Menopause is a natural stage of life, but this does not mean troublesome symptoms must be accepted without help. Perimenopause can begin several years before the final menstrual period and affect sleep, wellbeing, sexuality and daily functioning.
What changes are typical?
Cycles may become shorter, longer or irregular. Hot flushes, night sweats, sleep problems, mood changes, vaginal dryness, pain during intercourse and urinary symptoms are common. Severity varies greatly. Natural menopause is usually established after 12 months without menstruation when there is no other cause and hormonal contraception is not being used. Assessment may differ during hormonal treatment or after certain operations. WHO: menopause.
Are hormone tests always necessary?
After age 45, typical symptoms in an otherwise healthy person often do not require an extensive hormone panel, as hormone levels fluctuate in perimenopause. Tests may be needed if symptoms start unusually early, the picture is atypical or another cause, such as thyroid disease or anaemia, needs to be excluded. NICE NG23: menopause diagnosis and management.
What treatment options are available?
The choice depends on the main symptoms, health risks and patient preferences. Options include menopausal hormone therapy, local oestrogen for urogenital symptoms and non-hormonal approaches. Before treatment, the doctor reviews medical history, bleeding patterns, thrombosis and cancer risks. Individual assessment is more important than a universal regimen. NICE NG23: menopause diagnosis and management.
What can you do day to day?
Regular strength and aerobic activity support bone, heart and metabolic health. A stable sleep routine, stopping smoking, limiting alcohol and adequate dietary calcium and protein are helpful. A symptom diary may reveal hot flush triggers.
A consultation at KIRSH
Book a gynaecology consultation at KIRSH if cycle changes, hot flushes or other symptoms affect your wellbeing. Prepare a record of periods and symptoms, a medication list and your main questions. The doctor will help assess suitable support options.
Sources and further reading
This information is educational and does not replace an individual medical consultation. For acute or life-threatening symptoms, call 113.
