Menopause signs and symptoms

Menopause hub: Everything you need to know about perimenopause and beyond

10th June 2024 | Author: Victoria Woollaston-Webber

We’ve pulled together everything you need to know about menopause and beyond – from menopause symptoms to treatments, when it starts, when it finishes and more 


Following decades of menopause being a taboo subject, an increasing number of brands, celebrities and influencers are putting it firmly on the agenda. And rightly so.

A large portion of our readership at mamabella – including ourselves – are of an age where perimenopause and menopause are increasingly front of mind.

Some of us are going through it, some of us are coming out the other side while others are approaching “menopause age” and are trying to be get prepared as much as they can.

With this in mind, we wanted to pull all of our menopause resources together into a single menopause hub.

This way you can get answers to some of the most common questions, as well as ask us any specific questions that may be on your mind.

This page isn’t designed to scare or worry you.

Yes, menopause can be a turbulent time and your body goes through a lot but being armed with what to expect can hopefully make you prepared.

Half of the population go through it. Let’s come together to share the load!

FURTHER READING: Best menopause treatments 


What is the menopause? Key menopause stages

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There are three major stages involved in menopause.

  • Perimenopause: This describes the period of time (usually several years) leading up to when your body stops having periods. It can also be called pre-menopause or early menopause. Your hormones gradually start shifting, your periods become less regular and your body reduces how many eggs it produces. This is the period that most people mean when they talk about “being in menopause.”
  • Menopause: One you’ve gone 12 months without a single period, meaning your body has stopped producing eggs, you’ve officially reached menopause.
  • Post-menopause: As soon as hit that milestone, you move into post-menopause. This means you’re no longer menopausal and most of the symptoms that have been consuming your life for the past years settle down.

A big misconception is that the term menopause covers the entire process. In fact, menopause is just a moment in time. Once a woman hasn’t had a period for 12 consecutive months, she’s finished menopause. Every symptom and change experienced before the end of this 12 months is known as perimenopause – and everything after it is post-menopause.

Within these three major milestones are a total of seven menopause stages:

  • Pre-menopause: The time before any menopausal symptoms begin.
  • Early perimenopause: The onset of irregular menstrual cycles and mild symptoms.
  • Late perimenopause: More significant menstrual irregularities and more intense symptoms.
  • Menopause: The point when you’ve not had a menstrual period for 12 consecutive months.
  • Early post-menopause: The first five years after menopause, where symptoms may still be significant.
  • Mid post-menopause: Symptoms may start to decline.
  • Late post-menopause: Generally, symptoms have significantly lessened or resolved.

For the purposes of this article, we’re going to use the word menopause to include both perimenopause and menopause. 


Menopause age: When does menopause start?

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The timings of perimenopause and menopause vary from woman to woman, and from race to ethnicity, but it typically starts between the ages of 45 and 55. The average age is 51.

In cases where women experience menopause between the ages of 40 and 45, this is clinically classified as early menopause.

In rare cases (1 in 100 in the UK), menopause can start in your 30s and this is classed as premature menopause, or primary ovarian insufficiency (POI).

Several factors influence your menopause age. These include:

Menopause age vs genetics

Your genes play a significant role in determining when menopause starts. If your Mum or sisters went through menopause early, your up to six times more likely to go through early menopause too, and six times more likely to start it late, if your Mum had a late menopause.

The reason for this isn’t fully understood. There isn’t a single “menopause gene” and researchers believe a complex interplay of as many as 300 genes determines your menopause age.

All genes may have different variations (alleles). Some alleles can accelerate the decline of your eggs, which leads to early menopause. Other alleles have a protective effect and slow this process down, effectively delaying menopause. The specific combination of alleles you get from your parents determines how these alleles behave.


Menopause age vs race/ethnicity

When generalisations are made about menopause age, they can be largely made using studies and research on white women.

Black, Hispanic, and Latina women have been found to experience menopause typically a year or two earlier than white women. There are then further variations. Asian American women, for instance have been found to have different menopause ages and these variations across all races and ethinicities, again, come down to variations in the genes associated with hormone production and ovarian function.

Some studies have linked these differences to social determinants of health, like access to healthcare and socioeconomic status. For example, chronic health conditions more prevalent in some racial groups have been linked to earlier menopause.


