Perimenopause and menopause may bring hot flushes, night sweats, altered sleep, mood changes, vaginal symptoms, joint or muscle pain and sexual difficulties. Symptoms, their severity and their duration vary. For people aged 45 or over with typical symptoms, NICE recommends identifying menopause clinically rather than with routine hormone testing.[1]
When symptoms need assessment
Symptoms can overlap with other health concerns. An assessment may cover your menstrual pattern, symptoms, medical and family history, medicines, contraception, preferences and any symptoms that may need a different investigation. Hormone blood tests are not routinely needed to diagnose menopause in otherwise healthy women aged 45 or over (NICE guidance); testing may be appropriate in younger women, atypical presentations, or where another diagnosis is being considered.
Treatment discussions
NICE recommends shared decision-making. HRT is one option for some people with menopause-associated symptoms, while menopause-specific CBT and other symptom-directed options may be relevant for others. The possible benefits and risks depend on the treatment, route, health history and the person’s priorities.[1][2]
Questions that can support a useful appointment
- Could another health issue be contributing to my symptoms?
- What are my options, including non-hormonal options?
- What benefits, risks and uncertainties matter in my circumstances?
- When should the treatment or symptoms be reviewed?
When to seek urgent help
Do not assume new, severe or rapidly worsening symptoms are caused by menopause. Call 999 for symptoms of a life-threatening emergency. Use NHS 111 or seek urgent clinical advice for concerning symptoms when you are unsure what to do.
Frequently asked questions
Is HRT suitable for everyone?
No. Whether HRT is suitable depends on symptoms, medical history, current medicines, possible contraindications and personal preferences. A prescriber should discuss benefits, risks and alternatives with you.
Do I need hormone blood tests?
Hormone blood tests are not routinely needed to diagnose menopause in otherwise healthy people aged 45 or over with typical symptoms. Testing may be appropriate for younger people, atypical presentations or when another diagnosis is being considered.
Are there alternatives to HRT?
Options can include menopause-specific CBT, non-hormonal treatments for some symptoms, and vaginal moisturisers or lubricants for some genitourinary symptoms. The relevant options depend on your symptoms and circumstances.
How long is HRT used for?
There is no single duration that is right for everyone. Treatment should be reviewed with the prescribing clinician as symptoms, benefits, risks and preferences change.
Related information
Menopause and heart health
Cardiovascular health questions to discuss
Private gynaecology
Explore an appropriate care route
Blood tests
Testing may be considered in some circumstances
Book an appointment
Suitability and availability are confirmed at booking