Symptoms

There are at least 35 menopause symptoms, but you may not experience them all. Below is a list of the most common menopause symptoms you may experience:

• Hot flushes and night sweats +
• Insomnia +
• Joint aches +
• Weight gain +
• Psychological symptoms +
• Sexual problems +
• Headaches +
• Fatigue +
• Irregular periods, including period pain and heavy periods +
• Memory loss +

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

The hot flush is experienced by up to 80% of those going through the menopause and is the most common symptom. Often accompanied by extreme sweating (known as vasomotor symptoms), a hot flush is caused by changes in hormone levels upsetting the part of the brain that regulates temperature. Basically, your body thinks it is overheating even when it isn’t, and things like hot drinks or alcohol, eating spicy food or sitting in the sun can exacerbate symptoms.

A night sweat is a hot flush that happens at night – the sweat is a chemical reaction that opens up the blood vessels in the skin causing a feeling of sudden heat. Sweat is released to dispel that heat.

Hot flushes usually last from three to five minutes and can vary in severity. Some women find them nicely warming but around 20% are instantly drenched and scarlet in the face. This can impact on work, social occasions and disrupt sleep.

Hot flushes usually continue for about two years, but some women continue to have them post-menopause.

“Did you know? Whilst we all know about hot flushes, did you know that anxiety and low self-esteem can get much worse around menopause?” – Dr Jane Davis

Tips for managing hot flushes

• Avoid alcohol and spicy foods and cut down on caffeine. A healthy diet rich in fruit and vegetables, whole grains, soya products and flax seed, supplemented with vitamins B and D and magnesium may be helpful in managing your hot flushes and other menopause symptoms.
• Avoid clothes made from synthetics and wear loose cotton layers. This will help you to regulate your temperature when a hot flush occurs.
• Keep rooms fairly cool by opening a window.
• Invest in a fan or portable air conditioning unit. This can be particularly useful if you work and are unable to open a window. Handheld fans can be very convenient.
• Use light layers on your bed to enable you to shed them as required in the night.
• If you can, take a cool shower.
• Have a cool drink, ice lolly or other cool food.
• If you are over a healthy body weight, consider losing weight or following a healthy diet. Although research into the link between hot flushes and weight is mixed; by following a healthy diet and looking after your body, you will be better placed to manage menopausal symptoms. Take a look at our tips for leading a healthy lifestyle +
• Look after yourself – try to relieve stress, take some exercise and eat well to nourish your body. Although this may not help with your hot flushes as and when they happen, it’ll help you to feel better and manage your symptoms.

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

Sleeplessness and disturbed sleep can be a common symptom of the perimenopause and menopause. They can continue on and off for years after your periods have stopped. Around 60% of menopausal women have sleep problems during the menopause.

Not only is a lack of sleep frustrating and difficult to deal with; it can lead to irritability, an inability to concentrate, anxiety, fatigue and drowsiness, none of which help you to lead a balanced life.

Your insomnia may be due to the night sweats, but they can also be caused by changing levels of hormones in your body, particularly progesterone.

TIPS for managing insomnia

• Wear loose cotton to bed.
• Keep your bedroom cool and well-ventilated.
• Avoid alcohol and spicy foods, especially within a couple of hours of going to bed.
• Take regular exercise, but not in the late evening.
• Go to bed at around the same time each night, get up at the same time each morning to create a routine sleep schedule.
• Avoid too much caffeine – you may find you get very sensitive to it during and after the menopause.
• Avoid naps during the day, which can prevent you from sleeping well at night.
• Take a warm bath before bedtime with two cups of Epsom salts in it – magnesium is best absorbed through the skin, and not enough may affect sleep.
• Limit screen-time before bed, there is much research into the impact of blue light on sleep, many mobile devices have in-built night modes to help reduce blue light, if you can’t limit screen-time.
• Try to read before bed, or listen to soothing music to help you drift off, or if you wake in the night.
• Read up on ‘sleep hygiene’ to find other approaches that may help you fall asleep, stay asleep or get back to sleep if you wake.

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

Aching joints or ‘arthralgia’ is another common menopause symptom. Hips and knees, hands and fingers, and neck and shoulders are often affected, but any or all joints could ache. Oestrogen plays a part in maintaining joint and bone health, as it drops it can increase the risk of osteoporosis, osteoarthritis and increase joint pain.

Joint pain may be linked to other health issues, so it is important to have any ongoing concerns checked by a medical professional.

