Menopause symptoms

What is Menopause symptoms?

Menopause occurs when the ovaries stop producing oestrogen and progesterone, causing periods to cease permanently. The average age of menopause in the UK is 51, though it can occur earlier — either naturally or as a result of surgery, chemotherapy or other medical causes (premature ovarian insufficiency).

The years leading up to menopause — perimenopause — are often when symptoms are most pronounced, as hormone levels fluctuate unpredictably before declining. Perimenopause can begin several years before the final period and involves many of the same symptoms as menopause itself.

Post-menopause, oestrogen deficiency has longer-term health implications including increased risk of osteoporosis and cardiovascular disease, which is why proactive health management during and after menopause is important.

Signs and symptoms

Menopause symptoms vary significantly in type, severity and duration. Common symptoms include:

• Hot flushes and night sweats (vasomotor symptoms) — the most commonly reported symptoms, affecting around 75% of women
• Sleep disturbance — often driven by night sweats but also by independent hormonal changes
• Mood changes — anxiety, low mood, irritability and brain fog
• Vaginal dryness and discomfort — genitourinary syndrome of menopause (GSM)
• Reduced libido
• Joint pain and muscle aches
• Headaches
• Palpitations
• Memory and concentration difficulties ("brain fog")
• Changes in skin and hair

How therapy can help

HRT (hormone replacement therapy) is the most effective medical treatment for vasomotor and other oestrogen-deficiency symptoms. The decision about HRT is personal and should be made in discussion with a GP or menopause specialist. Complementary therapies offer significant additional support alongside or instead of HRT:

• CBT for menopause — NICE recommends CBT specifically for hot flushes and night sweats, and for low mood and anxiety associated with menopause. Evidence shows meaningful reduction in both the frequency and bother of vasomotor symptoms
• Acupuncture — good evidence for reducing hot flush frequency and severity, and improving sleep and mood in menopausal women
• Mindfulness-based approaches — improving sleep quality, reducing anxiety and improving psychological wellbeing during menopause transition
• Yoga and movement therapies — evidence for reducing vasomotor symptoms, improving mood and supporting bone health
• Hypnotherapy — specific hypnosis protocols for hot flushes have shown significant reductions in frequency and severity in clinical trials
• Massage therapy and osteopathy — for musculoskeletal symptoms including joint pain and muscle tension that commonly accompany menopause

Seeking help

If menopause symptoms are affecting your quality of life, you do not have to manage them alone. A GP with menopause expertise or a British Menopause Society-accredited specialist can advise on HRT and other medical options. Many women benefit from a combination of medical and complementary approaches.

The Menopause Charity, Menopause Matters and the British Menopause Society all offer excellent resources. If you are under 45 and experiencing symptoms of menopause, speak to your GP promptly — premature ovarian insufficiency requires specific assessment and management.

Therapies that may help with Menopause symptoms