Hormones during menopause: what to know

Ovarian hormone production becomes less predictable before periods stop, then settles at a lower level. This transition may bring hot flushes, night sweats, mood changes, vaginal dryness or lower sexual interest. Symptoms vary widely: some people notice one change, while others experience several together. Vaginal and pelvic tissues may become thinner or less flexible, which can cause discomfort with sex or urinary symptoms. These changes are common, but persistent or troublesome symptoms still deserve an individual assessment.

Track bleeding, flushes, sleep, mood and vaginal symptoms, including what makes them better or worse. A clinician can discuss non-hormonal measures, local treatments or menopausal hormone therapy when appropriate, considering your symptoms, medical history and personal preferences. Regular movement, breathable clothing, a cool sleeping space and a vaginal moisturiser may help some people. Do not start, stop or change hormones without checking the product and dose with a qualified clinician.

Arrange medical advice for symptoms that disrupt sleep, work, relationships or sex, or for bleeding that returns after periods have stopped. Seek urgent help for very heavy bleeding, severe pelvic pain, fainting, chest pain, sudden breathlessness or one-sided weakness. A new bulge or pressure in the vagina also warrants assessment because pelvic organ prolapse can have several causes.

Which symptom is most likely related to menopause, and what other causes should be checked? Would local or whole-body treatment fit my health history? What warning signs should I watch for, and when should treatment be reviewed?