Tips for managing aching joints

• Leading a healthy lifestyle + can help you to manage menopause symptoms. If you are over a healthy bodyweight, losing weight my help relieve pressure on joints. Speak to your doctor for guidance.
• If you undertake regular high-impact exercise, like running on pavements and roads, and it exacerbates your joint problems, consider trail running which offers softer surfaces. Alternatively, try low impact sports such as yoga and swimming, these won’t put as much pressure on your joints but will still keep you fit.
• Calcium, magnesium and vitamin D supplements may help – calcium keeps bones strong and healthy and magnesium helps relax muscles.
• If you’re stressed your body releases cortisol, an inflammatory hormone, so try to relax with meditation or yoga each day. These can also have other benefits, such as helping with any emotional or mental health symptoms you may have,
• Various types of massage, Reiki or acupuncture may also help by directly treating the source of the pain. See our section on complementary therapies for more information.
• HRT + may also help with menopause symptoms like joint pain, if you’d like to know more, discuss HRT with your GP.

We also have a factsheet on bone health and the menopause +

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

Many people gain weight during and after the menopause, one reason may be the change in hormone levels because oestrogen helps to regulate metabolism and body weight.

People may also expend less energy than they used to as energy levels can drop around perimenopause and menopause. Added to this, any reduction in exercise for whatever reason can cause loss of muscle mass, which also slows down the metabolism.

Move more

• People say weight loss is a simple process of exercise more and eat less. But it’s not always that simple.
• Find exercise that you enjoy, fits with your life and your body. There’s no point taking up running if you hate it. Consider other forms of exercise from walking to swimming, cycling to lifting weights. As mentioned above, muscle mass helps to boost metabolism, and feeling stronger can only be a good thing!
• NHS guidelines are that adults 19-64 should do at least 150 minutes of moderate exercise a week and strength exercises on two or more days. Work towards these, start in smaller chunks and build up if the full 150 minutes feels daunting. It’s just over 20 minutes a day of moderate exercise, so consider how you may be able to factor that into your week.

 Healthier choices

• You’re building up your exercise, now to consider the foods you eat. Making healthier choices can help.
• Try to avoid processed carbs like white bread, rice and pasta. There are many alternatives now, consider making healthier swaps and they’ll soon become part of normal life.
• Cut back on your salt, caffeine and alcohol intake. This doesn’t mean abstinence, you don’t have to deny yourself, just consider reducing the amount you have. Spicy foods, alcohol, caffeine (tea and coffee as well as chocolate and cola drinks) can make hot flushes worse so avoiding these may help.
• A healthy balanced ‘Mediterranean style’ diet based on fresh fish, vegetables and good fats such as olive oil, is good for general health.
• Try to reduce stress. The NHS considers stress to be a ‘hidden cause’ of weight gain, whether that’s from increases in the stress hormone cortisol or stress eating, reducing stress can help your overall health and wellbeing.
• Try to increase sleep. Sleep is essential to weight loss, rest your body to help it perform at its best.
• Drink lots of water – it will help your body to metabolise the fat better and prevent water retention.
• If you find that you get hungry often and your blood sugar levels dip, consider eating smaller, more frequent meals.

Read more on diet and lifestyle changes + and our factsheet on Alternatives to HRT +

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

A lot of different pressures can come together around the time of your menopause. You may be experiencing menopausal insomnia, or your menopause symptoms might be similar to PMS symptoms you’ve had in the past. This can result in mood swings, anxiety, irritability, forgetfulness and general difficulty in coping with everyday life.

At the same time, you may have children might be growing up and leaving home, or supporting elderly parents whilst working full time. It can easily become overwhelming when managing changes in hormone levels too. Feelings of sadness and lack of motivation may result in short fuses or snapping, and a changing body shape may cause loss of confidence. It’s a tricky time to negotiate.

TIPS for managing psychological symptoms of menopause

• Eat healthily, nourish your body, keep hydrated. Read our tips for diet and lifestyle changes +.
• Take up a calming hobby like yoga or meditation, read a book, take time to watch your favourite show or exercise to clear your head. It’s quite often that your needs get put to the bottom of the priority list, but there’s a lot to be gained from prioritising yourself.
• Join in with your family, friends and community – try not to isolate yourself.
• Be open and honest with those around you about how you’re feeling and ask them to give you some space, to support you, or just understand that this is what you’re experiencing.
• Consider learning a new skill – something you’ve always wanted to do, like painting or learning the piano. This helps to focus your energy and gives you time for yourself.
• Some people may benefit from cognitive behavioural therapy (CBT) + for low mood or anxiety.

