Hormones & periods
Menopause and Perimenopause Symptoms: Early Signs, Causes and When to See a Doctor
Quick answer
Common menopause symptoms are irregular periods, hot flushes, night sweats, trouble sleeping, mood changes, brain fog, vaginal dryness and joint aches. They often start in perimenopause, the years before periods stop, and are caused by falling oestrogen levels. Symptoms vary widely, and a doctor can discuss treatment options if they affect daily life.
Last reviewed NariCareLife editorial team · 5 sources
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What is Menopause?
Menopause is when periods stop because the ovaries make less oestrogen and no longer release eggs. It is confirmed when you have gone 12 months without a period. For most women it happens between 45 and 55 years of age.
Perimenopause is the transition time before menopause, when hormone levels rise and fall unevenly. Many symptoms begin here, often while periods are still coming, and this stage can last several years.
Every woman’s experience is different. Some have mild changes, while others find symptoms affect sleep, work and relationships. Menopause can also happen earlier, naturally or after surgery or some medical treatments.
Common symptoms of Menopause
Changes to periods
Periods may become irregular, closer together, further apart, lighter or heavier before they stop completely.
Hot flushes
Sudden waves of heat in the face, neck and chest, sometimes with redness, sweating or a racing heart.
Night sweats
Hot flushes at night can cause heavy sweating that disturbs sleep.
Difficulty sleeping
Trouble falling or staying asleep, which can add to daytime tiredness and irritability.
Mood changes and anxiety
Low mood, irritability, anxiety or feeling less like yourself are common during the transition.
Brain fog
Problems with memory or concentration, such as forgetting words or losing your train of thought.
Vaginal dryness and discomfort
Dryness, itching or pain during sex can happen as oestrogen falls, and interest in sex may change.
Joint and muscle aches
Stiffness or aches in joints and muscles are reported by many women during this stage.
Urinary changes
Needing to pass urine more often, leaking urine or more frequent urine infections.
Headaches and palpitations
Some women notice more headaches or an awareness of their heartbeat.
What can cause Menopause?
- Natural ageing of the ovaries, which gradually make less oestrogen and progesterone, is the usual cause.
- Surgery to remove both ovaries brings on menopause straight away.
- Some cancer treatments, such as chemotherapy or radiotherapy to the pelvis, can cause menopause earlier.
- Premature ovarian insufficiency, where the ovaries stop working normally before 40, can cause early menopause.
- Family history can influence the age at which menopause begins.
How is Menopause diagnosed?
A doctor can usually diagnose perimenopause or menopause from your age, your symptoms and changes in your periods, especially if you are over 45. Blood tests to check hormone levels are not always needed, because hormone levels change from day to day in perimenopause. Tests may be suggested if you are younger than 45, to rule out other causes such as thyroid problems. Your doctor may also check blood pressure, weight and bone health risk.
When to see a doctor
See a doctor if menopause symptoms are affecting your sleep, mood, work or relationships, or if you have symptoms before 45. There are treatment options, including hormone replacement therapy (HRT) and non-hormonal choices, and your doctor can explain the benefits and risks for you. Always get any bleeding after menopause checked promptly, even if it is light or happens only once.
Get medical help promptly if you notice:
- Any vaginal bleeding after menopause, meaning 12 months or more after your last period.
- Very heavy bleeding, bleeding between periods or bleeding after sex.
- Periods stopping or menopause symptoms starting before the age of 40.
- Severe low mood, hopelessness or thoughts of harming yourself.
- Chest pain, severe breathlessness or a racing heartbeat that does not settle.
In an emergency, call 112 or go to the nearest hospital.
How nutrition and lifestyle may help
Food does not cure or treat Menopause, but everyday habits can support your overall wellbeing alongside the care your doctor recommends.
Protect your bones with calcium-rich foods
Bone loss speeds up after menopause. Including curd, milk, paneer, ragi and sesame seeds may help support bone health.
Get safe sunlight and ask about vitamin D
Sunlight on the skin helps the body make vitamin D. Discuss testing or supplements with your doctor rather than self-dosing.
Include protein at every meal
Dal, chana, eggs, fish, paneer or curd with each meal may help support muscle strength and fullness.
Notice your hot flush triggers
For some women, spicy food, caffeine, alcohol or hot drinks make flushes worse. Keeping a simple diary can show what affects you.
Move your body regularly
Brisk walking, yoga and strength exercises can support mood, sleep, weight and bone strength.
Keep a steady sleep routine
A cool, dark room, regular sleep times and lighter evening meals may help support better rest.
Indian foods to include
- Curd and buttermilk
- Milk and paneer
- Ragi roti or ragi porridge
- Til (sesame) seeds and til chikki in small amounts
- Chana, rajma and moong dal
- Green leafy vegetables such as methi and palak
- Eggs and fish such as sardines
- Whole grains such as jowar, bajra and brown rice
- Fresh fruits such as guava, amla and papaya
Key takeaways
- Perimenopause symptoms often begin years before periods stop.
- Irregular periods, hot flushes, night sweats, poor sleep and mood changes are the most common signs.
- Bleeding after menopause always needs to be checked by a doctor.
- Doctors can discuss HRT and non-hormonal treatment options.
- Calcium, protein, regular activity and good sleep may help support wellbeing through this stage.
Menopause: frequently asked questions
The first sign of perimenopause is usually a change in your periods, such as cycles becoming shorter, longer, lighter or heavier. Hot flushes, night sweats, poor sleep, mood changes and brain fog may start around the same time. These signs can begin while you still have periods, often in your 40s.
Menopause usually happens between 45 and 55 years of age. Menopause before 45 is called early menopause, and before 40 it may be premature ovarian insufficiency, which needs medical assessment. Perimenopause symptoms can begin several years before your final period, so changes in your early to mid-40s are common.
Menopause symptoms usually last several years, and the length varies a lot between women. Hot flushes and night sweats often ease over time, while vaginal dryness may continue unless it is treated. If symptoms are affecting your life, speak to a doctor, as treatment can help at any stage.
Yes, many women find they gain weight more easily around menopause, especially around the tummy. Hormone changes, loss of muscle with age, poorer sleep and lower activity all play a part. Protein-rich meals, strength exercises, regular walking and good sleep can support healthy weight management during this stage.
No, bleeding after menopause is not normal and should always be checked by a doctor. This includes spotting or a single episode of light bleeding 12 months or more after your last period. Often the cause is not serious, but it needs to be examined to rule out conditions that need treatment.
Diet may help a little with hot flushes for some women, mainly by avoiding personal triggers. Spicy food, caffeine, alcohol and hot drinks can make flushes worse in some people. Regular meals, staying cool and managing stress may also help. If flushes are troublesome, a doctor can discuss HRT or non-hormonal treatments.
Sources & references
- Menopause — NHS
- Menopause fact sheet — World Health Organization
- Menopause basics — Office on Women’s Health, U.S. Department of Health and Human Services
- The Menopause Years — American College of Obstetricians and Gynecologists (ACOG)
- What Is Menopause? — National Institute on Aging
