There are several symptoms that can occur during this transition phase of a woman’s life.

Some you may be aware of, but these are some less well-known symptoms arising from the menopause.

Look at our symptom checker.
The symptoms of the menopause can be divided into 3 stages

early symptoms of the menopause.

intermediate symptoms of the menopause.

affects later

Early symptoms

Hot flushes and night sweats.

About 70% of women in western cultures experience vasomotor symptoms such as hot flushes and night sweats.

The decline in oestrogen levels is thought to cause these symptoms.

Hot flushes may start before periods stop but are most prevalent in the first year after the final menstrual period.

These symptoms can continue for around 7 years, but in some women can continue until the age of 60 years.

Brain fog

Brain fog describes the inability to think clearly and complete tasks that some women describe. It involves.


Difficulty in concentrating.

Mental fatigue.

Inability to problem solve.

These symptoms can feel quite debilitating and affect our ability to perform at work and affect out quality of life.

The good news is the symptoms improve with time and can improve with lifestyle changes and medication such as HRT.

Hair loss in the menopause.

Reductions in hormone levels particularly oestrogen levels can affect hair. The ratio of testosterone to oestrogen, results in a relatively higher testosterone levels which can shrink hair follicles leading to hair loss and dry, brittle hair.

Stress and anxiety can also affect hair growth pattern leading to hair loss.

Maintaining a healthy diet and regular exercise can help reduce levels of anxiety and stress.

Topical medications can also be used to successfully improve hair growth such as minoxidil, these need to be applied of a daily basis.

HRT can also improve hair health in some women.

Psychological symptoms

These are common in the menopause and may manifest themselves in different ways. Here are some symptoms that women experience.

Lack of confidence low self-esteem.

This is a feeling a loss of confidence and low self-esteem and this can be exaggerated in the menopause.

Manage these feelings by promoting more positive thoughts about yourself and taking time out for self-care.

Depressed mood, feeling down and low in your mood, or feeling numb.

Anxiety affecting sleep, palpitations, feeling on edge, nervous.

Irritability, getting easily annoyed and impatient. Sensitive to sounds and noises.

Mood swings, dramatic and sudden mood changes, easily overwhelmed, panic attacks, rage, becoming tearful.

Lethargy and lack of energy

Can all occur during the menopause. These may seem out of character and come unexpectedly, and this can impact personal, social, home and work life.

Chat through your symptoms with a doctor to help identify the cause for your symptoms.

Manage your stress levels through yoga and meditation.

Try mindfulness techniques, breathing exercises can help. Why not visit for an introduction to mindfulness.

Take care of your physical health, exercise helps reduce stress levels and boosts your serotonin levels to make you feel happier.

Chat to your doctor about HRT , it may help women with low mood in the menopause.

Reduced sleep

Hormonal changes around the perimenopause and menopause can result in poor sleep for several women going through the menopause.

This is a result of hot flushes, anxiety levels, insomnia caused by the hormonal changes in the perimenopause and menopause.

It can affect cognitive skills, ability to concentrate and cause exhaustion.

Sleep hygiene is an effective way of helping to combat some of the symptoms of the poor sleep.

Hrt can help improve hot flushes which can improve your sleep. Discuss the benefits and risks of hrt medication at an online appointment with our doctor.

Aches and pains and reduced muscle mass in the menopause.

Many women report aches and pains in the menopause. This can be related to reduced muscle mass in the menopause from reduced oestrogen levels. There is also a shift in body distribution of fat, with an increase in fat deposited around the abdominal area and also a reduction in bone density.

Lifestyle modifications such as 

Eating more lean protein,

Weight bearing exercises twice weekly.

Staying active

Stopping smoking

Reducing alcohol intake 

Can help improve muscle mass and reduce the decline of bone density.

Loss of libido

Desire for sexual intercourse and intimacy can vary through different stages of life. Many women report these symptoms in the perimenopausal and menopausal phase of their life. This is as a result of the reduced oestrogen levels which reduce the sensitivity of the vaginal and clitoris regions. This results in reduced vaginal and cervical secretions, and this can also cause dryness in the vagina causing discomfort during intercourse, further reducing the desire for intimacy.

Loss of libido is also affected by other factors including stress, tiredness, poor sleep, poor body image. This can negatively affect self-esteem and affect relationships.

Speak to our doctor to further discuss and manage these symptoms.

Intermediate symptoms


These can affect around 50% of postmenopausal women.

Loss of oestrogen in the menopause can lead to changes in the lining of the vagina leading to symptoms of

  • Dryness
  • Burning
  • Itching
  • Painful sex
Urinary Tract

It can lead to symptoms in the urinary tract such as

  • Urgency
  • Frequency
  • Incontinence
  • Discomfort passing urine.  

There are several treatment options that are available, including hormonal and non-hormonal treatments, so please speak to us to discuss what would be beneficial for you.

Dry eye

Around 61% of perimenopausal and menopausal women are affected by dry eye syndrome.

Among these physical symptoms is dry eyes, characterized by dry, itchy and burning eyes.

Symptoms of dry eye syndrome

  • Red eyes
  • Burning in the eyes
  • Itchy eyes
  • Blurred vision
  • Gritty feeling in the eyes
  • The feeling something is caught in your eye.
  • Excessive tearing

There are treatments available to help with these symptoms, such as eye lubricants, please discuss this with us.

Having an annual eye test is advised to check changes in visual acuity and intraocular pressures, so book n with your local optician to arrange this.

Long term effects

Cardiovascular Health

Cardiovascular disease is a leading cause of death in women. Oestrogen is known to have a beneficial effect on cardiovascular health in women, and as a result premenopausal women have a lower risk of coronary artery disease. The rate of coronary artery disease increases after the menopause and this may be linked to the reduced levels of oestrogen. Hence HRT may be beneficial in perimenopausal or early menopause years.

Book an appointment to discuss a tailor-made treatment plan for you in the involving discussion of your risk factors for cardiovascular disease, and advice on how you can improve your perimenopausal and menopausal health.

Bone Health

Bone thinning, known as osteoporosis, can lead to increased bone thinning and risk of bone fractures. The risk increases beyond 50 years of age. Approximately, 2% of women have osteoporosis at 50 years of age and 25% of women at 80 years.

Advice on lifestyle modification and bone health in the perimenopause and menopause can help reduce the progression. A balanced diet; adequate calcium, and vitamin D; weight bearing exercises; smoking cessation and avoiding excessive alcohol consumption will all help reduce the risk of bone thinning.

HRT has been shown to help reduce bone thinning and improve bone health, and is used in women who also have menopausal symptoms e.g. hot flushes. The doctor will discuss if this is a treatment option for you.

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