Menopause

The menopause is a natural part of ageing and happens as our oestrogen levels decline. The average age in the UK for a woman to reach menopause is 51.

  • It usually occurs between 45 and 55 years of age. However, some women may experience menopause before the age of 40, this is known as premature menopause (this affects about 1 in 100 women)
  • You may start to have symptoms for many years before your periods completely stop. This is called the perimenopause.
  • Periods may start to become less frequent over a few months or years before they stop altogether. Sometimes they can stop suddenly
Menopause

Symptoms

Many women experience menopause differently. 8 in 10 women develop symptoms.

Some women find that their symptoms can be quite severe and may have a significant impact on their daily lives.

Symptoms may continue for 4 years after your last period; however 1 in 10 women may have symptoms for much longer.

Common symptoms include:

  • Irregular, light/heavy periods
  • Hot flushes
  • Night sweats
  • Vaginal dryness and discomfort during sex
  • Reduced sex drive
  • Low mood or anxiety
  • Difficulty sleeping

If you develop any unusual symptoms bleeding (such as bleeding after sex) it is important to make any appointment with your GP

Hormone Replacement Therapy

The main treatment for menopausal symptoms is HRT. However, there are other treatments available which may help with some specific symptoms of menopause.

  • Menopause symptoms are caused by low oestrogen levels. Hormone Replacement Therapy (HRT) replaces the hormones that are missing, and it is therefore very effective at helping to relieve menopausal symptoms.
  • If you have a womb you will also need progestogen to protect the womb lining
  • HRT can help relieve your symptoms and help prevent thinning of bones (osteoporosis), which is common after menopause
  • HRT is available as a skin patch, a gel or as a tablet. Different women prefer different forms, and it is therefore important to find what is right for you – your GP will be able to discuss this with you and answer any concerns you have. You may find some of the below information useful when considering what may be right for you.
  • There are two routines for taking HRT:
    • Cyclical HRT is offered if your last period was less than 12 months ago – This allows your periods to continue for as long as they naturally would
    • Continuous HRT is offered if your last period was over 12 months ago
TabletsTablets are usually taken once a day
– Combined HRT: Combines oestrogen and progestogen (to protect the lining of your womb)
– Oestrogen-only HRT: Is offered if you have had an operation to remove your womb (hysterectomy)
PatchesPatches contain oestrogen and are applied to your skin every few days
– If you still have a womb, you will also need to take a progestogen tablet, to reduce your risk of womb cancer
GelOestrogen gels are rubbed into the skin daily
– If you still have a womb, you will also need to take a progestogen tablet, to reduce your risk of womb cancer
Vaginal oestrogenVaginal oestrogen is available as a cream or pessary
– Vaginal oestrogens are helpful in relieving symptoms of vaginal dryness. They will not help with other symptoms, such as hot flushes.
– Vaginal oestrogens do not carry the same risks as HRT taken in other forms and therefore you do not need to take a separate progestogen tablet, even if you still have a womb

FAQ and useful information

Are there any risks in taking HRT?

For many women, the benefits usually outweigh the risks of HRT. The risks are very small and depend on what form and for how long you take HRT. Any risks fall after you stop taking it:

  • Breast cancer – Combined HRT carries a very small increase in the risk of developing breast cancer. It is therefore very important that you attend breast screening invitations and continue your self-examinations. You can find further information on breast cancer awareness in our Breast Awareness section.
  • Blood clots – There is no increased risk of blood clots if you take HRT gels or patches. There is a very small increased risk of blood clots if you take tablet HRT.
  • Stroke – There is a very small increased risk of stroke if you take tablet HRT, however the risk of stroke in women under 60 is generally very small.

If you have any concerns, then your GP will be able to discuss this with you.

Are there any side effects with HRT?

Most medication has some side effects. Many women feel the symptoms of menopause outweigh any side effects of HRT medication.

  • Oestrogen – Bloating, breast tenderness, feeling sick, headaches, indigestion, and vaginal bleeding
  • Progestogen – Breast tenderness, headaches, mood swings, acnes, vaginal bleeding

If you have any concerns, then discuss this with your GP. Any bleeding that is new for you should always be discussed with your GP.

Are there any alternatives to HRT?

Regular exercise and a balanced diet can help boost mood, regulate sleep and help keep your weight and bones healthy

Wearing light clothing and keeping rooms cool may help with hot flushes

Stopping smoking and reducing alcohol and caffeine can also help reduce hot flushes and keep your body healthy

There are other medications and options available which you can discuss with your GP/nurse practitioner

Are there any information resources available online?

Page last updated: 15 April, 2024