Menopause Advice & Education
The menopause and perimenopause are often not frequently discussed even among women and in some communities a certain stigma is attached to them. I’m on a mission to provide helpful menopause advice and perimenopause help so women aren’t left in the dark with no or limited support. My flip cards below provide a short menopause education on some of the key topics. If you would like further advice and support on your mid-life journey, please get in touch with me to book an online menopause consultation.
1) What is the Menopause?
In Greek terminology, MENO is month and PAUSE is to cease. It marks the end of a woman’s menstrual cycle. It is officially diagnosed after 12 consecutive months without a period, and most women reach it between the ages of 45 and 55, with the average age in the UK being around 51. Menopause happens because the ovaries gradually stop producing the hormones oestrogen and progesterone, which are responsible for regulating the menstrual cycle. While it signals the end of fertility, that can bring physical and emotional changes.
2) What is the Perimenopause?
Perimenopause is known as the transition period leading up to menopause. I call it the “puberty” of the menopause. It usually begins in your 40s and can last between 4-10 years. Women begin to experience many of the classic symptoms of the menopause as hormones begin to fluctuate. Your menstrual cycle may begin to change and become irregular, longer, shorter, lighter, or heavier, but your cycle can also remain regular. Perimenopause ends when a woman has gone 12 full months without a period, marking the start of menopause. Perimenopause help/advice is available from the NHS and The Menopause Charity as well as private clinics like my own, Your Menopause Care with Rupa.
3) What is Post-Menopause?
Once a woman reaches the menopause and has not had a period for 12 months or more, she is considered post-menopausal. The reproductive years are over and hormones remain low and stable. Post Menopause symptoms can be experienced but the main focus at this stage is on long-term bone, heart and metabolic health.
4) What are the key menopause symptoms?
Up to 80-90% of women will experience menopause symptoms with 25% describing them as severe and debilitating. The most commons symptoms are hot flushes and night sweats (vasomotor symptoms) experienced by 70-80% of women. Other menopause symptoms include disturbed sleep and insomnia, low energy levels, low mood, anxiety, low libido and low sexual drive, impaired memory and concentration, ‘brain fog’, skin and hair changes, joint aches, headaches, palpitations and vaginal dryness and urinary symptoms to name a few.
5) What are other causes of the Menopause?
Surgical menopause happens when both ovaries are removed during surgery. For example, during a hysterectomy with oophorectomy (removal of the uterus and ovaries). As the ovaries make oestrogen, their removal causes an immediate menopause, regardless of age. Certain cancer treatments, such as chemotherapy or radiotherapy, can damage the ovaries and lead to an early or temporary menopause. About 1% of women in the UK experience Premature Ovarian Insufficiency (POI) occurs before age 40 caused by autoimmune, genetic or unknown reasons.
6) What is the role of oestrogen?
Oestrogen is a hormone made by the ovaries that help regulate the menstrual cycle. Oestrogen acts on receptors throughout the body. These receptors are found in the brain, bones, heart, skin, joints, the bladder and the vagina. Lower oestrogen can change how the body regulates temperature, which leads to hot flushes and night sweats. It can affect mood, sleep and concentration, and some women notice increased anxiety or ‘brain fog’. Skin and connective tissues lose collagen and elasticity, which can cause dryness and joint discomfort. Bone density also decreases, making bones more fragile and increasing risk of osteoporosis. However, effective treatment can help with these menopause symptoms with long term health benefits.
7) What is the role of progesterone?
Progesterone works alongside oestrogen to balance the womb lining and regulate the menstrual cycle. When progesterone levels fall in perimenopause, periods can become irregular, heavier, or closer together because the womb lining is not shed as predictably. Lower progesterone can also affect the brain, leading to disturbed sleep, irritability, low mood or feelings of anxiety for some women. Progesterone has a natural calming effect in the body, so when levels decline, many women notice lighter, broken sleep or a sense of restlessness. By the time a woman reaches menopause and periods have stopped, progesterone levels are low. For women using HRT and still having a womb, progesterone is needed alongside oestrogen to protect the womb lining and reduce the risk of it becoming too thick.
8) What about Testosterone?
Known as a male hormone, testosterone is also made by the female body and plays an important role with supporting sexual desire, energy, and overall sexual health. The main indication is for Hypoactive Sexual Desire Disorder (HSDD) but most women find improvement with mood, memory, concentration and brain fog and energy levels. However, there are no clinical data to support this.
9) How is the menopause diagnosed?
The diagnosis itself is mainly based on menopause symptoms alone. Women over the age of 45 do not require a blood test to check hormone levels as the results are likely to be unreliable due to fluctuating oestrogen levels. For women aged between 40-45, a blood test checking the Follicle Stimulating Hormone (FSH) may be appropriate, but if the symptoms clearly indicate menopause, a blood test may not be needed.
10) What menopause treatments are available?
