Word on Health

Word on Menopause

Our grateful thanks to the British Menopause Society (BMS) for their contribution to this week's radio report which you can hear again at the bottom of this page via our audio player.

The Women’s Health Concern (WHC), established in 1972 and the patient arm of the BMS since 2012. provides a confidential, independent service to advise, inform and reassure women about their gynaecological, sexual and post reproductive health. You can find the WHC via this link.

We'd also like to thank the NHS for the use of the information below. 

Menopause is when your periods stop due to lower hormone levels. This usually happens between the ages of 45 and 55.

It can sometimes happen earlier naturally. Or for reasons such as surgery to remove the ovaries (oophorectomy) or the uterus (hysterectomy), cancer treatments like chemotherapy, or a genetic reason. Sometimes the reason is unknown.

Perimenopause is when you have symptoms before your periods have stopped. You reach menopause when you have not had a period for 12 months.

Menopause and perimenopause can cause symptoms like anxiety, mood swings, brain fog, hot flushes and irregular periods. These symptoms can start years before your periods stop and carry on afterwards.

Common symptoms of menopause and perimenopause. Symptoms can have a big impact on your daily life, including relationships, social life, family life and work. It can feel different for everyone. You may have a number of symptoms or none. Symptoms usually start months or years before your periods stop. This is called the perimenopause.

Changes to your periods. The first sign of the perimenopause is usually, but not always, a change in the normal pattern of your periods, for example they become irregular. Eventually you'll stop having periods altogether.

Mental health symptoms. Common mental health symptoms of menopause and perimenopause include:

  • changes to your mood, like low mood, anxiety, mood swings and low self-esteem
  • problems with memory or concentration (brain fog)

Physical symptoms. Common physical symptoms of menopause and perimenopause include:

  • hot flushes, when you have sudden feelings of hot or cold in your face, neck and chest which can make you dizzy
  • difficulty sleeping, which may be a result of night sweats and make you feel tired and irritable during the day
  • palpitations, when your heartbeats suddenly become more noticeable
  • headaches and migraines that are worse than usual
  • muscle aches and joint pains
  • changed body shape and weight gain
  • skin changes including dry and itchy skin
  • reduced sex drive
  • vaginal dryness and pain, itching or discomfort during sex
  • recurrent urinary tract infections (UTIs)

Symptoms can last for months or years, and can change with time.

Lifestyle changes to help menopause and perimenopause. Eating well, exercising and looking after your mental wellbeing can help with symptoms during perimenopause and menopause.

It's common to have mood swings, low mood and anxiety around the time of the menopause and perimenopause. You can try to:

  • get plenty of rest
  • exercise regularly
  • do relaxing activities
  • Cognitive behavioural therapy (CBT) is a type of talking therapy that can help with a low mood and feelings of anxiety. It can also help with sleep problems.

Easing hot flushes and night sweats

  • wear light clothing
  • keep your bedroom cool at night
  • take a cool shower, use a fan or have a cold drink
  • try to reduce your stress level
  • avoid or reduce potential triggers, such as spicy food, caffeine, hot drinks, smoking and alcohol
  • exercise regularly
  • lose weight if you're overweight
  • CBT can also help manage hot flushes.

Easing vaginal dryness. There are vaginal moisturisers or lubricants you can get without a prescription at a pharmacy. Talk to a pharmacist in private if you'd like help to decide which moisturiser is right for you.

If you're having sex and using condoms, do not use oil-based lubricant as this can damage condoms. You can use a water-based lubricant.

There are other treatments for vaginal dryness that a doctor can prescribe, such as HRT (hormone replacement therapy) or hormonal treatment (creams, pessaries, gel or vaginal rings).

Protecting against weak bones

  • exercise regularly, including weight-bearing exercises, where your feet and legs support your weight (like walking, running or dancing) and resistance exercises (for example, using weights)
  • eat a healthy diet that includes plenty of fruit, vegetables and sources of calcium, such as milk, yoghurt and kale
  • get some sunlight on your skin as this triggers the production of vitamin D, which can help keep your bones healthy
  • take vitamin D supplements
  • stop smoking and cut down on alcohol

Treatment for menopause and perimenopause. The main medicine treatment for menopause and perimenopause symptoms is hormone replacement therapy (HRT), which replaces the hormones that are at low levels.

