If you're starting to spot the signs of menopause you may have many questions. You may even be noticing changes that you're not sure are menopause symptoms because they can vary widely and every woman is unique.
In the UK, one-third of the female population are perimenopausal or menopausal, and around two-thirds will experience menopause symptoms. While lots of women will have a relatively easy time, others will suffer greatly with the changes happening in their body. In 2019, a report found that three in five women aged 45-55 said their menopause symptoms had a negative effect on their ability to work, and a nearly a third admitted to taking sick leave as a result.
Here, we look at some menopausal symptoms, why they happen, and how you can help yourself. If you're concerned about the menopause or think you may be experiencing early menopause, the best thing to do is see your GP. They will able to diagnose what issues you're having and determine any suitable treatment. If you feel like your GP isn't taking your symptoms seriously, try contacting a menopause specialist.
Menopause symptoms
When StressNoMore analysed 50 common menopause symptoms, and how many related Google searches are made each month in the UK, it found that weight gain had the most monthly searches, followed by night sweats. Other commonly searched for symptoms include hot flushes, hair loss and anxiety (as featured below), as well as headaches, bloating, breast soreness and joint pain.
1. Hot flushes
Why it happens: Perhaps the symptom most associated with going through the menopause, three in four women will experience hot flushes at this time in life. Usually lasting a few minutes, a hot flush can cause your face, neck, and chest to go hot and red, and make you sweat. Some women feel faint or sick during a hot flush. The amount you get a day can vary and they normally occur for about two to three years. Nicki Williams, nutritionist, women's health expert and founder of Happy Hormones for Life says: 'Because oestrogen plays a role in your temperature regulation, hot flushes and night sweats can occur as your oestrogen starts to fluctuate.'
How to treat it: Following a 'menopause diet' can really improve symptoms. Nicki suggests 'food based phytoestrogens – e.g. flaxseeds, lentils, organic soy. These can be helpful to regulate oestrogen levels,' she says. Holly Zoccolan, nutritional health coach & founder of The Health Zoc, also recommends 'eating a healthy and balanced diet full of healthy fats, minerals and vitamins, fibre and good quality protein.'
Take a moment to review the stress in your life, too as this can impact on your hormones and exacerbate symptoms. Holly adds: 'Reducing stress levels, meditation, light movement (such as gentle yoga and stretches), journalling and breathwork can all help to lower cortisol, your stress hormone. Supplements such as Black Cohosh may also help with hot flashes, too.' Try MenoCool Black Cohosh (£10.99 for 30 tablets, Holland and Barrett).
However, if your hot flushes are severe Nicki recommends hormone replacement therapy (HRT). Although it's not suitable for everyone it can be a great for others. 'Go for body identical oestrogen gel, patch or spray,' she says.
2. Night sweats
Why it happens: Just as you can get hot flushes during the day you can also get night sweats. These, say Holly, are caused by 'changes in your hormone levels that affect your body's temperature control.' They can make you feel restless and uncomfortable and affect your sleep. Sometimes, if they are really bad, you might have to change your bedding and night clothes.
How to treat it: Like hot flushes, look to your diet. 'Similarly with hot flushes, eating a healthy and balanced diet full of healthy fats, minerals and vitamins, fibre and good quality protein can help with night sweats,' says Holly.
Holly also applies the same advice about reducing stress levels as she does for hot flushes. So meditation, light movement, journalling and breathwork to lower your stress hormone, cortisol, and – again – a supplement such as Black Cohosh.
3. Irregular periods
Why it happens: As women's bodies produce less hormones such as oestrogen and progesterone our periods can become more irregular. Conversely, some women who have had irregular periods all their life may find that their periods become a bit more predictable. 'Menopause is caused by hormonal changes so the period before menopause – known as perimenopause – is when irregular periods start,' says Holly. 'Periods can become lighter or heavier, less frequent and irregular.'
How to treat it: 'Irregular periods are very normal when going through perimenopause so it's nothing to worry about,' says Holly. 'We want to be balancing our hormones as much as we can to reduce menopause symptoms so make sure that you eat a very balanced diet full of healthy fats, vitamins and minerals, lots of cruciferous vegetables and high fibre foods.'
As well as adapting your diet to help you manage your symptoms, it's also worth keeping a diary or using a menstruation app and making a note of any noticeable differences. As well as your periods becoming lighter or heavier, some women find their once-painful periods disappear while others find they become more painful (see your GP if they get particularly bad). Another top tip is always carry sanitary pads, tampons or a menstrual cup in your bag so you don't get caught short, as you may suddenly and unexpectedly get your period.
4. Trouble sleeping and/or mood changes
Why it happens: It will probably come as little surprise to learn that sleep problems and/or mood changes are common menopause symptoms. Nicki tell us that as 'hormones start to decline, it can affect your sleep and mood.' The hormone changes you'll experience during the menopause can make you feel very sleepy during the day and then stop you from getting to sleep at night. To add insult to injury, night sweats can wake you up when you finally nod off! Here's how to get more restful deep sleep.
