Claudia Jackson (RN)
Dr Adam Abbs
Next Review: Sep 1, 2025
Definition of menopause02
What are the 3 stages of menopause?03
What are the symptoms of menopause?04
How long does menopause last?05
Psychological symptoms of menopause06
Menopause and tiredness07
Other symptoms of menopause08
When to see a doctor09
How long menopause lasts is different for every woman, but on average, the transition through menopause takes around 4 years. What we term “menopause” is actually a gradual process that occurs over several months or years. It is made up of 3 stages, perimenopause, menopause, and post-menopause.
Definition of menopause
The medical definition of menopause is not having had a menstrual period for one year.
What are the 3 stages of menopause?
Perimenopause is the period leading up to menopause. In this stage, your hormones fluctuate causing symptoms like irregular periods, hot flashes, sleep disturbances, and mood changes.
Menopause is medically diagnosed when you haven’t had a period for a year. At this stage, your ovaries are no longer releasing eggs, and your periods have stopped permanently.
Post-menopause is the last stage of the menopausal transition. The symptoms of perimenopause and menopause should gradually start to improve during post-menopause, though some symptoms may persist until your hormone levels stabilise. Reduced levels of oestrogen in post-menopause may increase your risk of some health conditions such as osteoporosis (brittle bones), heart disease, and urinary tract infections (UTIs).
What are the symptoms of menopause?
The symptoms of menopause are different for everyone. Some women experience hardly any or no symptoms, while for others, symptoms can be severe and distressing, impacting their quality of life. Your symptoms may also change as you go through menopause. Here are some of the most common symptoms of menopause:
This is often one of the first signs of perimenopause. Perimenopause is the lead-up to menopause and lasts on average 4 years. Fluctuations in your hormones mean your periods may become less regular, lighter, or heavier, or your cycle may be longer or shorter than before.
Hot flashes (or hot flushes) are characterised by a sensation of heat that spreads across your chest, neck, and face accompanied by reddening of the skin. You may have a fast heartbeat, sweat profusely, and feel anxious. Hot flashes normally last around 2 to 5 minutes and after it passes you may feel a chilled sensation. Hot flashes affect around 75% of women and are one of the most common symptoms of menopause. They are thought to be due to a drop in oestrogen that affects the body’s ability to regulate its temperature.
Chills or cold flashes may follow a hot flash, or they may happen on their own. A cold flash is a sudden feeling of being cold, tingly, or shivery when there is no change in the temperature of your environment. Like hot flashes, chills are thought to be due to your body’s internal thermostat being more sensitive due to fluctuations in your hormone levels.
Night sweats are hot flashes that happen during the night. They commonly cause you to sweat excessively and disturb your sleep.
Sleep problems are common in menopause and include difficulty falling asleep or staying asleep, or poor sleep quality. Problems with sleep may be secondary to other menopause symptoms including hot flashes, night sweats, anxiety, and depression.
Hormonal fluctuations during menopause can affect the production of serotonin, a neurotransmitter responsible for regulating our moods. It’s common to experience mood swings during menopause and many women have symptoms of anxiety and depression during this time. You may also have trouble concentrating and problems remembering things. Mood changes are often made worse by other symptoms like difficulty sleeping.
The female hormone oestrogen plays many important roles in a woman’s health and wellbeing. During menopause, levels of oestrogen drop, causing the vagina to become drier and less lubricated. It can also cause the walls of the vagina to become thinner and less elastic, which can make sex painful and lead to skin tearing and infections.
Weight gain and slowed metabolism
Lower levels of oestrogen change the way your body stores fat, meaning you may gain weight around your abdomen (tummy). Your metabolic rate also slows which can often result in weight gain despite eating the same amount of calories as you did before the menopause.
Thinning hair and dry skin
Oestrogen helps skin retain water making it appear plumper and more hydrated as well as contributing to hair growth. When oestrogen levels drop, your skin may become drier and your hair thinner.
Loss of breast fullness
During menopause breast tissue becomes fattier and less dense due to a drop in oestrogen, which may affect the size and shape of your breasts. Some women also experience breast pain or tenderness, and you may find lumps in your breasts. These changes are likely due to hormonal fluctuations, but if you find a lump in your breasts, or are worried about changes to your breasts, you must make an appointment with your GP immediately.
How long does menopause last?
Menopause is a natural stage in every woman’s life and occurs when your hormone levels drop, your ovaries stop making eggs and your periods stop permanently. The most common age for menopause in the UK is 51, with most women going through menopause between the ages of 45 and 55. Menopause before the age of 45 is known as early menopause, and before the age of 40 as premature menopause. This may occur because of certain surgeries or medical treatments, though often the cause is not known. Common symptoms of menopause include hot flashes, mood changes, and difficulty sleeping.
