We ask the experts for menopause signs & symptoms every woman should know about

ONCE you hit your late 40s, every sweaty moment, muscle cramp and mood swing can have you questioning if it has started. By it, we mean the menopause.

But, as anyone who’s been through it – or is in the throes of it – will testify, there’s more to it than that. 

The first symptoms of the menopause can be felt years before your last menstrual cycle, and there’s no one-size-fits-all experience. Dr Louise Newson, GP and founder of The Menopause Charity and free, tells Fabulous: “Some women barely have a symptom, while others struggle on for several years. But I have three pieces of advice.

“The first is to educate yourself and read up on symptoms and treatments that can help. Secondly, listen to your body. It’s easy to put signs, like tiredness and low libido, down to being busy and stressed. Thirdly, if symptoms are affecting your quality of life, see a doctor to discuss a treatment plan.”

Our Menopause Matters campaign is calling for free HRT on the NHS, for every workplace to support menopausal women, and that we all work together to bust taboos. So here we look at the different stages of the menopause and the symptoms to expect.

The different stages

Perimenopause

Before her final period, a woman will experience perimenopause, Dr Radhika Vohra, GP and trustee of , tells Fabulous. This is when your ovaries produce less oestrogen and progesterone – two key sex hormones. As levels dip, it’s common to notice changes to the body, from your bones to your mental health.

Dr Vohra argues this is the most important time to get clued up. “The perimenopause can start up to seven years before your last period,” she says. “It’s important to be proactive, because if you wait until after that point, you may have  suffered far longer than you needed to.” 

Menopause

“By definition, women are perimenopausal until their last period,” Dr Vohra says. “And then you are classified as menopausal one year after your final menstruation.”

The average age is 51, but it can be any time from 45 to 55, according to the NHS. One in 100 women reach menopause before the age  of 40, which is known as premature or early menopause.

However, Dr Vohra says the technical definition isn’t always useful. “I don’t think it’s practical for women to wait for a year after their last period before getting help for the menopause,” she says. 

Post-menopause

A year after that final time of the month, a woman is considered to be entering the post-menopausal stage. It quite literally means “life after the menopause”, and most women will spend about a third of their lifespan in it.

But symptoms can carry on for years, Dr Vohra warns. “Every woman is different,” she says. “I’ve seen some women having hot flushes and still taking HRT well into their 80s.”

Common symptoms 

Hot flushes, brain fog and a change in your periods are likely to be the menopause symptoms you’ve heard of. But, believe it or not, there are almost 50 different recognised symptoms of the menopause. While some women could experience around a dozen, others may only notice the odd one or two. “It’s not black and white, it’s like a menopause spectrum,” Dr Vohra explains. Here, she reveals some of the most common signs to watch out for…

Change in periods

One of the main signs of the perimenopause is a change in your periods – they can be closer together, further apart or heavier. However, this isn’t a universal sign. For some women, oestrogen will fall more slowly, meaning periods can stay the same, while also causing other symptoms elsewhere in the body.

Low libido

Often women will notice a drop in their sex drive, says Dr Vohra. It can be hard to pinpoint the exact cause – it can be linked to feeling unwell, a lack of confidence or weight gain.

“However, chemically, the ovaries do stop making testosterone, which plays an important role in libido, energy levels, sexual response and wellbeing. Speak to your doctor, as there are testosterone therapy treatments that can help.”

Another common problem is vaginal dryness. This is down to the drop in oestrogen, which impacts the body’s natural lubricant, leaving women in pain and discomfort during sex. The NHS recommends using water-based lubricants before sex, vaginal moisturisers, enjoying foreplay more and avoiding perfumed soaps and washes down below. See your GP, as HRT can also help. 

PMS gets worse

Didn’t think it could get any worse? Well, turns out it can! “Women may have body aches, they may also feel more tired, either at certain times of the month or in the run-up to their periods, because the oestrogen levels drop naturally just before your period.

“These PMS symptoms can get worse in menopause due to fluctuating hormone levels.”

Mood swings 

Just like puberty and pregnancy, the change in hormones can trigger mood swings. “Irritability and anxiety are very common, and also feeling unduly anxious about things that you would normally have managed fine,” explains Dr Vohra.

“During Covid, it’s been really easy to put this down to pandemic worries. But I’ve seen women who have told me: ‘I can’t drive, I can’t go on the motorway.’” Things that have previously been second nature can become difficult and self-confidence can get quite low at this time of life.”

Trouble sleeping

“Not sleeping is a really big one,” says Dr Vohra. Problems can range from night sweats, anxiety and aches keeping you awake, to full-blown insomnia. And it can leave you struggling during the day.

Hot flushes

This is the classic symptom and episodes can last around five minutes, starting in the chest. It’s an overwhelming, warm feeling that can cause you to sweat or blush. “Hot flushes aren’t harmless,” says Dr Vohra. “They are an inflammation process in your body and inflammation can be linked to other problems, such as increased blood pressure, high cholesterol and a risk of depression and joint pain.”