Menopause & perimenopauseHot flushes, poor sleep, brain fog? Help is here.Changing periods, night sweats, low mood or feeling not quite yourself in your 40s or 50s are often the perimenopause or menopause. It is a normal stage of life, but you do not have to put up with symptoms. Effective, safe treatments are available.Book a GP appointmentCall 07857 761328Bleeding after your periods have stopped for 12 months needs checking promptly. For chest pain or signs of a stroke, call 999.Same & next-day appointmentsHRT & non-hormonal optionsTime to talk it throughYou keep your NHS GPMenopause blood test £991What is it?2Symptoms3Types4Who is at risk5Your appointment6Treatment7Self-help & work8Get help now9FAQs Medically reviewed by Dr Muhammad Roslan, MBChB, DGM, MRCGP · GP & Clinical Educator · GMC 7446695OUR GP Dundee · Last reviewed November 2026Seen by a GPSymptoms taken seriouslyEvery option explainedRegular reviewStart hereWhat the menopause and perimenopause areThe menopause is when periods stop for good because the ovaries make much less oestrogen. The perimenopause is the time leading up to it, when most symptoms start.The menopause is confirmed after 12 months without a period. For most women in the UK it happens between 45 and 55, and the average age is 51. The perimenopause often lasts several years: hormone levels rise and fall unpredictably, so symptoms can come and go and change from month to month.Up to 9 in 10 women notice symptoms. Some barely notice them; for others they affect sleep, work, relationships and confidence. Symptoms often last several years, and treatment can make a real difference.It is diagnosed from your storyIf you are over 45 with typical symptoms, you usually do not need a blood test.Symptoms vary a lotHot flushes, mood, sleep, memory, joints and the bladder can all be affected.You can still get pregnantUntil 2 years after your last period if under 50, or 1 year if you are over 50.Treatment worksHRT, non-hormonal medicines, CBT and lifestyle changes all help. We help you choose.Back to top ↑SymptomsWhat women often noticeYou may have a few of these or many. They can start years before your last period.Periods closer together, further apart, heavier or lighterSudden waves of heat in the face, neck and chestNight sweats that soak the bed and wake you upPoor sleep, waking early and feeling exhaustedLow mood, anxiety, irritability or tearfulnessBrain fog: losing words, focus and train of thoughtVaginal dryness, soreness or pain during sexNeeding to wee more often, or repeated urine infectionsAching joints and muscles, headaches or palpitationsLess interest in sex, and changes to skin, hair or weightBrain fog and low mood are real symptoms. They are common in the perimenopause and are not a sign of dementia or of failing to cope. Women who had PMS or postnatal depression are more likely to notice mood changes.At OUR GPMenopause Profile blood testFor women under 45 with possible menopause symptoms, or anyone whose symptoms are unclear.A 30-minute appointment with a hormone blood test, so you and your GP can decide what to do next.Good to know: over 45, menopause is usually diagnosed from your symptoms, and a blood test is not always needed.About our health checks →£99Menopause Profile · about 30 minutes Book nowBack to top ↑Types and stagesStages and types of menopauseMost women reach the menopause naturally, but it can come earlier, or suddenly after surgery or cancer treatment.Stage or typeWhat it meansPerimenopauseThe years before your last period. Periods change and symptoms often begin. It ends 12 months after your final period.MenopauseYour final period, confirmed once you have gone 12 months without one. Usually between 45 and 55.PostmenopauseThe time after menopause. Flushes usually settle over time, but vaginal and bladder symptoms often continue without treatment.Early menopauseMenopause between 40 and 45. HRT is usually advised until at least the average age of menopause.Premature ovarian insufficiencyThe ovaries stop working before 40. Always see a GP: hormone treatment protects your bones, heart and brain.After surgery or treatmentRemoval of both ovaries, chemotherapy or radiotherapy can bring the menopause on suddenly, often with stronger symptoms.Hormonal contraception, such as the pill, implant, injection or hormonal coil, can hide period changes. Your GP can help you work out what is happening.Who may start earlier or have stronger symptomsAny woman can have troublesome symptoms, but they are more likely, or start earlier, if you:smoke (menopause can come 1 to 2 years earlier)have a family history of early menopausehave had surgery to the ovaries or wombhave had chemotherapy or radiotherapyare of Black ethnicity (flushes tend to be stronger and last longer)have had PMS or postnatal depression (more mood symptoms)Back to top ↑Your appointmentWhat the GP will doThe aim is to understand what is happening, rule out anything else, and agree a plan that suits you.Listen to your storyYour symptoms, periods, how it affects your life, your health, medicines, family history and what you would like from treatment.Check for other causesBlood pressure and weight, and when needed tests for thyroid problems, anaemia, diabetes or pregnancy.Blood hormone tests only when usefulUsually not needed over 45. They can help if you are under 45, or over 50 and using progestogen-only contraception.Agree a plan and review itWe go through the benefits and risks of each option, then review any new treatment at 3 months and at least once a year.Back to top ↑TreatmentTreatments that workThe right treatment depends on your symptoms, your health and what matters to you. Many women use more than one.HRTReplaces oestrogen. The most effective treatment for flushes and sweats, and it protects bones. If you have a womb, you also need a progestogen.Patches, gel or sprayOestrogen through the skin does not raise the risk of blood clots and is unlikely to raise stroke risk. Often the first choice.Vaginal oestrogenLow-dose creams, tablets or a ring ease dryness, soreness and bladder symptoms. Very little reaches the rest of the body.Non-hormonal medicinesIf HRT is not suitable or not wanted: fezolinetant, some antidepressants, clonidine or gabapentin can reduce flushes.Menopause CBTA talking therapy proven to help hot flushes, poor sleep and low mood, alone or alongside other