There are other treatments if you cannot, or choose not to, have HRT.

Hormone replacement therapy (HRT)

  • HRT is a safe and effective treatment for most going through menopause and perimenopause. Your GP will discuss any risks with you.
  • HRT involves using oestrogen to replace your body's own levels around the time of the menopause.
  • There are different types and doses of HRT. Using the right dose and type usually means your symptoms improve.

Oestrogen comes as:

  • skin patches
  • a gel or spray to put on the skin
  • implants
  • tablets

If you have a womb (uterus) you also need to take progesterone to protect your womb lining from the effects of oestrogen. Taking oestrogen and progesterone is called combined HRT.

Progesterone comes as:

  • patches, as part of a combined patch with oestrogen
  • IUS (intrauterine system, or coil)
  • tablets

If you have low sex drive because of menopause and HRT does not improve it, you may be offered testosterone.

Benefits of HRT. The main benefit of HRT is that it can help relieve most menopause and perimenopause symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.

Hot flushes or night sweats often improve within a few weeks. Other symptoms like mood changes and vaginal dryness can take a few months to improve.

Taking HRT can also reduce your risk of hormone-related health problems including osteoporosis and heart disease.

Risks of HRT. The risks of HRT are small and usually outweighed by the benefits.

If you’re interested in HRT, your doctor or nurse can discuss the risks with you.

Oestrogen for vaginal dryness and discomfort  Your vagina may become dry, painful or itchy as a result of the menopause and perimenopause.

A GP can prescribe oestrogen treatments you can insert into your vagina, as a tablet, cream or ring. This can also improve any urinary symptoms caused by menopause and perimenopause, like discomfort when you pee.

Non-hormone medicines There are non-hormone treatments if your symptoms are having a big impact on your life and you cannot, or choose not to, have HRT.

Hot flushes and night sweats. There are some medicines that can help with hot flushes and night sweats.  Talk with a GP about these medicines and their side effects, and if they might be suitable for you.

Mood symptoms. Antidepressants can help with mood symptoms if you've been diagnosed with depression or anxiety.

Cognitive behavioural therapy (CBT) is a talking therapy which can help with:

  • low mood and anxiety caused by menopause and perimenopause
  • some physical symptoms like hot flushes and joint pain

Follow-up appointments. If you're having treatment for your symptoms of menopause or perimenopause, you'll need to return to the doctor or nurse who is prescribing your HRT for a follow-up review after 3 months.

When you and your doctor or nurse agree your treatment is working well for you, you'll need to see them once a year. During your reviews, your doctor or nurse may:

  • make sure your symptoms are under control
  • ask about any side effects and vaginal bleeding
  • check your weight and blood pressure
  • review the type of HRT you're taking and make any necessary changes
  • You may need treatment for a few years, until most of your menopause and perimenopause symptoms have passed.

You can choose to continue taking HRT. The doctor or nurse prescribing your HRT can discuss with you the benefits and risks, so you can decide what’s right for you.

Complementary and alternative therapies such as herbal remedies and compounded bioidentical ("natural") hormones, are not recommended for symptoms of the menopause or perimenopause. This is because it's not clear how safe and effective they are.

Red clover and black cohosh are herbal remedies but there is no strong evidence that they work.

Some complementary and alternative therapies can also interact with other medicines and cause side effects.

Ask your GP or pharmacist for advice if you're thinking about using a complementary therapy.

Compounded bioidentical hormones are sometimes offered in private clinics as HRT. They are not recommended because it's not known how well they work or how safe they are. They are not available on the NHS.

They are different from regulated bioidentical hormones, also called body identical hormones.

Bioidentical hormones are available on the NHS as HRT. They have been tested to see how well they work and how safe they are.

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.