Perimenopause & Menopause: Symptoms, Changes and When to Seek Support

Perimenopause and menopause are natural stages of life, but that does not mean difficult symptoms should simply be endured. Hormonal changes can affect physical health, emotional wellbeing, relationships, work and everyday life. Understanding what may be happening is often the first step towards getting the right support.

Start with our Perimenopause & Menopause Support Hub or book a private women's health consultation in Rochdale.

What is perimenopause?

Perimenopause is the transition leading up to menopause. Hormone levels can fluctuate and periods may change in frequency, duration or flow. Importantly, symptoms can begin before periods stop and may not look the same from one person to another.

What is menopause?

Menopause occurs when periods stop as ovarian hormone production changes. For people aged 45 or over who have typical menopause-associated symptoms, NICE advises that perimenopause and menopause can often be identified clinically without laboratory testing. Individual circumstances still matter, particularly when symptoms occur at a younger age or the diagnosis is uncertain.

Common symptoms of perimenopause and menopause

Hot flushes and changing periods are well known, but the possible effects are much broader. They can include:

• hot flushes and night sweats
• difficulty sleeping and tiredness
• changes in mood, anxiety or low mood
• problems with memory or concentration, sometimes described as 'brain fog'
• headaches or migraines that are worse than usual
• palpitations
• muscle and joint aches
• changes in body shape or weight
• skin changes
• reduced sex drive
• vaginal dryness, discomfort or pain during sex
• recurrent urinary symptoms or urinary tract infections

Not everyone experiences all of these symptoms, and severity can vary significantly.

Can perimenopause affect mental wellbeing?

Yes. Mood changes, anxiety, low mood, sleep disruption and difficulties with memory or concentration can occur around menopause. These symptoms deserve the same attention as physical symptoms. New or severe mental health symptoms should be assessed appropriately rather than automatically assumed to be hormonal.

What can help menopause symptoms?

Support should be individual. Depending on symptoms and medical history, discussions may include exercise, sleep, diet, reducing alcohol, stopping smoking, psychological support, symptom-specific treatments, HRT and non-hormonal options. Read our HRT explainer for an evidence-led overview.

Vaginal, urinary and bladder changes

Lower oestrogen levels can contribute to vaginal dryness, irritation, discomfort during sex and urinary symptoms. These problems can be overlooked because people may feel embarrassed discussing them. Read more about vaginal dryness and urinary health and urinary incontinence in women.

What about weight changes during menopause?

Some people notice changes in weight or body composition around midlife. Ageing, sleep, activity, diet and hormonal changes can all interact. Avoid crash diets and unproven 'menopause' supplements. If weight is affecting your health, an evidence-based assessment is more useful than assuming hormones are the only explanation. You can learn more about our Weight Management service. Weight management is a separate service and is not a treatment for menopause.

When should you speak to a healthcare professional?

Seek advice if symptoms are affecting your quality of life, you are uncertain whether they are related to menopause, symptoms begin unusually early, or you want to discuss treatment. Bleeding after menopause should always be assessed by a GP. New, severe or concerning symptoms may need investigation for causes unrelated to menopause.

Questions worth taking to a menopause appointment

• Could my symptoms be related to perimenopause or menopause?
• Could another health condition or medicine be contributing?
• What lifestyle changes could realistically help me?
• What are the potential benefits and risks of HRT for me?
• Are non-hormonal options appropriate?
• What can help vaginal, urinary, sleep, mood or sexual symptoms?
• When should my symptoms or treatment be reviewed?

Women's health support in Rochdale & Greater Manchester

Longeva Wellness aims to make conversations about women's health straightforward, informed and confidential. Explore our Menopause Support Hub and Women's Health services.

Book a private women's health consultation

GPhC registered pharmacy: 9012378.

This guide provides general health information and does not diagnose menopause or replace individual medical advice. Treatment, including prescription treatment, depends on clinical assessment and may require GP or specialist care.