Once a hush-hush topic, in recent years, conversations around menopause have begun to shift. From Drew Barrymore having her ‘first perimenopause hot flash’ on air a few years ago to Davina McCall lobbying the government to reduce HRT prescription costs in England, understanding of and compassion for women going through the physical, mental and emotional experiences of menopause has improved – but there’s still a long way to go.
Nevertheless, hearing women speaking publicly and candidly about their lived experiences of (peri)menopause is refreshing and can help others recognise when they might also be going through it.
If you feel like you might be (peri) menopausal yourself, below, experts explain some of the potential symptoms and what to look out for.
What is the menopause?
First up, what is the menopause? Quite simply, it’s when the ovaries can no longer produce the hormone oestrogen. Over a period of years or decades (perimenopause), they gradually become less active and efficient until, eventually, they fail completely. After this point, no more eggs are produced and there are no more periods. Menopause, then, is the term used to describe this period for women 45+.
Early menopause is when you stop having regular periods before the age of 45. But why does it happen to some women and not others? 'All women are born with a certain number of eggs. When these run out, our ovaries will stop working,' says GP and menopause specialist, Dr Louise Newman. 'However, certain women have an increased risk, such as those who’ve got a family history of early menopause; have had a hysterectomy; or have an auto-immune condition such as diabetes, thyroid problems or coeliac disease.'
Premature menopause – now more commonly known as Premature Ovarian Insufficiency (POI) – is the term used for when you stop having regular periods before the age of 40. This might happen naturally or due to treatment for other conditions, for example, radiotherapy or chemotherapy.
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While POI is relatively rare, it does happen. According to the NHS, it affects approximately one in 10,000 people before the age of 20, one in 1,000 before the age of 30 and one in 100 before the age of 40.
Menopause symptoms
With the long-term impacts of a menopause misdiagnosis including a heightened risk of osteoporosis, heart disease and depression, it’s important to familiarise yourself with the potential symptoms.
‘As with any condition, menopause symptoms vary greatly from woman to woman,’ says Dr Newson. ‘As does how long they last. Some women may experience signs of the menopause for a few years; for others, they may last decades. The younger you are, or if you’ve had your ovaries removed, typically, the more severe they are.’
The NHS notes that symptoms typically fall into three categories: changes to your periods, mental health symptoms and physical symptoms. ‘The first sign of the perimenopause is usually, but not always, a change in the normal pattern of your periods, for example, they become irregular,’ it says.
Mental health symptoms can include:
- Changes to your mood, like low mood, anxiety, mood swings and low self-esteem.
- Problems with memory or concentration (brain fog).
Physical symptoms can include:
- Hot flushes – when you have sudden feelings of hot or cold in your face, neck and chest which can make you dizzy.
- Difficulty sleeping, which may be a result of night sweats and make you feel tired and irritable during the day.
- Palpitations – when your heartbeats suddenly become more noticeable.
- Headaches and migraines that are worse than usual.
- Muscle aches and joint pains.
- Changed body shape and weight gain.
- Skin changes, including dry and itchy skin.
- Reduced sex drive.
- Vaginal dryness and pain, itching or discomfort during sex.
- Recurrent urinary tract infections (UTIs).
- Sensitive teeth, painful gums or other mouth problems.
Below, we break down five common symptoms further.
1. Irregular periods
Menstruation far from clockwork? Irregular periods, or if your periods seem to have stopped, can both be signs of menopause. Why? Because it means your ovaries aren’t producing oestrogen as they once were and your hormonal cycle is starting to shift.
If this sounds like you, head to your GP and fill them in on your symptoms. 'If left unchecked, this can cause oestrogen deficiency, which in turn can increase a woman’s risk of having weak bones as they get older,' says consultant gynaecologist Shirin Irani.
2. Vaginal dryness
Vaginal dryness is not nice. Yet it’s annoyingly, surprisingly common. Although it can be triggered for a host of reasons such as swimming pool chemicals, soaps, antidepressants and the combined contraceptive pill, it is also a sign that the glands inside the vagina are producing fewer natural secretions – which is what happens when a woman is breastfeeding, or going through (peri)menopause, and oestrogen levels drop.
'Generally, vaginal dryness is uncomfortable for women,' says sexual health nurse and author of Sexplained Helen Knox. 'But left unmanaged, it can become very painful. The lack of moisture maintaining the vagina’s natural environment can cause the healthy bacterial balance to be disrupted more easily, too, leaving you prone to thrush and bacterial vaginosis.'
3. Hot flushes and night sweats
One of the most common causes of night sweats for women is fluctuating oestrogen levels.
'Menopause is associated with hot flushes, so it’s not uncommon for patients to report sweating even during their sleep,' says Dr Neomi Shah, associate professor of pulmonary and sleep medicine at the Icahn School of Medicine at Mount Sinai.
'Sweating from menopause is unpredictable; talk to your doctor about hormone replacement therapy, as it could help keep your temperatures under control.'
4. Anxiety
Drastic changes to your mood, such as feeling really low for no clear reason or experiencing intense sensations of anxiety which are new to you can also be a sign that hormone changes are occurring in your body – and might be associated with (peri)menopause.
How to seek (peri)menopause support
Despite how differently women may experience (peri)menopause, all feelings are valid and it's vital you feel listened to – not dismissed.
If you’re struggling with what you suspect could be physical or mental (peri)menopause symptoms, menopause campaigner and educator Diane Danzebrink suggests starting by reading not-for-profit Menopause Support’s Understanding Menopause booklet, which is available on menopausesupport.co.uk. If your symptoms are affecting your quality of life, she advises consulting a GP or practice nurse – preferably someone who takes a special interest in menopause.
If you do feel as if you're not being listened to, Danzebrink encourages you to request an appointment with another doctor or practice nurse. ‘If that proves unsuccessful, you’re very welcome to contact us at Menopause Support – we provide 45-minute 1-1 support consultations for anyone struggling to be heard and can write a letter to your doctor to help you advocate for yourself,’ she says. ‘As a purpose-over-profit organisation, we always try to provide these consultations fully funded to anyone experiencing financial hardship.’
Amelia Bell is the Multiplatform Beauty Director for ELLE UK and Harper’s Bazaar, developing beauty strategy, writing, editing, and commissioning, and leading beauty content across both sites. Amelia has a particular interest in wellness and longevity, exploring the skin-mind connection, and decoding the latest treatments, tweakments and runway trends. She also has bylines for Women's Health, Refinery29, British Vogue, Harrods Magazine, and more.
