Menopause Symptoms

Symptoms of Peri-Menopause* and Menopause

*Peri-menopause is the build-up to the time when a woman’s periods completely stop. It can last several years and can begin 10 years before full-blown menopause. During this time, a woman’s hormones will fluctuate, and her periods may well become erratic. She may start experiencing other menopausal symptoms during this time.

If she is aged over 45, it isn’t normally appropriate to use a blood test to look at hormone levels because they fluctuate so much. Menopause should be considered based upon the woman’s reporting of symptoms.


On average, women will enter the menopause aged around 51 – but that means many women can enter menopause earlier or later.

Some women will be in an induced or medical menopause, where powerful drugs are used to ‘switch off’ normal hormonal cycles, as a palliative treatment for conditions like endometriosis, adenomyosis, or Pre-Menstrual Dysphoric Dysfunction (PMDD). Other women may be in surgical menopause, where their ovaries have been removed as a treatment for some cancers or, in some cases, endometriosis (although this is not a recommended course of action).

So, what are the possible symptoms of peri-menopause and menopause? Menopause symptoms are not just hot flushes, night sweats and changing periods although these are, of course, well-reported symptoms.

Many women experience mental and emotional symptoms before any physical symptoms, these can include; anxiety, panic, low mood, difficulty concentrating, and a loss of confidence.

Common physical symptoms include:

  • Hot flushes
  • Sweating (including at night-time)
  • Episodes of excessive cold and trembling
  • Palpitations / racing heart
  • Tiredness
  • Lacking energy
  • Feeling dizzy or faint
  • Headaches
  • Joint pain
  • Itchy / dry skin
  • Dry eyes
  • Hair loss
  • Vaginal dryness
  • Increased urinary tract infections
  • Increased constipation
  • Loss of libido
  • Raised blood pressure

Common psychological symptoms may include:

  • Anxiety
  • Depression
  • Tearfulness
  • Panic
  • Loss of confidence
  • Mood swings
  • Forgetfulness
  • Loss of concentration
  • Finding it difficult to ‘think straight’ (brain fog)
  • Recurrence of any mental health issues experienced during / after pregnancy

According to the NICE Guidelines, published in 2015, Hormone Replacement Therapy (HRT) should be the first line treatment for menopause, not anti-depressants. This is because the psychological symptoms many women report are down to a lack of hormones, not clinical depression.

Women who choose not to take HRT or for whom it isn’t recommended should be given information and support about alternatives.

Body identical hormone replacement therapy, both oestrogen and progesterone, is available via the NHS, even in Wales! Women who still have their womb must be prescribed oestrogen and progesterone to protect the womb lining.

For women who have had their womb and ovaries removed as a treatment for endometriosis, it is also thought that taking both oestrogen and progesterone might be a better course of action. This is because oestrogen alone could cause symptom recurrence. HOWEVER, given the complexity of these issues, it is advisable that women with a complex medical history prior to menopause (natural or surgical) should be referred to a menopause specialist for consultation and treatment options. It is THIS for which FTWW is calling in Wales – please sign our petition here.