What is menopause?

Menopause and Women

Although we use the term women when discussing menopause we acknowledge that some transgender men, non binary people assigned female at birth and some intersex people or those with variations in sex characteristics may also experience menopausal symptoms.

We aim to support anyone who is going through menopause, both within the clinic and at our community talks.

Menopause Symptoms

Perimenopause and menopause share similar underlying symptoms, since both are driven by the changes in oestrogen and progesterone. Perimenopause is the transition leading up to menopause, when hormone levels fluctuate rather than decline steadily, whereas menopause itself is the point 12 months after your periods have stopped. Hormone levels in perimenopause are often very fluctuant and changeable, whereas after menopause, levels are steadier but often low. Symptoms often change over time due to the shifts in hormones that take place.

Common Symptoms Include

• Hot flushes and night sweats
• Irregular, heavier, or more frequent periods
• Poor sleep or insomnia
• Anxiety, low mood, irritability, or emotional sensitivity
• Brain fog, memory or concentration difficulties
• Fatigue and reduced resilience
• Joint or muscle aches
• Headaches or migraines
• Reduced libido or changes in sexual comfort
• Palpitations or inner restlessness
• Reduced confidence or feeling less like yourself

Symptoms vary widely between individuals, can affect both physical and mental wellbeing, and may change over time. Periods are often still regular during early perimenopause and hormone blood tests are often unreliable during this stage. This means that diagnosis is usually based on symptoms and cycle changes rather than a single test.

For a fuller look at what perimenopause involves, when it typically starts, and how it's diagnosed, visit our Perimenopause page.

Hormone Replacement Therapy (HRT)

HRT is an effective and well-established treatment for symptoms related to perimenopause and menopause. It works by replacing and supporting the hormones that naturally fluctuate and decline during this life stage, including oestrogen, progesterone and testosterone.

The term body-identical HRT refers to hormones that are identical in molecular structure to those produced by the ovaries prior to menopause. These are considered very safe when prescribed appropriately, and transdermal oestrogen in particular (absorbed through the skin via gels, patches, or sprays) does not carry the small increased risk of blood clots associated with older oral synthetic HRT.

If you have a womb and have not had a total hysterectomy, progesterone is required alongside oestrogen to protect the lining of the womb. We often use micronised progesterone, which is body-identical and generally well tolerated, though the most appropriate option for you will depend on your individual circumstances.

At Manchester Menopause Hive, we prescribe HRT thoughtfully and individually, with an approach that's evidence-based and tailored to your symptoms, medical history, lifestyle, and personal preferences.

To learn more about how oestrogen, progesterone and testosterone are prescribed, and to read answers to common HRT questions, visit our About HRT page.