treatment.TestosteroneSometimes added for low sex drive if HRT alone has not helped and other causes have been looked at.HRT: benefits and risks in plain wordsFor most women under 60, the benefits of HRT for symptoms outweigh the risks. Your GP will go through your own risks with you.TopicWhat the evidence showsSymptomsOestrogen is the most effective treatment for flushes and night sweats, and can help sleep, mood and joint aches.BonesProtects against osteoporosis and fractures while you are taking it.Blood clots and strokeTablets slightly raise the risk, especially in the first year. Patches, gel and spray do not raise clot risk.Breast cancerCombined HRT slightly raises the risk, more the longer you take it, and it falls after stopping. Oestrogen-only HRT has little or no effect.Heart and dementiaNo increase in heart disease. Starting around the menopause does not appear to raise dementia risk.BleedingIrregular bleeding is common in the first 6 months. Tell us about any bleeding after that.There is no set time limit for HRT. You and your GP review it at least once a year. HRT is not a contraceptive. Herbal remedies such as black cohosh, St John’s wort and isoflavones are unregulated and can interact with medicines, so please ask first.Back to top ↑Self-helpWhat you can doSmall changes help with symptoms and protect your bones and heart for the years ahead.Keep a diaryTrack periods, flushes, sleep and mood for a few weeks and bring it to your appointment.Stay coolWear layers and use a fan. Cut down caffeine, alcohol, spicy food and smoking, which can trigger flushes.Keep movingBrisk walking and strength exercise protect bones and heart, lift mood and help sleep. Yoga may ease stress.Eat for your bonesA balanced diet with enough calcium, and vitamin D 10 micrograms a day in autumn and winter.Protect your sleepA regular bedtime, a cool bedroom and cotton bedding. Wind down away from screens.Talk about itTell family and friends what helps. At work, ask about flexible hours, a fan or a cooler desk.Menopause at workBrain fog, hot flushes and poor sleep can make work harder, and many women struggle in silence. Small changes often help a lot. Things you could ask your manager or HR about:flexible hours or some working from homea desk fan, or a seat near a window or away from heateasy access to toilets and cold drinking waterregular breaks and a quiet space when you need onea uniform in lighter, breathable fabrictime off for appointmentsUnder the Equality Act 2010, menopause symptoms can count as a disability if they have a substantial, long-term effect on day-to-day life. Many employers now have a menopause policy. Your GP can talk through what to ask for.Supporting a partner or family memberMenopause affects partners and families too. The most helpful things are often simple: listen without rushing to fix things, learn about the symptoms together, and offer to come along to appointments. Mood changes and low sex drive often improve with treatment, so talking openly and being patient really helps. Look after yourself as well. Menopause symptomsDownload our menopause leafletA free two-page guide for women, partners and families: the common symptoms, what you can do, what the GP will do, and when to get help. Print it or share it.PDF · 2 pages · A4 · 225 KBDownload leaflet (PDF)Open to printBack to top ↑Get help nowWhen it can’t waitCall 999 if you havechest pain · sudden breathlessness or coughing up blood · sudden weakness of the face, arm or leg, or slurred speech · thoughts of ending your life and you feel unsafeContact a GP the same day, or NHS 24 on 111 out of hours, if you haveany bleeding after 12 months without a period, unexpected bleeding on HRT after the first 6 months, bleeding after sex, a painful swollen calf, or a new breast lump.A private appointment is not a substitute for emergency care. If you are unsure, call 999 or NHS 24 on 111.Back to top ↑FAQsCommon questions What is the difference between perimenopause and menopause?The perimenopause is the time leading up to your last period, when hormones fluctuate and symptoms start. The menopause is your final period, confirmed after 12 months without one. Do I need a blood test to find out if I am menopausal?Usually not if you are over 45 with typical symptoms. A test can help if you are under 45, or over 50 and using progestogen-only contraception. How long do symptoms last?Hot flushes and sweats often last several years before fading, and some women have them for longer. Vaginal and bladder symptoms tend to continue unless treated. Is HRT safe?For most women under 60, the benefits outweigh the risks. Patches, gel or spray do not raise the risk of blood clots. Combined HRT slightly raises breast cancer risk. Your GP will talk through your own risks. How long can I take HRT for?There is no fixed limit. You can keep taking it while the benefits outweigh the risks for you, with a review at least once a year. Do I still need contraception?Yes. Use contraception until 2 years after your last period if you are under 50, or 1 year if you are over 50. HRT is not a contraceptive. What if I cannot or do not want to take HRT?Options include fezolinetant, some antidepressants, clonidine or gabapentin for flushes, menopause CBT, vaginal moisturisers and lifestyle changes.Worried right now?If you have bleeding after your periods have stopped, contact a GP promptly. For chest pain or signs of a stroke, call 999. Out of hours, call NHS 24 on 111.Back to top ↑EvidenceWhere this information comes fromThis page follows current UK guidance on diagnosing and treating the menopause.NICE NG23: Menopause: identification and managementNICE Clinical Knowledge Summaries: MenopauseBNF treatment summary: MenopauseBMJ Best Practice: MenopauseMenopause Matters: Principles of HRTBack to top ↑Ready to feel more like yourself?Book a GP appointment and we will talk through your symptoms and every treatment option with you.Book a GP appointmentWhatsApp 07857 761328This page is general information and is not medical advice or a diagnosis. What’s appropriate is a clinical decision made with a GP at your appointment. OUR GP is a trading name of SRS Health Group Limited, regulated by Healthcare Improvement Scotland. All doctors hold a licence to practise with the General Medical Council. Meet our team. We see patients from Dundee, Angus, Perthshire and Fife. More questions? See our FAQs.