Let’s take a closer look at what menopause is, what symptoms you may experience, and what you can do to make this natural transition easier.
Psychological symptoms of menopause
Sometimes called the “change of life,” the menopause can have a big effect on your mental, as well as physical, health. It is often a time of significant life events such as children flying the nest or caring for elderly parents as well as dealing with the physical changes to your body. Fluctuating hormone levels can also affect your mental health leading to depression, anxiety, difficulty concentrating, and memory loss.
Menopause fatigue is a feeling of extreme tiredness and low energy that can affect your ability to carry out normal daily activities. Symptoms of menopause fatigue include:
- Extreme tiredness that isn’t relieved by sleep or rest
- difficulty carrying out day-to-day tasks
- Lack of motivation and enthusiasm for normal activities
Is menopause fatigue normal?
It’s normal to feel tired from time to time, especially after a period of strenuous physical or mental activity, but menopause fatigue is a severe form of tiredness that impacts your quality of life and doesn’t improve with rest.
Causes of menopause fatigue
There are several causes of menopause fatigue including:
- Hormonal fluctuations affecting the way your body regulates energy
- Difficulty sleeping
- Sleep apnoea (a condition where your breathing stops and starts during sleep)
- Night sweats
Managing menopause fatigue
If you are suffering from menopause fatigue there are a few things you can try to improve your symptoms including:
- Sleeping in a cool room and wearing light, loose-fitting clothing
- Avoiding alcohol, caffeine, and spicy food, especially before bed
- Eating soy-rich foods to help balance your hormones
- Taking regular exercise
- Over-the-counter sleep remedies like melatonin or passionflower
- Therapies such as cognitive behavioural therapy (CBT) to help reduce anxiety and improve sleep
- Developing a sleep routine and sticking to a sleep schedule
- Maintaining good sleep hygiene (things such as not watching TV or reading in bed)
Other symptoms of menopause
While most of us have heard about the more common symptoms of menopause, there are some less common symptoms you may not be aware of, these include:
Dry, brittle nails
As you go through menopause your skin may become drier due to lower levels of oestrogen. This can also affect your nails making them drier and more likely to break.
Dry mouth and dental problems
Another effect of lower oestrogen levels can be a dry mouth. This can make it easier for bacteria to grow, possibly leading to dental decay and gum problems.
A metallic taste in the mouth
A rare symptom of menopause is a metallic taste in the mouth which may be accompanied by pain or a burning sensation of the lips, mouth, or tongue. Your sense of taste may also be affected. If you have this symptom, please see a doctor to assess if you need any further investigations.
Increased body odour when going through menopause is normally a result of hot flashes and excessive sweating. You can read more about managing body odour during menopause in our article, Natural menopause treatments that really work.
During menopause, the tissue of the vagina and vulva can become thinner and less lubricated which can lead to vaginal pain, irritation, and tearing of the skin, especially during sex.
When to see a doctor
If menopause fatigue is affecting your ability to perform day-to-day tasks, your relationships or your quality of life, make an appointment with your GP.
Menopause can be a challenging time as you deal with the physical and psychological aspects of this natural transition. While some women are glad to see the end of periods, monthly cramps, and PMT, others find the changes overwhelming. Menopause is a natural process, but there are still many treatment options available to help relieve symptoms and make the process easier. Some treatment options include:
- Prescription medications like hormone replacement therapy (HRT) and antidepressants
- Cognitive behavioural therapy
- Relaxation techniques
- Lifestyle choices such as stopping smoking, eating a healthy diet, and taking regular exercise
- Over-the-counter supplements like black cohosh and St John’s wort.
If you are experiencing symptoms of menopause, it’s easy to check with a simple home test kit.
If you are going through menopause and would like to explore treatment options, make an appointment with a GP.
National Institute for Health and Care Excellence (NICE): Menopause diagnosis and management. December 5th, 2019 (Accessed July 18th, 2022)
NHS: Symptoms. Menopause May 17th, 2022 (Accessed July 18th, 2022)
The North American Menopause Society: Hot Flashes (Accessed July 18th, 2022)
Women`s Health Concern: Menopause and Insomnia September 2021 (Accessed July 18th, 2022)
Age UK: Six things to know about the menopause April 20th, 2021 (Accessed July 18th, 2022)
PubMed: The Perimenopausal Fatigue Self-Management Scale Is Suitable for Evaluating Perimenopausal Taiwanese Women’s Vulnerability to Fatigue Syndrome March 2021 (Accessed July 18th, 2022)
WebMD: What to Know about Menopause Fatigue July 1st, 2022 (Accessed July 18th, 2022)
Everyday Health: Menopause Symptoms That May Surprise You August 23rd, 2021 (Accessed July 18th, 2022)