An insightful overview of what menopause feels like for many
Menopause is usually described as the point when a woman hasn’t had a period for twelve months, most often between the ages of 45 and 55. That’s the technical definition. But in real life, experience of the transition varies widely.
What I see far more often in clinic is perimenopause, the years leading up to the final period, when hormones begin to fluctuate unpredictably. This is when women start noticing changes that can feel confusing and, at times, quite unsettling. Think puberty but in reverse.
Periods may become irregular or heavier. Sleep becomes lighter or broken. Anxiety can appear in women who have never struggled with it before. Concentration dips. Weight shifts towards the middle. Joints ache. Libido changes. Some women describe it simply as “not feeling like myself anymore.”
I have supported hundreds of women through this stage, and one of the most common concerns I hear is uncertainty, women wondering whether what they’re experiencing is normal, whether they should just push through it, or whether something more serious might be wrong.
The reality is that during perimenopause, oestrogen and progesterone don’t decline smoothly. They fluctuate. Sometimes dramatically. It is often this instability rather than simply “low hormones” that causes symptoms. For some women, the impact is mild. For others, it can affect sleep, mood, confidence, work performance and overall quality of life.
Menopause is also more than a collection of symptoms. It is a metabolic transition. Oestrogen plays a role in protecting bone strength, supporting heart health, maintaining muscle mass and helping regulate how our bodies handle blood sugar. As levels fall, we can see increased abdominal fat, gradual muscle loss, changes in cholesterol levels and a higher long-term risk of osteoporosis and cardiovascular disease. These changes are biological, not a sign of personal failure or lack of effort.
Treatment is always individual. Lifestyle measures such as strength training, adequate protein intake, improving sleep and moderating alcohol can make a meaningful difference. For women with more intrusive symptoms, hormone replacement therapy (HRT) can be very effective and remains the most evidence-based treatment for hot flushes and bone protection. Where HRT isn’t suitable or isn’t a preferred option, there are also non-hormonal prescription treatments available.
Menopause is not an illness, but it is a significant life stage. With clear information and personalised support, women do not need to simply “put up” with it. They can understand what is happening in their bodies and make informed choices about how they want to navigate this transition.
