As a general practitioner, I still encounter women who are confused by the wide range of symptoms, even though menopause is now more openly discussed than ever before.
It’s not only about your periods ceasing or hot flushes — there are believed to be over 30 different symptoms connected to menopause.
You don’t need to experience the well-known ones to seek help or even consider hormone replacement therapy (HRT).
It’s also a misconception that menopause only happens at a specific age; its symptoms can persist for decades after periods stop and may even start up to ten years beforehand — and yes, it can be quite unpleasant!
But that doesn’t mean you have to simply “put up with it.”
Menopause impacts your entire body. Although it begins in your ovaries, its effects reach far beyond them.
This shouldn’t surprise anyone — after all, puberty affects our bodies and emotions in much the same way.
According to the British Menopause Society, women experience an average of seven menopause-related symptoms, and some of them might seem completely unrelated.
1. RATTLING AROUND
There are various aches and pains during menopause that may feel like arthritis.
Many women may have even been misdiagnosed because these aches and pains linked to menopause are often not taken seriously enough.
People often dismiss such discomforts as “a normal part of ageing” or “something that just happens.”
I personally don’t agree with that view.
What makes things worse is that this stage of life is also when osteoarthritis and other joint issues can develop.
Hormones influence body tissues such as muscles, ligaments, and cartilage, all essential for the smooth functioning of joints like the knees, shoulders, and hips.
When hormone levels shift, joint strength and stability may decline, leading to stiffness and pain.
A drop in oestrogen affects how our connective tissues, bones, and spinal discs metabolize — and muscle mass can also decrease.
These joint aches are often underestimated; when you feel sore, you’re less likely to exercise or feel motivated, which can lead to weight gain and a low mood — forming a tough cycle.
Regular physical activity is key to easing joint pain. I also recommend taking vitamin D and ensuring your diet contains enough calcium.
Additionally, HRT is known to provide relief, and that alone is a valid reason to give it a try.
2. DULL THROB
It’s easy to dismiss headaches or blame them on dehydration, but headaches are a recognized menopause symptom, especially if you’ve always experienced them during your periods or premenstrual tension (PMT).
Women are more likely to suffer from headaches than men, largely due to fluctuating hormone levels — just like when starting a contraceptive pill or during monthly cycles.
It’s not necessarily high or low hormone levels that cause the problem, but rather the constant up-and-down changes.
If you start experiencing new headaches, it’s important to discuss them with your doctor.
For women prone to migraines, these often worsen during menopause.
While HRT may help, it can also trigger headaches in some individuals, so your doctor might suggest specific migraine medications as an alternative.
3. SURPRISE ENCORE
Everyone associates menopause with the end of periods, since menopause is defined as having no period for 12 consecutive months.
So it can be surprising to find you’re still bleeding.
During the transitional phase known as perimenopause, your cycles may become shorter or longer, you might skip some periods, and experience heavier or unpredictable bleeding.
This can mean having two periods in one month or dealing with periods that are irregular and difficult to predict — which can be frustrating when you thought you were nearing the end.
The pattern of irregular bleeding varies from person to person, and the reason isn’t fully understood.
During this stage, doctors often prescribe a specific type of HRT called cyclical HRT, which helps regulate and reduce heavy bleeding.
You may still bleed, but it tends to be lighter and more predictable.
However, if you experience any bleeding after your periods have completely stopped, you should consult a doctor immediately, as it could, in rare cases, indicate endometrial cancer.
4. DRIP AND DASH
Although menopause primarily affects the reproductive system, it also impacts the urinary system — including the bladder and kidneys — because these organs are closely connected.
The oestrogen hormone helps maintain the health of the urethra and bladder.
As oestrogen levels drop, the bladder lining can become thinner and drier, leading to increased sensitivity, frequent urination, irritation, and sometimes recurrent infections.
Combine that with weakened pelvic floor muscles, which often deteriorate around this time, and it’s no surprise many women experience bladder issues.
