Menopause and perimenopause

Symptoms of menopause and perimenopause can include mood changes, memory or concentration problems, hot flushes and vaginal dryness.

The main treatment for menopause and perimenopause symptoms for those who need it is hormone replacement therapy (HRT).

There are things you can do to help ease some menopause and perimenopause symptoms, including lifestyle changes and talking therapy.

Perimenopause and menopause are different for everyone.

You may get symptoms that have a big impact on your daily life, including relationships, social life, family life and work, or you may hardly have any symptoms at all.

Symptoms can happen during perimenopause and menopause. They can also happen after your menopause has ended (post menopause).

Sometimes, ethnic background can affect symptoms of perimenopause and menopause, how severe they are and how long they last. For example, women from a Black ethnic background are more likely to have hot flushes that are severe and continue longer.

Changes to your periods

One of the first signs of perimenopause is usually a change to your periods. They may happen more often or less often, and bleeding may get heavier or lighter. Eventually, you stop having periods altogether.

Hot flushes and night sweats

Hot flushes are when your face, neck and chest suddenly feel very hot or cold. It can make you sweat a lot, cause palpitations or anxiety, or make you feel dizzy. It can happen during the day or night (night sweats) and last for several minutes.

Sleep problems

Not being able to get to sleep or stay asleep can affect your daily life. It can make you feel irritable, stressed and anxious. Sleep problems may be worse if you also have night sweats.

Mood changes, poor memory and brain fog

You may have mood swings, low mood or depression. You may also notice problems with your memory or concentration. These symptoms may feel worse if you have sleep problems and feel very tired.

Weight gain

Weight gain during perimenopause and menopause is common. It often happens around the stomach and upper body.

Vaginal problems

You may get symptoms such as dryness, a burning feeling, irritation or itching in and around the vagina. These symptoms can also make sex feel painful.

UTIs (urinary tract infections)

You may get more UTIs (urinary tract infections) or symptoms that feel like a UTI. This includes feeling pain or a burning sensation when you pee and needing to pee more often than usual, including at night.

Other symptoms of menopause and perimenopause

Menopause and perimenopause may affect you in other ways, including:

• a faster, slower or more noticeable heartbeat (palpitations)
• weakening bones (loss of bone density), which can lead to osteoporosis
• feeling the need to pee more or not being able to control when you pee (urinary incontinence)
• headaches and migraines that are worse than usual
• muscle aches and joint pains
• hair thinning or hair loss
• skin changes, including dry and itchy skin
• reduced sex drive (loss of libido)
• sensitive teeth, painful gums or other mouth problems

• you think you have symptoms of menopause or perimenopause and want to know what your options are
• you have symptoms like a fast heartbeat (palpitations)
• you still have periods but your bleeding pattern has changed and you're bleeding more, not less, than before
• you have not had a period for 12 months or more, and you have any vaginal bleeding

Early advice can help reduce the effects of menopause and perimenopause on your health, relationships and work.

Find out more:

• Menopause in ethnic minority women on the British Menopause Society website (PDF only, 129KB)
• Menopause symptoms and symptoms tracker on the Rock My Menopause website

If you have symptoms of perimenopause or menopause, talk to a doctor, nurse or pharmacist about HRT and other options available.

The type of HRT you're offered will depend on whether you still have periods or not, or if you have had your womb removed (hysterectomy).

Oestrogen

Oestrogen is the main type of HRT and can help manage your symptoms. It can be taken as tablets or used as patches, spray or gel.

It's sometimes used as a cream or pessary to treat vaginal dryness and soreness, or urinary symptoms, after the menopause.

Progestogen

If you're taking oestrogen and have not had a hysterectomy, it's important to take progestogen to protect your womb.

Progestogen can be taken as tablets, as part of a combined patch or as the hormonal coil (intrauterine system, or IUS).

Testosterone

Testosterone gel or cream can help to improve low libido (sex drive) for some.

There are many reasons why you may have low libido around the menopause, including relationship difficulties, how you feel about yourself, and physical discomfort. You may be able to get testosterone on prescription from a menopause specialist.

More information

Find out more about hormone replacement therapy (HRT).

Eating well, exercising and looking after your mental wellbeing can help with symptoms during perimenopause and menopause.

It can also help you keep as well as possible in the future.

• try to get plenty of rest, including keeping to regular sleep routines

• try to eat a healthy, balanced diet

• eat calcium-rich food like milk, yoghurt and kale, if you can, to keep your bones healthy

• exercise regularly, with focus on weight-bearing exercises to build strength as this can help protect against weakening bones

• try relaxing things such as yoga, tai chi or meditation

• talk to other people going through the same thing, like family, friends or colleagues

• talk to a doctor before taking herbal supplements or complementary medicines

• talk to a doctor about hormonal contraception if you need to – HRT is not contraception

• do not smoke as this can make menopause symptoms worse

• try not to drink more than the recommended alcohol limit – it may affect your symptoms