The National Institute for Health and Care Excellence, which produces guidelines for healthcare professionals says that antidepressants have not been shown to help low mood during menopause if you haven’t been diagnosed with depression. It makes it clear that low mood is different to depression. However, it says there is limited evidence that SSRI antidepressants may be effective in menopausal people who have anxiety. Read our information on the use of antidepressants in menopause +

Take a look at our information on Menopause and Mental Health +

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

The loss of oestrogen (and to a lesser extent testosterone) at the menopause can lead to problems like vaginal dryness and lack of libido.

“Did you know? It is normal to get less wet with sex. This is called vaginal dryness. It is very common.” – Dr Jane Davis

Vaginal dryness can be incredibly uncomfortable and impact on quality of life. It may include your vagina feeling sore in general or during sex, it may cause itching or an increased need to pee. It could even lead to urinary tract infections (UTIs). This can lead to general discomfort but also affect your enjoyment of sex.

As well as vaginal dryness affecting interest in sex, you may experience a drop in libido around menopause. This can be caused by changing hormone levels or your general mental wellbeing.

As mentioned above, a lack of oestrogen can also affect the bladder, meaning you need to go to the loo more often or increasing incidence of UTIs.

You may feel embarrassed to discuss these symptoms with your GP, but there’s no need to suffer in silence, there are treatments out there which can change your life.

“Did you know? You can still get pregnant once your periods have stopped. The simplest approach may be to assume you’ll need contraception up to your 56th birthday.” – Dr Jane Davis

Tips for managing

• Consider oil-based lubricants which work well. However, they may not be suitable for use with condoms.
• Water-soluble lubricants are available online or even from the supermarket and can be safer with condoms.
• Non-hormonal vaginal moisturisers are also available on the high street.
• Stay hydrated, this can help to treat UTIs, as can cranberry juice and over the counter treatments.
• Wear loose, cotton underwear to help your vagina breathe.

“Did you know? Vaginal oestrogen is a brilliant solution and is very safe for most people. It ‘plumps up’ the vaginal skin allowing it to produce your natural lubrication again. Goodbye ‘sandpaper’ sex.” – Dr Jane Davis

Ask your GP about

• Vaginal oestrogen therapy (usually given by tablet, cream or pessary).
• Oral drugs which make vaginal tissue thicker and not so delicate, so there is less pain during sex. Speak to your healthcare professional about whether these may be suitable for you.
• HRT +

Read our factsheet on vaginal dryness +

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

Whether you’ve always suffered with hormonal headaches around your period, or have barely been troubled by any, menopause can either bring relief or make them worse. As with most menopausal symptoms, the way that headaches affect you during perimenopause and menopause varies from person to person.

While some women may find that their headaches ease off, others may experience more frequent or more severe headaches during this time, some people find that they get hormonal headaches for the first time. People who have always suffered from migraines may also find that these headaches get worse during menopause.

All of this is due to the fluctuations in the hormones, oestrogen and progesterone, that menopause brings.

Tips for managing menopause-related headaches:

Apart from popping paracetamol, there are a number of ways that you can treat headaches during menopause.

• Certain types of food and drinks (for example chocolate, cheese, caffeine, red wine) could trigger your headaches, so keep a food diary to track if anything triggers the pain. If you do identify something, cut it out to see if it alleviates your symptoms.
• Dehydration can lead to headaches, so keep your fluid levels up by aiming to drink a small glass of water on the hour, every hour (don’t drink as frequently after 9pm though if you want to avoid getting up for the loo all night!).
• Try to avoid stress where you can, as this can trigger headaches. See our section on menopause and mental health + or check out the section on managing psychological symptoms +
• Eat regularly to keep your blood sugar levels up. Healthy snacking between meals, for example on dried fruit and nuts, or fruits and vegetables will keep your levels balanced.

If you take HRT + and you start getting headaches or your headaches get worse, talk to your GP about adjusting your HRT regimen.

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

Do you feel exhausted all day, every day? In the morning, does the thought of even getting out of bed seems impossible thanks to a complete lack of energy? Fatigue, or chronic tiredness, is one of the most debilitating symptoms of menopause and can hit without warning.