These problems can range from urgency and leakage (incontinence) to a general lack of bladder control.
Studies suggest that up to half of menopausal women may experience urinary symptoms.
This can be distressing and embarrassing, especially when you constantly worry about finding a toilet or having an accident.
One effective treatment for bladder-related symptoms is topical or vaginal HRT, available as a cream or pessary.
It’s now possible to buy this form of treatment over the counter, and many women find it extremely beneficial.
Five GP-recommended menopause aids
- SkinGenius ‘Oil Day Long’ – Helps manage menopause-related skin changes
- Indi MIND – Reduces fatigue and mental fog
- HANX Lubricant – Relieves vaginal dryness
- Gina Vaginal Oestrogen HRT – Available without prescription
- Tisserand Sleep Better Pillow Mist Spray – Naturally promotes better sleep
5. TOSSING AND TURNING
Around a third of adults in the UK say they struggle with insomnia, so sleep problems are common.
However, 60 per cent of menopausal women report new or worsening sleep disturbances during this stage of life.
Insomnia can occur on its own, but it’s often linked to other menopause symptoms like night sweats.
Having to change clothes at night or get up frequently to urinate disrupts rest, worsening mood and contributing to anxiety the following day.
Many women find the progesterone in HRT particularly beneficial for improving sleep quality.
Doctors can also prescribe melatonin for people over 55 — a hormone that naturally regulates the body’s sleep-wake cycle.
Although melatonin is widely available as a supplement in other countries, it requires a prescription in the UK.
6. GROW NO MORE
Many times, I’ve diagnosed menopause after a woman came in complaining of hair loss.
Our hair responds to various hormones, and when oestrogen levels fall, it can cause dramatic changes in thickness and condition.
Some women notice increased hair shedding — especially while washing or brushing.
Others may develop female pattern hair loss, where hair thins at the crown, front, or sides.
Discussing hair loss with your doctor is crucial, not only for self-esteem but also because it could signal thyroid issues, iron deficiency, or menopause itself.
With HRT restoring oestrogen levels, many women notice an improvement in their hair over time.
7. SAGGING SAGA
Few of us fondly remember the acne of our teenage years, but menopause can trigger similar skin issues due to hormonal fluctuations.
During menopause, acne may return or appear for the first time.
In addition, wrinkles and sun damage naturally increase with age, while falling oestrogen levels cause the skin to lose elasticity, moisture, and collagen — the protein that gives skin its firmness.
As collagen breaks down, skin becomes looser, thinner, and more prone to bruising.
It can be difficult to tell whether these skin changes stem from menopause, ageing, or environmental factors like sun exposure.
Some women notice better skin while on HRT, even if they started it for other reasons.
Be cautious with collagen supplements — their benefits are often exaggerated.
You might achieve better results using a high-quality moisturiser and serum instead.
The various menopause treatments
The main treatment for menopause is Hormone Replacement Therapy (HRT), which restores low hormone levels.
There are different types and dosages, so it’s important to find what works best for you.
Oestrogen is available as:
- Skin patches
- Gels or sprays for the skin
- Implants
- Tablets
If you still have a uterus, you’ll also need progesterone to protect the womb lining — using both is called combined HRT.
Progesterone can come as:
- A combined patch with oestrogen
- An IUS (intrauterine system or coil)
- Tablets
Some women may also be prescribed testosterone gels or creams to boost sex drive, mood, and energy. Others use extra oestrogen creams, tablets, or rings to ease vaginal dryness and discomfort.
Other medications that help with menopause symptoms include:
- Clonidine (a blood pressure medicine) and gabapentin (an epilepsy drug) for hot flushes and night sweats
- Antidepressants for anxiety or depression
- Cognitive Behavioural Therapy (CBT) for emotional balance
Alternative or herbal treatments are generally not recommended, as their safety and effectiveness remain unclear.
Source: NHS and The Sun, UK on 23 September 2025
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