Menopause and Perimenopause: Recognising the Signs and Knowing When to Seek Help and Support
Menopause is a natural stage in every woman's life, though the symptoms leading up to it can be confusing and, for some, difficult to live with. Recognising the early signs of perimenopause helps you understand what your body is doing and when it is worth seeking advice. This October, Menopause Awareness Month is a timely reminder to take those symptoms seriously rather than simply putting up with them. Mr Nicholas Morris, Consultant Obstetrician and Gynaecologist, assesses menopausal symptoms and discusses the options available to you.
What is the difference between perimenopause and menopause?
Perimenopause is the transition leading up to menopause, when hormone levels begin to change and symptoms often first appear. Menopause itself is defined as the point when a woman has not had a period for twelve consecutive months, as the ovaries stop releasing eggs and produce less oestrogen. Perimenopause can last for several years before that point is reached, which is why symptoms may come and go for some time. Menopause usually occurs between the ages of 45 and 55, though it can happen earlier for some women.
| Feature | Perimenopause | Menopause |
|---|---|---|
| What it is | The transition before menopause, as hormone levels change | The stage reached after twelve months with no period |
| Periods | Often irregular, with changes in flow | Have stopped for twelve months |
| Typical age | Often from the mid-forties, sometimes earlier | Usually between 45 and 55 |
| Oestrogen levels | Fluctuating and unpredictable | Settled at a lower level |
| Common symptoms | Hot flushes and disturbed sleep | Similar symptoms, which may continue for years |
What are the early signs of perimenopause?
Perimenopause affects women differently, and symptoms can appear gradually before periods change noticeably. Common signs include:
• Changes to your periods, such as irregular timing or a change in flow
• Hot flushes and night sweats
• Difficulty sleeping
• Changes in mood, including low mood or irritability
• Problems with memory or concentration, sometimes called brain fog
• Vaginal dryness or discomfort
• Reduced interest in sex
Symptoms vary widely from one woman to another, so your experience may look quite different from someone else's.
Vaginal atrophy: menopause and your vaginal and urinary health
Some of the most under-discussed symptoms of menopause affect the vagina and bladder, as lower oestrogen levels cause the delicate tissues in this area to thin and shrink. Women may notice vaginal dryness or discomfort during sex, and some experience a need to pass urine more often or recurrent urinary infections. These are collectively known as the genitourinary symptoms of menopause, and they tend to persist rather than settle on their own. Effective treatments are available, including topical vaginal oestrogen and non-hormonal options, which a specialist can discuss and tailor to you.
Menopause questions are being added to NHS Health Checks
A recent change means menopause is being formally recognised in routine NHS care for the first time. The Department of Health and Social Care announced in October 2025 that, from 2026, NHS Health Checks in England will include questions about menopause. These checks are offered to adults aged 40 to 74 every five years, and the change is expected to benefit nearly five million women. The aim is to identify women who could be helped sooner, so symptoms are recognised and support is offered earlier rather than endured in silence.
When should you see a specialist about menopause?
There is no need to wait until symptoms become overwhelming before seeking advice. It is worth speaking to a doctor or specialist if your symptoms are affecting your daily life or your sleep, or if you are unsure whether what you are experiencing is perimenopause. A specialist can confirm what is happening and rule out other causes. Once that is clear, the options can be discussed, including lifestyle changes and, where suitable, hormone replacement therapy or non-hormonal treatments. Mr Morris takes time to understand your symptoms and explains which approach suits your health and your preferences.
Frequently asked questions
At what age does menopause usually start?
Menopause usually occurs between the ages of 45 and 55, and the average age in the UK is 51. Perimenopause often begins several years before that point. Some women experience it sooner, which is worth discussing with a specialist.
How do I know if I am perimenopausal?
Perimenopause is often recognised from a combination of changing periods and new symptoms such as hot flushes or sleep problems. A specialist can assess your symptoms and confirm whether perimenopause is the likely cause.
Can menopause symptoms be treated?
Yes. Options include lifestyle measures and, where suitable, hormone replacement therapy or non-hormonal treatments, depending on your symptoms and health. A specialist can explain what is suitable for you.
What are the genitourinary symptoms of menopause?
These are symptoms affecting the vagina and bladder, such as vaginal dryness or discomfort during sex, along with urinary changes for some women. They tend to persist without treatment, though effective options are available.
How soon can I see Mr Morris?
Mr Morris offers assessment for menopause and other gynaecological concerns, usually within 24 to 48 hours, in person or online.
Speak to Mr Morris
If menopause symptoms are affecting your daily life, speaking to a specialist can bring clarity and a clear plan. Mr Morris assesses your symptoms and explains the options available to you. He also answers any questions or concerns you have along the way. Appointments are usually available within 24 to 48 hours, in person at his Harley Street and West London clinics, or online. To arrange an assessment, call 020 8371 1510 or email secretary@rapidaccessgynaecology.co.uk.