There are two main approaches to managing menopause symptoms: Hormone Replacement Therapy (HRT) and non-hormonal treatments. HRT is the most effective treatment for menopausal symptoms and it also reduces the risk of osteoporosis, bone fractures and has protective effects on heart health. Vaginal HRT can be used alongside systemic HRT to help with vaginal dryness. For women who do not wish to use HRT or cannot due to medical conditions can consider non-hormonal options that can be discussed at your online menopause appointment.
11) What else helps with menopause symptoms?
Lifestyle plays a vital role in managing menopausal symptoms. Having a healthy and well-balanced diet, exercising, managing stress, improving sleep, and self-care become non-negotiable in mid-life. Cognitive Behaviour Therapy (CBT) is recommended by NICE to support low mood and anxiety as well as controlling hot flushes, night sweats and poor sleep.
12) Menopause in Ethnic Minority Women
Menopause affects all women, but not in the same way. Women from different ethnic backgrounds often experience different symptoms of menopause, face unique challenges in getting support and may have distinct cultural attitudes toward menopause and ageing. Evidence in many minority ethnic groups is limited or based on international studies, so we still have more to learn. This does not prevent or limit access to advice, menopause treatment and care.
13) What are the barriers for ethnic minority women?
In many communities, menopause is still a taboo topic. Cultural beliefs may discourage women from speaking up, especially if menopause is seen as a “normal part of life” or a loss of femininity. Some women worry they’ll be judged or misunderstood, especially if they don’t see themselves represented in educational materials. Language barriers, lack of awareness, and fear of menopause medication can make it harder to access care.
14) Menopause in White Caucasian Women
The average age for the menopause in the UK is 51 years old. Most menopause research has focused on White women which means there is generally more clinical data available in this group. However, many still report confusion about menopause symptoms, menopause treatment or where to seek advice. This highlights a need for clearer, more inclusive menopause advice and education for every woman.
15) Menopause in South Asian Women
The average age to reach menopause in women from India, Pakistan and Bangladesh is 46–47 years old. Hot flushes, joint pain, urogenital symptoms and mood changes are commonly reported. There is higher risk of heart disease, diabetes, high blood pressure and weight gain during midlife and hesitation to discuss mental or sexual health. It’s common for South Asian women to use natural or traditional remedies first, and to seek advice and menopause treatment later if symptoms don’t improve.
16) Menopause in African & Caribbean Women
On average African and Caribbean women reach menopause at around 49 years of age. Studies suggest they may experience more frequent or longer-lasting hot flushes, as well as sleep difficulties, changes in mood, or weight gain. Support and effective treatment options are available, and no one should feel they have to cope alone.
17) Menopause in South-East Asian Women
Chinese and East Asian women may report fewer hot flushes, but can experience joint aches, changes in libido, or difficulties with memory or concentration. Bone density tends to be lower in this group, which means long-term bone health is important, especially after menopause. Many feel comfortable seeking medical advice, while others prefer to manage menopause symptoms quietly.
18) The impact of menopause in the workplace
Menopause can have a significant effect on a woman’s working life. Menopause symptoms can reduce concentration, productivity, and confidence at work. For some women, this can lead to increased absences, early retirement, or even leaving the workforce altogether. A 2019 UK survey found that one in four women had considered leaving their job because of symptoms. Yet many feel unable to talk about it due to stigma or lack of menopause support at work. Workplaces that provide menopause workshops, promote awareness, provide flexibility, and access to support can help women feel empowered, valued and able to thrive through this stage of life. I deliver menopause workshops for organisations that are looking to provide effective menopause support at work for their valued women employees.
19) The impact of menopause on relationships
Menopause can affect relationships in many ways, not just physically but emotionally too. Some women feel less confident or disconnected from their partner, while others report feeling misunderstood or unsupported. These changes can also strain relationships with children, colleagues, or friends if menopause symptoms like irritability, poor sleep, or low mood aren’t recognised for what they are. Open communication, education, and support (for both the woman and those around her) can help reduce tension and improve connection during this phase of life.
20) The impact of self-esteem and confidence in menopause
Menopause can bring powerful emotional shifts and for many women, one of the most overlooked but deeply felt changes is a loss of confidence and self-esteem. Many women in mid-life are caring for ageing parents, supporting teenage or adult children, managing careers, navigating relationship challenges, and carrying financial or household burdens. When symptoms like brain fog, low mood, poor sleep or overwhelm set in, sense of self can chip away at even in the most confident women. Feeling mentally scattered at work, snapping at family, or withdrawing from intimacy can lead to guilt, self-doubt and the quiet fear that they’re “not coping”. You haven’t lost your strength — you’ve just been running on empty. It’s time to refuel with personalised, compassionate and evidence-led menopause support and it starts with a menopause consultation.
21) The impact of menopause on mental health
Menopause can significantly affect mental wellbeing. As hormone levels begin to decline, many women experience low mood, irritability, anxiety and emotional overwhelm. These changes can appear suddenly or gradually and may feel confusing, particularly for women who have never had mental health struggles before. Oestrogen supports important brain chemicals like serotonin and dopamine, which regulate mood, focus, and emotional balance. When these hormone levels drop mental health can be affected. You don’t have to just “get on with it” - menopause support is available.
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