Beginning signs of menopause

This transition is called perimenopause. Symptoms vary between people and can fluctuate over time as ovarian hormone levels change.

Cycles may become less predictable, with bleeding arriving earlier or later or changing in flow. Other possible features include night sweats, hot flushes, vaginal dryness, discomfort during sex, lower sexual desire, headaches, joint aches, difficulty concentrating and changes in mood.

Menopause itself is reached after twelve consecutive months without a menstrual period when no other cause explains the change. Pregnancy remains possible during perimenopause while ovulation still occurs intermittently.

Record bleeding dates, flow changes, flushes, sleep and mood to reveal patterns. Layered clothing, a cooler sleep environment, regular activity and limiting personal flush triggers may help. Vaginal moisturisers can support ongoing dryness, while lubricants reduce friction during sex.

A clinician can discuss hormonal and non-hormonal options according to your symptoms, medical history, contraception needs and preferences. Do not assume every new symptom is hormonal, because thyroid disorders, pregnancy, medicines and other conditions can overlap.

Arrange a medical review if symptoms disrupt sleep, work, relationships or emotional wellbeing, or if you are uncertain whether the transition has begun. Seek prompt advice for very heavy bleeding, bleeding between periods, bleeding after sex, or pelvic pain.

Any vaginal bleeding after twelve months without a period needs medical assessment. Get urgent help for bleeding accompanied by fainting, severe weakness, chest pain or breathing difficulty.

Ask which symptoms fit perimenopause, whether another cause needs checking, and which treatment choices match your health history. Discuss contraception, bone and heart health, vaginal symptoms, sleep, mood, migraine, blood-clot history and any medicines or supplements.