Signs and symptoms

  • Anxiety.
  • changes in mood – such as low mood or irritability.
  • changes in skin conditions, including dryness or increase in oiliness and onset of adult acne.
  • difficulty sleeping – this may make you feel tired and irritable during the day.
  • discomfort during sex.
  • feelings of loss of self.
  • Irregular Periods. One of the first signs of menopause many women notice are irregular periods.
  • Hot Flashes. Many women experience hot flashes as a symptom of menopause. 
  • Vaginal Problems. 
  • Urinary Problems. 
  • Sleep Disturbances.
  • Mood Changes. 
  • Changes in Sexual Desire.

Types

  • Type 1: Natural menopause

This is obviously the most common type of entry into the menopause. The average age is 45 to 55. But some women will start maybe a few years early, and there is a small group of women that can be very late starting the menopause - even 58 or 59.

There are three main stages of a natural menopause. There's perimenopause, which is when your periods start to change or you may start to experience menopause symptoms.

Then you've got the menopause itself, which is when your periods stop for good because you're no longer producing enough hormones to cause ovulation and then there's post-menopause, which is basically forever afterwards and that's when your body starts to slowly adjust to being without the original level of sex hormones.

  • Type 2: Early Menopause

According to the NHS in the UK, early menopause is when your periods stop before the age of 45. (1) For some women, it can be as early as 35, although it’s more common in the early 40s than the late 30s.

Early menopause can be hereditary. So, if you know when other close female relatives such as your mum, gran, aunties, or older sisters approached menopause, then you tend (although it's not set in stone) to hit menopause at roughly the same age. So, if other close female relatives started before the age of 45, then it's quite possible that you may do the same.

We also know that other things can trigger early menopause. So, it can be certain health conditions such as diabetes. It can be lifestyle factors too. If you're really pushing yourself very, very hard, that can trigger an early menopause. It can be smoking. Very often, that would trigger the menopause maybe three or four years earlier. Lack of vitamin D is implicated in early menopause, according to some research. And being very overweight can do it too.

There's also something called premature ovarian failure. Now, this is quite rare, but it does happen. It can start in women in their late teens, right through their 20s and to their 30s. The cause of this one is often unknown - it seems to be quite difficult to pinpoint why it may happen. And obviously, for this one, there will need to be a lot of medical supervision to find out exactly what's going on.

  • Type 3: Induced/Surgical menopause

This is where either your womb, cervix, and/or ovaries are removed. It can be due to certain health conditions like fibroids. It could be due to endometriosis, or something called adenomyosis and it can also be due to certain types of cancer.

So, with a total hysterectomy or a full hysterectomy, this is where the ovaries, the womb and sometimes the cervix are removed. This will put you straight into a full menopause very, very quickly, because it's the ovaries that produce sex hormones, so if they're removed very suddenly, that drip feed of hormones will completely disappear.

For a lot of women, especially if they're in the younger age group when this happens, they will be advised to take HRT to protect their bones and their heart health. Obviously, if it's more to do with a specific type of cancer, then very often you wouldn't be allowed HRT and you would have to find other ways of supporting yourself through this induced menopause.

If your ovaries are left, you will tend to go through menopause at roughly the same age you would have done had you not had the operation. The only problem with this is that you are not going to have missing periods as a guide, so it's a lot more difficult to pinpoint whether you're in perimenopause, menopause, or post-menopause. With this one, you just must go by the symptoms you may be experiencing or how you feel generally, health-wise.

Causes of Menopause

Menopause happens when the ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month. Menopause can also occur when a woman's ovaries are affected by certain treatments such as chemotherapy or radiotherapy, or when the ovaries are removed, often at the time of a hysterectomy.

Diagnosis


The diagnosis is based on a combination of a woman’s age, her reported symptoms and specific hormonal testing if necessary.

It normally occurs in women between their late 40s and early 50s – Please see signs and symptoms.

Treatments


Hormone replacement therapy (HRT)

HRT is a safe and effective treatment for most going through menopause and perimenopause. Your GP will discuss any risks with you.

HRT involves using oestrogen to replace your body's own levels around the time of the menopause.

There are different types and doses of HRT. Using the right dose and type usually means your symptoms improve.

Oestrogen comes as:

  • skin patches
  • a gel or spray to put on the skin
  • implants
  • tablets

If you have a womb (uterus) you also need to take progesterone to protect your womb lining from the effects of oestrogen. Taking oestrogen and progesterone is called combined HRT.

Progesterone comes as:

  • patches, as part of a combined patch with oestrogen
  • IUS (intrauterine system, or coil)
  • Tablets

If you have low sex drive because of menopause and HRT does not improve it, you may be offered testosterone.

Benefits of HRT

The main benefit of HRT is that it can help relieve most menopause and perimenopause symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.

Hot flushes or night sweats often improve within a few weeks. Other symptoms like mood changes and vaginal dryness can take a few months to improve.

Taking HRT can also reduce your risk of hormone-related health problems including osteoporosis and heart disease.

Risks of HRT

The risks of HRT are small and usually outweighed by the benefits.

If you're interested in HRT, your doctor or nurse can discuss the risks with you.

Testosterone gel for reduced sex drive

If HRT does not help restore your sex drive, you might be offered a testosterone gel or cream. It can help improve sex drive, mood and energy levels.

Oestrogen for vaginal dryness and discomfort

A GP can prescribe oestrogen treatments you can insert into your vagina, as a tablet, cream or ring. This can also improve any urinary symptoms caused by menopause and perimenopause, like discomfort when you pee.

Non-hormone medicines

There are non-hormone treatments if your symptoms are having a big impact on your life and you cannot, or choose not to, have HRT.

Managing symptoms

exercising regularly – regular weight-bearing activities such as walking, running, and dancing have been shown to reduce symptoms of hot flushes, improve sleep and reduce the risk of osteoporosis. taking a cool shower, using a fan, or having a cold drink

Speak to a health care professional.

A GP, nurse or pharmacist can give you advice and help with your menopause or perimenopause symptoms.

There are also menopause specialists who have experience in supporting anyone going through perimenopause and menopause.

National Supporting services

  • Women's Health Concern.
  • Menopause Matters.
  • Daisy Network for premature menopause.
  • Menopause Café
  • Queer menopause for people who identify as LGBT+

Local Supporting services

Page last reviewed: 8 June 2024
Next review due: 8 June 2025