Menopause age vs lifestyle

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Smoking is one of the most significant lifestyle factors that can contribute to early menopause. Other factors, such as excessive alcohol consumption and being underweight, can also play a role. However, there have been multiple studies that have found links with a whole list of other factors, some of which seem obvious and others which feel more random. These include:

  • If your Mum smoked during pregnancy, this might lower your menopause age
  • Growing up in poverty
  • Being breastfed for less than one month
  • If you parents divorced, or you grew up in a single-parent household

On the opposite end of the spectrum, there are other factors that have been linked with preventing early menopause:

  • Starting your period after the age of 16
  • Irregular periods
  • Having a child, especially if you have that child later in life
  • Breastfeeding
  • Oral contraceptive use
  • High-calorie, healthy fat, and protein diet
  • Not becoming a vegetarian until the age of 40

Menopause age vs health conditions

Certain autoimmune diseases, such as lupus and rheumatoid arthritis, can cause premature menopause as can chronic health conditions such as diabetes and thyroid disease.

Again, the exact reasons are unknown but there are a number of suspected and studied causes.

  • Inflammation: Many autoimmune diseases and health conditions involve inflammation, which can damage tissues throughout the body, including the ovaries.
  • Hormones: The damage caused by too much inflammation can disrupt the hormonal balance needed for ovulation and egg production, potentially leading to earlier menopause. Thyroid disorders, for instance, directly affect hormone levels. This can mess with the delicate balance between oestrogen and progesterone, which regulate ovulation and menstruation.
  • Reduced blood flow: Certain health conditions, like diabetes or vascular diseases, can impair blood flow to the ovaries. This reduced blood flow can limit the delivery of oxygen and nutrients needed for optimal ovarian function.
  • Surgical procedures: Surgical procedures that remove the ovaries, such as a hysterectomy, will cause immediate menopause. Regardless of the age at which you have the surgery.

FURTHER READING: Worried about saggy boobs? Experts reveal how to beat the ‘boob drop’ or at least delay it


What happens during menopause?

What happens during menopause to skin and hairiStock

To reach menopause, the body goes through a significant hormonal shift. It’s not called “the change” for nothing.

  1. Follicles in the ovaries die and stop secreting oestrogen and progesterone.
  2. Oestrogen levels drop. Oestrogen is the female sex hormone and helps maintain vaginal blood flow, lubrication and elasticity. It’s what causes the lining of the uterus to thicken during the menstrual cycle, but it’s also the hormone that contributes to brain health, bone health, and the function of the cardiovascular system, among other bodily functions.
  3. Progesterone levels drop. This hormone is responsible for preparing the lining of the uterus for a fertilised egg and it helps keep the body in balance in early pregnancy.

To make matters worse, these two hormones work together in a delicate balance to keep the body in check so when perimenopause hits, this balance is thrown out of whack.

You can find out more about the symptoms, menopause treatments as well as how it impacts your sex life and more at Menopause Experts. The site offers free training and also offers training for men – the first of its kind.

FURTHER READING: The best intimate products for all your period and feminine hygiene needs


How long does menopause last?

  • Perimenopause typically lasts four to 10 years.
  • Menopause is a moment in time, when you have your final period.
  • Postmenopause continues for the rest of your life.

How can I tell if I’m starting menopause?

You might be starting menopause if you notice irregular periods, hot flushes, night sweats, mood swings, changes in your sleep patterns and vaginal dryness. We list the common, and more rare signs of menopause below.

A blood test measuring follicle-stimulating hormone (FSH) and estradiol levels can help confirm if you are in menopause or not.


Symptoms of menopause

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The symptoms of menopause can differ from woman to woman but because it involves changes in hormone levels, there are some common menopause, and early menopause symptoms.

The key menopause symptoms are below. You can learn more about these symptoms in our menopause symptoms and our treatments guide.

Other common signs of menopause include:

  • Hot flushes: Hot flushes are sudden feelings of heat that can be intense and can spread over the upper body and face, sometimes followed by sweating and then chills. You can get cooling bra inserts to help with these.
  • Vaginal dryness: Reduced moisture and lubrication in the vaginal area  can cause discomfort and pain during intercourse.
  • Urinary issues: You might find you need to wee more often, or more urgently, and you have a higher risk of urinary tract infections.
  • Weight gain: Changes in metabolism can lead to you putting on weight, particularly around your stomach. Even if you’ve always been thin and even if you haven’t changed your diet or exercise regime.
  • Decreased libido: A reduced interest in sex, often due to vaginal dryness and hormonal changes, is common in perimenopause.
  • Pain during intercourse: Vaginal dryness and thinning of the vaginal walls can lead to discomfort or pain during sexual activity.
  • Irregular heartbeats or a feeling that the heart is racing.
  • General aches and pains, stiffness, and sometimes swelling in the joints.

FURTHER READING: What happens to skin and hair during menopause? Tips on how to manage menopause symptoms


What are some uncommon symptoms of menopause?

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Uncommon symptoms of menopause include:

  • Burning mouth syndrome
  • Electric shock sensations
  • Tinnitus, which is a high-pitched ringing in the ears
  • Formication – the feeling of insects crawling on the skin
  • Changes in body odour – check out our best deodorants for women guide for help.