All of us can get emotional, or snap at people, when our period is due – and it's similar when you start to experience menopausal symptoms. The menopause can make you depressed, anxious and, in extreme cases, have suicidal thoughts. Your may feel unable to cope with things and feel like you're losing yourself and your femininity. If this sounds familiar, please don't suffer in silence. See your GP but be very clear that you think your low mood may relate to menopausal symptoms – a 2019 report found that more than a third of perimenopausal women were being offered antidepressants when other treatments such as HRT were more appropriate.
How to treat it: Holly's previous advice to reduce stress levels by meditation, light movement, journalling and breathwork all apply to encouraging a peaceful night's slumber. 'Try to avoid eating too much sugar and processed foods as this can impair sleep,' she adds, while Nicki recommends 'eating complex carbohydrates as these can help balance blood sugar and supply vital nutrients to the brain.'
If you're willing to try supplements 'St John's Wort has been shown to help improve sleep quality and duration,' says Holly. Check with your GP before starting St John's Wort, as it can react with other medications such as certain antidepressants.
5. Vaginal dryness
Why it happens: Again, it's those hormones. 'As levels of estrogen drop, the skin and support tissues around the vulva and vagina become a lot thinner, less elastic and the vagina becomes much drier,' says Holly. Vaginal dryness can be very uncomfortable and may make sexual intercourse painful.
How to treat it: Adapting your diet can really help with this uncomfortable and frustrating problem. 'Keeping your cells hydrated and nourished with a nutrient-dense diet with lots of healthy fats can help,' says Nicki. 'You could also add phytoestrogen foods into your diet,' says Holly. 'These are foods such as flaxseeds, soybeans, lentils, sesame seeds, carrots and apples. Ginseng has also been used as a supplement to help with vaginal dryness, too,' she says.
For a quick fix, topical treatments can be very soothing. 'You can find localised oestrogen in either pessaries or cream that your doctor can prescribe,' advises Nicki. See your GP, or try a moisturising cream without hormones such as Dr. Wolff's Vagisan cream (£14.99, Boots), which is available over the counter.
6. Weight gain and slowed metabolism
Why it happens: Also known as the 'disappearing waistline' symptom, Holly explains that the hormonal changes that occur around this time 'have been shown to make you more likely to gain weight as your metabolism slows slightly. Weight gain tends to happen more around the abdomen, hips and thighs in menopause,' she says.
Nicki explains further: 'Metabolism can slow a bit as we age and less activity and muscle mass can also slow down metabolism.' She continues: 'Other factors of weight gain can include too much stress (cortisol lays down fat around your belly area), poor thyroid function, oestrogen decline (changing your shape) and increasing insulin resistance (we don’t tolerate carbs as well as we used to).'
How to treat it: If you're a fan of refined carbs such as biscuits, cakes and white bread, and processed foods such as ready meals and packet sauce, it's time to bin those for better-for-you foods. 'Balance blood sugar with protein and healthy fats to help manage stress and cortisol, says Nicki.
And because cortisol can lead to further weight gain, again Holly reiterates the important of reducing stress levels. 'Moving your body is also important,' she says. 'Making exercise a part of your daily routine can help with your metabolism and reduce weight gain.'
A problem with your thyroid could also cause weight gain. 'Get your thyroid checked for any issues,' advises Nicki, as symptoms can be very similar. An untreated thyroid condition can also lead to an exacerbation of menopausal symptoms.
7. Thinning hair and dry skin
Why it happens: Noticing that you're developing dry ageing skin or that your hair is losing its body and texture can hugely affect your confidence and mood. Classically 'female' hormones are essential for many functions – both internal and external. 'As oestrogen and progesterone levels drop, it causes hair thinning and dry skin,' says Holly. 'Hair loss or thinning can be due to an imbalance in hormones – especially testosterone – thyroid, low iron or other nutrients and stress,' adds Nicki.
How to treat it: It may seem contradictory if you're attempting to keep your weight down but at this stage in your life fat is your friend – so long as it's good fats. Holly recommends 'eating lots of healthy fats (find them in avocados, oily fish such as salmon, olive oil, nuts and seeds) and good quality protein (organic lean meat if you can afford it), as well as bone broth (which contains collagen). Staying hydrated can also help with thinning hair and dry skin,' she says.
It's also worth getting a full blood count to discount issues with your thyroid or low iron, as these can contribute to hair loss.
8. Chills
Why it happens: Feeling chilly can also be one of the many signs of menopause. 'Just like hot flushes, chills can be a symptom,' says Nicki. 'Oestrogen has a vital role in thermoregulation – it basically regulates your temperature.'
How to treat it: Nicki suggest you talk to your doctor. You may be able to go on HRT if applicable. She also recommends getting your thyroid hormones checked out as feeling cold is a common symptom of hypothyroidism.
