their periods simply stop. After 12 months, they’re officially ‘postmenopausal’.
However, 80% of women experience one or more symptoms and for 25% of women, symptoms will be severe.
There are hormone receptors throughout the body so the effects of low estrogen, progesterone and testosterone levels can result in a wide range of symptoms, the most common ones are listed below.
Physical symptoms of menopause
- Tiredness
- Headache/Worsening migraine
- Muscle and joint pains
- Poor sleep
- Low libido
- Vaginal dryness
- Painful penetrative sex
- Frequent or urgent passing of urine
- Recurrent urinary tract infection
- Dry eyes and dry mouth
- Hair loss
- Weight gain
- Skin change (dry, itchy, crawling sensation)
Vasomotor symptoms of menopause
- Hot flushes
- Night sweats
- Palpitations
Psychological symptoms of menopause
- Anxiety
- Low mood
- Irritability
- Rage
- Poor memory
- Loss of confidence
- Tearfulness
Often, it is not just the physical symptoms that are the most troublesome but the psychological and emotional impact that this transition has on a woman’s confidence, her self-esteem, relationships and performance at work.
This list is not exhaustive but represents the wide variety of symptoms that can affect a woman in menopause.
You can chart your symptoms using the Menopause Symptom Checker
How long will the menopause last?
Once you have not had a period for 12 months, symptoms can continue for months or years as your body adjusts to lower levels of hormones. The average duration of menopause symptoms is 7-8 years, but it can be shorter or much longer than this.
What can I do to help myself during menopause?
The menopause is a really good opportunity to reflect on your lifestyle habits and consider how they will shape your future health. What can seem like small decisions day-to-day about diet and activity levels, for example, make a big difference to your quality of life in your postmenopausal years.
We have a wealth of information available on these key areas of lifestyle so click on any in bold to find out more.
- Eat Well – Our top tip is to keep it colourful and natural, with foods rich in protein, fibre, calcium and add a vitamin D supplement. If your body shape is changing in ways you don’t want, read our healthy weight guide to understand more about weight changes in menopause.
- Keep Moving – Keep it fun and frequent, combining activities that gets the heartrate up and ones that make your muscles and joints work. This will lift your mood too.
- Manage worry and stress – Don’t let it build up – relax, reflect and reset regularly. Reconnect with yourself and others. If you’re struggling with other emotions, read our guide mood and emotions.
- Sleep well – One of the best things you can do for mind and body is give yourself a decent night’s sleep. Every night.
- Connect – Meaningful relationships with others improves our wellbeing. Invest in your close connections and find support. If your sex life has taken a nosedive, you can read some helpful advice in our sex and pleasure guide.
What if I’m struggling to do all this?
We can all aspire to achieve lifestyle change but it can be a challenge when you do not feel at your best. This is not failure but an acknowledgement you need help.
If you have symptoms that are reducing your quality of life and impacting on home life, work life or relationships, speak to a healthcare professional to get tailored advice about what might work for you.
Everyone is different and no two women have the same experience of menopause. Get clued up about the different menopause treatments available and then talk about the pros and cons of possible options with a trained clinician.
HRT for menopause symptoms
In menopause, the ovaries have stopped producing hormones and these hormone levels remain low for the rest of your life, unless they are replaced.
Hormone replacement therapy or HRT refers to the replacement of one or more of the hormones estrogen, progesterone and testosterone:
- Estrogen can be given as a patch, gel or spray delivered across the skin, or as a tablet taken orally.
- Progestogen is needed if you take estrogen and you still have a womb. You can swallow it as a capsule or have a device inserted into your uterus that releases this hormone. There are also patches or tablets with estrogen and progestogen combined in one.
- Testosterone is mostly for women with low sex drive if HRT alone has not improved this. It is available in a cream or a gel.
- Local vaginal estrogen can be used alone or in combination with HRT for symptoms affecting the vulva, vagina and urinary function. Vaginal estrogen can be prescribed as a pessary, cream, gel or a ring that’s inserted into the vagina
Alternatives to HRT
- Cognitive Behavioural Therapy – this talking therapy is recommended as an option for the management of anxiety and low mood and there’s even evidence that it can help hot flushes.
- Prescription Medications – HRT would be most woman’s first line choice for treating symptoms but for women who cannot take HRT or choose not to, there are various prescription medications that may help some menopausal symptoms. These include antidepressants such as Venlafaxine and Citalopram which show some benefit in reducing hot flushes. Other medications such as Clonidine and Gabapentin can be considered but are frequently associated with side effects. Newer medications such as fezolinetant can also be considered for helping hot sweats or flushes.
- Herbal remedies – some women find herbal remedies help some symptoms, however there is little good evidence that they help any more than a placebo would. You may wish to investigate helpful supplements to support menopause. Take a look at our useful blog on this subject HRT and Supplements.
What can I expect from taking HRT?
- Relief of your symptoms – Often the dose needs some adjustment, but generally hot flushes and night sweats are relieved within a few weeks of starting. Low mood, anxiety and sleep disturbance take longer to settle but have usually improved within 3 months. Symptoms of vaginal dryness can take longer to settle and, in some women, can take up to a year.
- Reduced risk of osteoporosis – In late perimenopause and early menopause, there is a period of rapid bone loss leading to weakness and increased risk of fracture. HRT reduces this bone loss resulting in reduced risk of the disease osteoporosis and less chance of breaking a bone in the future.
- Reduced risk of cardiovascular disease – There is evidence that HRT started within 10 years of the menopause or below the age of 60 gives you a reduced risk of cardiovascular disease – the second most common cause of death in postmenopausal women.
If you’re going to start taking HRT for the first time, read our guide Starting HRT: What To Expect.
Are there any risks from taking HRT?
Taking HRT is a very personal decision and you can discuss this with your doctor considering your symptoms and how they are impacting your life, your personal and medical history, any pre-existing medical conditions, your family history and whether or not you still have a womb (uterus).
Historically, there have been two risks associated with older types of HRT:
Breast Cancer
This appears to be the most common worry for women when thinking about taking HRT but the reality is your personal breast cancer risk depends on many factors including age, family history, your weight, if you smoke, how much alcohol you drink and whether you exercise regularly.
Studies have shown that women who take estrogen-only HRT do not have any increased risk of breast cancer.
Women who take HRT containing estrogen and progestogen, may have a very small increased risk of breast cancer, but this risk can be minimised further by using micronised progesterone (e.g. Utrogestan).
Blood Clots
HRT taken orally as a tablet is associated with a small increased risk of a blood clot so it is generally not prescribed often these days. HRT taken across the skin as an estrogen patch, gel or spray does not increase the risk of a blood clot.
There are many lifestyle factors that do increase your risk of blood clot however, such as smoking, obesity and prolonged periods of inactivity, so efforts should be made to minimise these wherever possible to avoid a clot developing.
HRT is safe for most women but it is always best to make a well-informed decision that reflects your own concerns and priorities and in discussion with your doctor.
Last updated: June 2026
