Menopause marks the end of menstrual periods and is diagnosed after twelve months without a period. The years leading up to it — perimenopause — are often when symptoms are most noticeable, as hormone levels fluctuate before settling.

Symptoms vary greatly between women. Hot flushes, night sweats, disrupted sleep, mood changes, brain fog, joint aches, vaginal dryness and changes in libido are all common. Some women have few symptoms; for others the impact on daily life and work is considerable.

Assessment focuses on your symptoms, medical history and personal preferences rather than on blood tests alone, which are often unhelpful during perimenopause.

There are effective options. Menopausal hormone therapy is safe and appropriate for most women when started around the time of menopause, and non-hormonal treatments are available for those who cannot or prefer not to use it. Local vaginal oestrogen is very effective for genitourinary symptoms. Care is tailored, reviewed over time, and coordinated with your GP.