What are the symptoms of the menopause and how long do they last?

This is the stage that you begin to transition to the menopause as your body begins to make less oestrogen. Sometimes perimenopause can be confused with the menopause, but perimenopause can actually start up to ten years before you enter the menopause, typically in your 40’s. 

The most common symptoms of the perimenopause include hot flushes, night sweats, vaginal dryness and irregular periods. These symptoms will usually last around 4-5 years and will differ from person to person, for example some people will have more frequent and intense symptoms than others. 

Whilst it’s common and normal to experience irregular periods when you’re perimenopausal there are other, more serious conditions, such as cervical cancer, which can also cause irregular bleeding, so it’s important to see your doctor to rule out other causes if you:

• suddenly experience very heavy periods or periods with blood clots
• have periods lasting longer than usual
• spot or bleed after sex
• spot or bleed after your period
• have periods close together

The perimenopause ends and the menopause begins once you’ve gone an entire year without a period. There are many symptoms of the menopause, the most common include: 

Hot flushes. Perhaps the most well-known symptom of the menopause, hot flushes are a sudden rush of warmth which is felt in your face and upper body. They happen because of hormone fluctuations which change the temperature of your body and can also be triggered by lifestyle factors like smoking, drinking caffeine and alcohol, or because of stress and anxiety.

You may have multiple hot flushes a day or get only one or two a month. They may also come on suddenly, without warning, and be disruptive and uncomfortable. Hot flushes are usually harmless, but you should see your GP if they are coupled with other symptoms such as weight loss or nausea. 

Night sweats. When you have a hot flash while you are sleeping this can cause night sweats which disturb your sleep. Sometimes sleep problems such as insomnia can occur because of night sweats.

Vaginal changes. You may experience vaginal symptoms which include dryness and discomfort during sex and urinary incontinence. 

Reduced libido. You may also notice a reduction in sexual desire which is because of the lower levels of sex hormones – oestrogen and testosterone – that occur during and after the menopause. 

Psychological and emotional symptoms. These may include mild depression, mood swings, and irritability.

The symptoms of the menopause usually last for an average of four to five years, although for some women they can last longer, and they will decrease in frequency and intensity over time.

Experiencing the symptoms of the menopause and perimenopause can be uncomfortable, disruptive and even painful for some women. But there are ways you can manage the severity and impact of your symptoms.

Hot flushes. You may notice that certain lifestyle factors like drinking alcohol and caffeine or eating spicy foods can trigger your hot flushes, so try reducing or completely cutting out those things if you can. 

If you still have your period, you may find it helps to discuss taking a low dose contraceptive with your doctor.

Using a fan at work and at home can be really helpful and taking deep, slow breaths when a hot flash starts.

Vaginal dryness. During sex, this can be managed by using a water-based lubricant which are available over-the-counter and everyday symptoms can be improved by applying an over-the-counter vaginal moisturiser every few days.

If you have severe vaginal discomfort which isn’t improved by over-the-counter medication see you doctor as they may be able to prescribe medication.

Sleep problems. There are lots of things you can try to avoid trouble with sleeping. Being mindful of the time of day you do certain things can really help, such as avoiding large meals, caffeine and nicotine after midday and not exercising or drinking alcohol near bedtime.

And don’t underestimate the importance of your sleeping environment. Sleeping in a dark, quiet and cool room can really help. Some people find sleeping with a fan both cooling and comforting.

Emotional symptoms. Easing stress, eating right, and staying physically active can help balance your emotions and also help you to sleep better.

If you are still struggling emotionally, talking therapy such as cognitive behavioural therapy (CBT) and certain medications can help combat low mood and increases in anxiety.

It’s also helpful to join a support group for women in menopause so you have a safe place to share your concerns and issues.

You may need some additional help to manage your symptoms, in which case your doctor may prescribe Menopausal Hormone Therapy (MHT). MHT works by replacing the oestrogen levels in your body and can be prescribed as a tablet, skin patch or implant. As your oestrogen levels are replenished symptoms such as hot flushes, night sweats, insomnia and vaginal dryness will improve. For some people MHT can also reduce irritability, mood swings and depression. 

MHT can be really helpful for many women, but it’s important to speak to your doctor to learn more about hormonal therapy before making a decision to use it as there are side effects. You may also not be suitable because of a previous illness or because you take certain other medications.

Postmenopause is the time after menopause has occurred. Once you enter postmenopause, you will remain in this stage for the rest of your life. Your hormone levels will remain low and you'll no longer have a monthly period.

If you are experiencing symptoms of the menopause and are thinking about treatment options, or would like to speak to a specialist, you can book a consultation with one of our expert gynaecologists by calling 01625 545 000.

At The Wilmslow Hospital our specialist menopause and urogynaecology service takes a holistic approach to managing your symptoms. Your treatment and support will be designed around your lifestyle and personal needs.