Perimenopause and menopause are different for everyone.
You may get symptoms that have a big impact on your daily life, including relationships, social life, family life and work, or you may hardly have any symptoms at all.
Symptoms can happen during perimenopause and menopause. They can also happen after your menopause has ended (post menopause).
Sometimes, ethnic background can affect symptoms of perimenopause and menopause, how severe they are and how long they last. For example, women from a Black ethnic background are more likely to have hot flushes that are severe and continue longer.
Changes to your periods
One of the first signs of perimenopause is usually a change to your periods. They may happen more often or less often, and bleeding may get heavier or lighter. Eventually, you stop having periods altogether.
Hot flushes and night sweats
Hot flushes are when your face, neck and chest suddenly feel very hot or cold. It can make you sweat a lot, cause palpitations or anxiety, or make you feel dizzy. It can happen during the day or night (night sweats) and last for several minutes.
Sleep problems
Not being able to get to sleep or stay asleep can affect your daily life. It can make you feel irritable, stressed and anxious. Sleep problems may be worse if you also have night sweats.
Mood changes, poor memory and brain fog
You may have mood swings, low mood or depression. You may also notice problems with your memory or concentration. These symptoms may feel worse if you have sleep problems and feel very tired.
Weight gain
Weight gain during perimenopause and menopause is common. It often happens around the stomach and upper body.
Vaginal problems
You may get symptoms such as dryness, a burning feeling, irritation or itching in and around the vagina. These symptoms can also make sex feel painful.
UTIs (urinary tract infections)
You may get more UTIs (urinary tract infections) or symptoms that feel like a UTI. This includes feeling pain or a burning sensation when you pee and needing to pee more often than usual, including at night.
Other symptoms of menopause and perimenopause
Menopause and perimenopause may affect you in other ways, including:
- a faster, slower or more noticeable heartbeat (palpitations)
- weakening bones (loss of bone density), which can lead to osteoporosis
- feeling the need to pee more or not being able to control when you pee (urinary incontinence)
- headaches and migraines that are worse than usual
- muscle aches and joint pains
- hair thinning or hair loss
- skin changes, including dry and itchy skin
- reduced sex drive (loss of libido)
- sensitive teeth, painful gums or other mouth problems
- you think you have symptoms of menopause or perimenopause and want to know what your options are
- you have symptoms like a fast heartbeat (palpitations)
- you still have periods but your bleeding pattern has changed and you're bleeding more, not less, than before
- you have not had a period for 12 months or more, and you have any vaginal bleeding
Early advice can help reduce the effects of menopause and perimenopause on your health, relationships and work.
How long menopause and perimenopause symptoms last
Perimenopause ends when you reach menopause. Menopause is when you have not had a period for 12 months. After this it's called postmenopause.
Symptoms usually last for 7 to 9 years, sometimes longer, and during this time they can change.
For example, you may get hot flushes and night sweats for a while, but they may improve and be replaced by other symptoms such as low mood and anxiety.
You may also get symptoms that continue after menopause, such as joint pain and vaginal dryness.
Menopause and perimenopause symptoms if you're using hormonal contraception
Using hormonal contraception can make it harder to tell if you've reached perimenopause or menopause. This is because hormonal contraception can affect your periods.
Some types of hormonal contraception can make periods irregular or stop completely. These include the:
The combined pill causes monthly bleeds like a period for as long as you take it.
Talk to a GP about the best contraception for you. Depending on your age and whether you're in perimenopause or menopause, they may want to change it.
The combined pill is not recommended if you're aged 50 or over as the risks of taking it generally outweigh the benefits. A GP may recommend a progestogen-only contraception instead.
It's possible to get pregnant during perimenopause. You still need contraception:
- for 1 year after your final period, if you're 50 or over
- for 2 years after your final period, if you're aged 40 to 49 years old
Bleeding before and after menopause
Bleeding before menopause
During perimenopause, your periods may become irregular, lighter or heavier.
Taking hormone replacement therapy (HRT) during perimenopause can make your periods more regular. You may have some irregular bleeding or spotting but this should settle within 6 months.
Talk to your GP if you're taking HRT and still having irregular or heavier bleeding or spotting after 6 months.
Bleeding after menopause
If you have not had a period for more than 12 months and you get any vaginal bleeding (postmenopausal bleeding), this needs to be checked.
See a GP if:
You have postmenopausal bleeding, even if:
- it's only happened once
- there's only a small amount of blood, spotting, or pink or brown discharge
- you do not have any other symptoms
- you're not sure if it's blood
Postmenopausal bleeding is not usually serious but can be a sign of cancer. Cancer may be easier to treat if it's found early.