A hot flush in the middle of a meeting, periods that arrive whenever they please, nights broken by sweats and a mood that swings for no clear reason. Menopause can bring all of this, and when it eats into work, sleep or relationships, it deserves proper care.
Menopause is when menstrual periods stop permanently, and the years before it are called perimenopause. The World Health Organization notes that hormone changes during this transition can bring irregular periods, hot flushes, night sweats, sleep problems, mood changes, joint aches and vaginal dryness, with some women barely affected and others significantly.
Not every change is just menopause. Heavy bleeding, bleeding after sex, bleeding after periods have stopped, new pelvic pain or severe mood symptoms need medical assessment, and a gynaecologist can also check for conditions such as thyroid disease, anaemia or fibroids.
Falling oestrogen around menopause can speed bone loss, so weight-bearing activity, strength training, adequate calcium and vitamin D where needed, avoiding tobacco and limiting alcohol all support bone health. Some women may need bone-density testing or medicine based on age, fracture history and other risk factors.
Menopausal hormone therapy can be very effective for selected women with troublesome symptoms, but it is not the same choice for everyone, and as the Menopause Society sets out, the decision depends on symptoms, age, time since menopause and health history. A history of certain cancers, blood clots, stroke or liver disease can change the balance, so it should be discussed with a qualified clinician.