These symptoms are rare but can still occur.


What is HRT and what does HRT do to the body? 

Some people going through perimenopause choose to treat their symptoms with hormone replacement therapy – taking combinations of hormones to replace those no longer being produced by the body. In some cases, this can prevent many unwanted changes to the skin by addressing the root cause.

HRT AND BREAST CANCER

A long-term study by the Women’s Health Institute, between 1993-2002, raised concerns that taking a combined pill form of HRT increased a woman’s risk of breast cancer by as much as 75%.

However, not only were the results published too early into the trial, but there have since been concerns raised about the representation of the sample, and the methodology.

In 2015 and 2019, the National Institute for Health and Care Excellence (NICE) updated its guidelines to say HRT with oestrogen alone is associated with ‘little or no change in the risk of breast cancer.’

As its name implies, hormone replacement therapy is a treatment used to replace oestrogen and progesterone lost during perimenopause and menopause.

Treatment involves either taking both of these hormones, known as combined HRT, or by taking oestrogen-only HRT, usually only recommended if you’ve had a hysterectomy.

Historically, studies found that HRT could increase the risk of breast cancer but this has been largely refuted.

Older forms of HRT relied on synthetic forms of progesterone, and an oestrogen replacement typically made from mare’s urine, administered via a pill. More modern forms of HRT instead use what’s known as bioidentical hormones.

This means the chemical structure of the hormones in the treatment is identical to what women create naturally. And they’re now available in sprays, gels or patches – known as transdermal HRT.

Due to the fact modern, bioidentical HRT uses hormones that mimic those created naturally in the body, studies have reported fewer side effects including a lower risk of breast cancer than previously thought.

What’s more, transdermal HRT lowers the risk of breast cancer further because the hormones aren’t being transported into the body via the liver.

Medical reports found that it was the metabolism of oestrogen as it travelled through the liver, when delivered in pill-form, that was linked to increased instances of breast cancer, as well as blood clots and strokes.

Delivering oestrogen via the skin lowers this risk, even for women with a past history of these conditions.

One study showed taking oestrogen supplements for one year could improve skin’s thickness by 30%. Another showed taking HRT for a year increased collagen by 6%

Not everyone will be eligible to undergo HRT and the decision to start taking hormone supplements should be made by taking into account all the pros and cons and consulting with your doctor.


Menopause FAQs

Below we’ve started answering some of the questions we’ve been sent about menopause, its signs and symptoms. If you want to know anything specifically then send us a message on Instagram or Facebook.

What signals the end of menopause?

The end of menopause is signalled when you’ve not had a period for 12 months in a row. This means that if you get to 11 months without a period, but then have one in your 12 month the timer resets and starts again.

Once you’ve gone 12 consecutive months without bleeding, you’re considered to have reached post-menopause. While some symptoms may continue into post-menopause, the most significant hormonal fluctuations generally start to stabilise.

FURTHER READING: Holland & Barrett develops the first official British Sign Language guide for menopause


Is it better to go through menopause without HRT?

This is a highly personal decision and depends on how severe your symptoms are, your individual health risks, and preferences. Some women manage menopausal symptoms well with lifestyle changes, changing their diet, natural menopause treatments, or non-hormonal treatments.

However, if you have severe symptoms, HRT can give significant relief and improve your quality of life. It’s best to speak with a healthcare provider, your family and loved ones and make a decision that suits you best.


What can be mistaken for menopause?

Period symptoms at each stage of your periodmamabella | mamabella

Because our bodies go through a state of hormonal flux on a monthly basis, many of us don’t realise we’re perimenopausal for months or even years. Many of the signs of menopause are similar to those that occur during your menstrual cycle too.

Other women may think they’re in perimenopause because they’re experiencing common perimenopause symptoms, but then these symptoms suddenly stop. This happens because the hormones that had been dropping may suddenly peak. It doesn’t you’ve stopped being in perimenopause, and this can be confusing and upsetting.

Conditions that can be mistaken for menopause include thyroid disorders, depression, anxiety, chronic fatigue syndrome, and other hormonal imbalances. These can produce symptoms similar to menopause, such as mood changes, fatigue, and irregular periods.

If you’re not sure, speak with your GP or an expert.


Is there a test to know if you are in menopause?

Yes, there is a test that measures levels of follicle-stimulating hormone (FSH) and estradiol.

High FSH levels and low estradiol levels are typical markers of menopause. Anti-Mullerian Hormone (AMH) tests and antral follicle counts, done via ultrasound, can also give insights into ovarian reserve, although they are not definitive tests for menopause.


What are the red flags of menopause?

Red flags include severe hot flushes, night sweats, significant mood swings, depression, anxiety, severe sleep problems, unexplained weight changes, and prolonged irregular periods.


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