Menopause and perimenopause

Menopause and perimenopause are a natural stage of life caused by changing hormone levels. Perimenopause is the time leading up to menopause, when hormone levels begin to change and periods may become irregular. Menopause is reached when someone has not had a period for 12 consecutive months (if they are not using hormonal contraception that affects periods). It most commonly occurs between the ages of 45 and 55, although it can happen earlier naturally or following medical treatment or surgery.

Everyone's experience is different. Some people have few symptoms, while others find symptoms have a significant impact on their daily lives, relationships, work and wellbeing.

Common symptoms include:

  • Hot flushes and night sweats
  • Changes to periods
  • Difficulty sleeping
  • Low mood, anxiety or changes in confidence
  • Problems with memory or concentration ("brain fog")
  • Joint and muscle aches
  • Vaginal dryness or discomfort during sex
  • Changes in sex drive
  • Tiredness or reduced energy

Menopause symptoms can affect many aspects of daily life, including work, relationships, family life, confidence and social activities. The impact varies greatly from person to person, with some experiencing only mild symptoms while others find symptoms significantly affect their wellbeing and quality of life.

A brief, supportive conversation can help someone understand that support is available and encourage them to seek advice if symptoms are affecting their quality of life.

Very Brief Intervention

Ask

Use open, person-centred questions that invite discussion without making assumptions.

Examples include:

How have you been feeling recently?

Have you noticed any changes that are affecting your day-to-day life?

Is there anything that's making work, home life or sleep more difficult at the moment?

Have these changes affected your work or everyday activities in any way?

How are you managing your symptoms?

What impact, if any, are these changes having on your wellbeing?

Have you spoken to anyone about how you're feeling?

Is there any information or support that you think would be helpful?

What matters most to you at the moment?

Remember:

  • Avoid assuming someone is experiencing menopause because of their age.
  • Respect privacy and allow the person to decide how much they wish to share.
  • Be aware that menopause affects people differently, and experiences vary considerably.

Assist

Listen with empathy and reassure the person that menopause is a normal stage of life and that support is available.

You might say:

"It sounds as though these changes have been difficult for you."

"Many people experience menopause differently, and you don't have to manage it on your own."

"There are a number of things that can help. If your symptoms are affecting your daily life, it's worth speaking to your GP or another healthcare professional."

Depending on the conversation, you could discuss self care or signpost to recognised national support services, see ACT

Act

Self-care

Encourage healthy lifestyle habits that may help improve wellbeing and reduce symptoms.

  • Be physically active, including regular strength and weight-bearing exercise.
  • Eat a healthy, balanced diet with enough calcium and vitamin D to help maintain bone health.
  • Try to keep a regular sleep routine.
  • Stop smoking or seek support to quit if appropriate.
  • Limit alcohol and caffeine if they make symptoms worse.
  • Try relaxation techniques such as mindfulness, breathing exercises or yoga.
  • Stay connected with family, friends or support groups.
  • Use over-the-counter vaginal moisturisers or lubricants if vaginal dryness is a problem, seeking advice from a pharmacist if needed.

Explain, where appropriate, that effective treatments are available through the NHS, including hormone replacement therapy (HRT) and non-hormonal options. If someone has recently started treatment, it may take several weeks, and sometimes up to three months, before the full benefits are felt. Encourage them to continue speaking with their healthcare professional if symptoms persist or treatment needs adjusting.

During and after menopause, lower oestrogen levels increase the risk of osteoporosis (weakened bones). Regular weight-bearing exercise together with adequate calcium and vitamin D can help maintain bone health.

National Support Services

NHS

The NHS provides comprehensive information about:

  • Perimenopause and menopause
  • Symptoms
  • Self-care advice
  • Treatment options, including HRT
  • When to seek medical advice

https://www.nhs.uk/conditions/menopause-and-perimenopause/

People who pay for NHS prescriptions and use eligible HRT medicines may be able to reduce prescription costs through the NHS Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC).

Women's Health Concern

The patient arm of the British Menopause Society, providing evidence-based information, factsheets and resources.

https://www.womens-health-concern.org/

The Menopause Charity

Provides free, evidence-based information, educational resources and practical guidance for people experiencing menopause.

https://www.themenopausecharity.org/

MECC Key Messages

  • Menopause is a natural stage of life that affects everyone differently.
  • Listen without judgement and avoid making assumptions.
  • Recognise that symptoms can affect physical health, emotional wellbeing, relationships and work.
  • Encourage healthy lifestyle changes that may improve symptoms and long-term health.
  • Signpost to trusted information and healthcare professionals if symptoms are affecting quality of life.
  • Small, supportive conversations can help people feel understood, reduce stigma and encourage them to seek further support when needed.