Although insomnia and interrupted sleep, which come as a result of the changes in your hormone levels during menopause, can be to blame, that’s not the whole story. What if you’re sleeping well but still feel overwhelmingly tired? The drop in oestrogen levels that comes with menopause can severely affect your energy levels. In addition, the stress and anxiety that can come with this age and the way we live, such as simultaneously caring for children and ageing parents, juggling work and family life, and the mental load can take its toll, especially if you’re not caring for yourself properly.

tips for managing fatigue in menopause

• Try to avoid stress where possible (we know it’s much easier said than done). Don’t feel bad about saying no to demands on your time and putting your needs first. See our information on menopause and mental health + and our section on managing psychological symptoms +
• Eat a healthy, balanced diet. Skipping meals or eating the wrong foods (for example refined sugar and saturated fats) can drain your energy. Read our section on diet and lifestyle changes +
• Stay hydrated. Drinking enough water during the day helps you to avoid dehydration, which causes fatigue.
• Get enough sleep. Again, easier said than done, so take a look at our Insomnia symptoms + section for tips on how to get some good sleep during menopause.
• If you suffer from anxiety and/or depression, both of which can contribute to fatigue, talk to your GP. Cognitive behaviour therapy (CBT) is a talking therapy available on the NHS that might help as it equips you with practical techniques to manage these conditions. You may also find our menopause and mental health + and managing psychological symptoms + information useful.
• Get checked out for any underlying causes such as iron-deficient anaemia and low thyroid function, as these can both cause overwhelming fatigue.

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

If your periods are all over the shop, that’s one of the signs that you could be in perimenopause +.

Women can experience irregular periods for years – anything between two and 10 – before they stop completely. However, some women find that their periods just stop after years of being regular as clockwork. Although your periods can be irregular around menopause, if you experience any spotting between periods please speak to your GP.

Again, it’s the fluctuation and decline in the levels of the hormones oestrogen and progesterone during menopause that are to blame. Other factors, such as stress, can also play havoc with your natural cycle.

It can be frustrating and difficult to manage if your periods arrive unpredictably, and it can also be worrying. It may be a part of menopause and nothing to worry about, but if you are concerned, always speak to your GP.

Underlying health factors can also be to blame, so make sure that you get yourself checked out to rule out any other causes. Remember that it is still possible to get pregnant when perimenopausal. Even if you haven’t had a period for months, they could still return.

Tips for managing irregular periods

If irregular periods are a part of your perimenopause, there are things that you can do to provide some relief

• Manage the stress in your life. If you have too many demands on you – from work to kids to parents to just having too much on your plate – take steps to make things easier on yourself. It’s okay to say no. Our information on menopause and mental health + and managing psychological symptoms + may help.
• Make sure you get enough sleep +. This can help you to deal better with life’s stresses.

If you are worried at all by irregular periods, talk to your GP.

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.

We’ve all walked into a room and stood looking around, without the faintest clue as to what we went in there to do. Or stared hopelessly at the screen at work, having completely lost a train of thought. Occasional lapses in memory and a general ‘mind fog’ are frustrating but are a common symptom of perimenopause +.

Oestrogen is known to have multiple effects on brain function, affecting the development and ageing of brain regions that are crucial to higher cognitive functions such as memory. It’s the fluctuation and decline in oestrogen levels caused by perimenopause that could be responsible for memory changes, difficulty thinking, and problems with concentration.

As with any symptoms of the menopause, it’s important to talk to your GP so that they can rule out any other underlying causes of your memory loss.

“Did you know? ‘Word finding’ difficulties are a really common symptom of menopause. It gets better.” – Dr Jane Davis

Tips for managing memory loss in menopause

If you find that perimenopause is impacting on your memory, here’s how to help clear that brain fog:

• Keep your body active. Physical exercise stimulates the release of chemicals in the brain that affect the health of brain cells, the growth of new blood vessels in the brain, and even the production of new brain cells.
• Stimulate your brain. Mental exercise helps to build new neural connections, which helps to boost memory.
• Keep hydrated. Staying topped up with small glasses of water every hour helps to keep you sharp. As a famous doctor once said: “Never pass a tap without having a drink.”
• Write everything down. Whether it’s scribbling notes on a pad to help you remember what you need to do that day, keeping a meticulous calendar or setting reminders on your phone, keep on top of things by writing them down.
• A balanced diet is the foundation of good health. Foods that contain Omega-3 fatty acids can help to maintain a healthy brain and play an important role in hormone production. Read more on diet and lifestyle changes +

Download our helpful menopause symptoms tracker to keep a note of the symptoms you’re experiencing.