Effects of menopause

Periods may become irregular before stopping, while hot flushes and night sweats can disturb sleep. Some people notice irritability, low mood, anxiety, reduced concentration or lower sexual desire. Falling oestrogen can make vaginal tissues drier and sex uncomfortable, and urinary symptoms may occur. Pelvic floor changes can contribute to pressure, a bulge or difficulty emptying the bladder or bowel. Symptoms vary widely and can begin before the final period. They can also overlap with thyroid problems, anaemia, medication effects or depression, so a review is useful when changes are troublesome.

Track symptoms, bleeding and sleep so patterns are easier to discuss. Layers, a cool bedroom, regular movement, a balanced diet and a consistent bedtime may help some people. Vaginal moisturisers or lubricants can improve dryness and comfort; a clinician can discuss local or systemic hormone treatment and non-hormonal options when appropriate. Pelvic floor exercises and physiotherapy may help pressure or leakage. Choose care based on your symptoms, medical history, migraine pattern, clotting history and personal preferences.

Arrange medical advice for bleeding after menopause, very heavy or prolonged bleeding, bleeding after sex, a new pelvic bulge, persistent pain, or symptoms that affect sleep, work or relationships. Seek urgent help for severe pelvic pain, fainting, sudden weakness or heavy bleeding with dizziness. New or worsening low mood, hopelessness or thoughts of self-harm need prompt mental health support.

Which symptoms fit menopause and which need another check? What options suit my health history? Should unusual bleeding, vaginal symptoms or pelvic pressure be examined? What follow-up would you recommend if treatment does not help?