9. Loss of breast fullness
Why it happens: Mourning the loss of the pertness you enjoyed in your 20s and 30s? You're not alone. 'With declining oestrogen you can lose elasticity of the skin and connective tissue. This can make breasts seem less full and more loose,' explains Nicki.
How to treat it: Due to the loss of oestrogen, an option is to go on HRT. Chest exercises – while not changing the fatty tissue in your breasts – can help lift the area.
When does the menopause start
The NHS defines menopause as a stage women reach when they haven't had a period for a year or more. Leading up to this, most women will experience the perimenopause. This is often described as 'going through the menopause' or 'going through the change' and it occurs between the ages of 45-55, although some womens' hormones start to fluctuate earlier or later. Holly explains: 'Menopause is the permanent end of fertility and menstruation. Transition into menopause can occur as early as your early-mid 30s [if you're interested to read more, three women describe what it's like to go through an early menopause]; however, the majority of women enter menopause in their 40s-50s.'
Some of the first signs of perimenopause include breast tenderness, cramps, fatigue, hot flushes, irregular periods, a low sex drive, fatigue and vaginal dryness. You may also notice a weakening of your pelvic floor. This can result in wetting yourself when you cough or sneeze. As the perimenopause progresses your body will produce less hormones, including oestrogen. Because this can affect our periods, there's an erroneous belief that this renders women infertile, but it's still technically possible to get pregnant until you reach menopause.
What causes the menopause?
Here, Nicki breaks down the primary causes of the menopause:
- Every woman will go through menopause as her reproductive phase ends. The average age is 52.
- Premature Ovarian Insufficiency. This can happen at any age and is when your ovaries stop working.
- Full hysterectomy. The removal of ovaries will induce menopause.
- Illness, injury and/or medical treatment. All of these can trigger or induce menopause.
While it's uncommon, a minority of women under the age of 45 will have an early menopause. This occurs for a number of reasons, including chromosome abnormalities. 'Menopause may also occur earlier due to cancer treatment, surgical removal of the ovaries and health conditions such as eating disorders,' says Holly. It can also be genetic.
How long does the menopause last?
Perimenopause – the period leading up the menopause when symptoms may occur – usually lasts from a few months up to five years, although it can go on for up to eight years or more. Symptoms can come and go and change over time as hormone levels fluctuate so you may experience hot flushes at some point, then headaches, then weight gain. Or you may get lucky and barely notice any changes.
Because our adrenal glands continue to produce a small amount of oestrone (a type of oestrogen), some postmenopausal women can get certain symptoms, so don't be afraid to ask for support after the menopause.
When to see your doctor
You don't need to go through any discomfort, unhappiness or pain alone. If any of your symptoms are causing you worry or discomfort seek help. 'If you're having any symptoms that are impacting your life you should talk to your doctor or a menopause specialist. They can advise you on treatment options,' says Nicki. 'You may also want to consult a menopause nutritionist who can help you with more natural solutions.'
Treatments for menopause symptoms
Here are common treatments for menopause symptoms:
- Changing your diet to provide your body with the nutrients it needs during this time.
- Reducing stress, including exercising more.
- Treating other conditions that can exacerbate menopause symptoms, such as a low thyroid.
- Supplements, including vitamins, minerals and herbs.
- Hormone Replace Therapy (HRT).
As Nicki and Holly explained, adapting your diet is key. Eat more more healthy fats, good quality protein, wholegrains and phytoestrogen foods. Ditch junk and processed foods. This can make a significant difference.
Reducing stress – and in the process – your cortisol levels, can also help reduce symptoms, as can treating other conditions such as a sluggish thyroid or anaemia, which can mimic or worsen menopause symptoms.
You can also take supplements, such as Black Cohosh or St. Johns Wort (as suggested by Holly) or a formulation. We like Menopace Plus (£16.10 for 56 tablets, Vitabiotics). It contains 26 nutrients including vitamins, minerals, soya isoflavones and herbs believed to support the body during menopause.
If you hate taking tablets, try gummies. The Menopure Stack gets rave reviews. Taking these regularly can help to reduce hair loss, hot flushes, mood changes and poor memory (£35.99 for one month's supply or £29.99 for a monthly subscription, Nourished). It is advisable, however, to check with your GP or a nutritionist before starting supplements.
Hormone Replacement Therapy
If symptoms are severe or affecting your daily life your doctor can prescribe hormone replacement therapy (HRT). This comes in tablets, patches that you wear, or as a cream or gel you rub in. There are differing types of HRT: body identical, which on her website menopause specialist Dr Alice Scott explains as being 'exactly the same as your body’s own natural hormones'. Or there are bioidentical hormones. These, writes Dr Scott, are 'compounded products which are marketed as natural, individualised or customised.'
Although many women swear by plant-based bioidentical hormones, these aren't regulated or recommended by the British Menopause Society.
If you're not keen on taking hormones, ask your doctor for advice on other options. They may be unsuitable if you have a history (or family history) of breast, ovarian or womb cancer. Or, if you have untreated high blood pressure, liver disease or a higher than usual risk of blood clots,
