Changing periods
Cycles may become shorter, longer, heavier or less predictable during perimenopause. Bleeding after 12 months without a period is not an expected menopause symptom and needs assessment.
Menopause care
Feel like yourself through a changing stage of health.
Practical support for hot flushes, sleep, mood, vaginal and urinary symptoms, changing bleeding, sexual wellbeing and future bone and heart health.
Whole-person care Symptoms, safety & healthy ageing
What may change
Menopause affects more than periods—and every experience is different.
Symptoms can begin before periods stop and vary over time. Assessment considers other possible causes rather than assuming every new symptom is menopause.
Hot flushes & night sweats
Vasomotor symptoms can disturb sleep, work and concentration. Severity—not whether someone “should cope”—guides whether treatment is useful.
Sleep, mood & thinking
Sleep disruption, anxiety, low mood and difficulty concentrating can occur, but thyroid disease, depression, medicines and other causes may also need consideration.
Vaginal & urinary symptoms
Dryness, burning, pain during intercourse, urinary urgency or repeated infections can reflect genitourinary syndrome of menopause and often persist without treatment.
Bone & muscle health
Bone loss accelerates around menopause. Early menopause, fractures, steroid use, low body weight and family history can justify earlier risk assessment.
Sexual wellbeing
Comfort, desire, relationships and body changes can be discussed directly. Treatment may involve local symptom care, counselling and review of medicines or health conditions.
Treatment choices
Relief should be effective, safe and acceptable to you.
Choice depends on symptoms, uterus status, age, time since menopause, medical history and preference. Treatment is reviewed rather than continued automatically.
Everyday foundations
Regular resistance and weight-bearing activity, adequate nutrition, tobacco avoidance and sleep support improve general health but do not need to be presented as a cure for every symptom.
Menopausal hormone therapy
Systemic oestrogen—with progestogen when a uterus is present—can be highly effective for hot flushes and related symptoms in appropriately selected patients. Personal risks, route, dose and review matter.
Non-hormonal options
Selected prescription medicines and behavioural approaches can reduce hot flushes or improve sleep when hormone therapy is unsuitable or not preferred.
Local vaginal treatment
Vaginal moisturisers and lubricants help some people. Low-dose vaginal oestrogen or other prescription options may be considered for persistent vaginal and urinary symptoms.
Important bleeding rule
Arrange an assessment Bleeding after menopause needs assessment.
Bleeding, spotting or blood-stained discharge after 12 months without periods should not be attributed to “hormonal changes” without review. Evaluation may include examination, ultrasound and endometrial assessment according to findings and risk.
Healthy ageing
Treat symptoms and future health as connected—but separate—goals.
A menopause visit can review blood pressure, diabetes and cholesterol risk, cervical and breast screening, bone-health factors, contraception, sexual health and emotional wellbeing.
Explore preventive healthBone risk
Review fracture history, early menopause, medicines and whether bone-density testing is indicated.
Heart and metabolic risk
Address blood pressure, glucose, cholesterol, tobacco, activity and pregnancy history directly.
Screening
Continue cervical and breast screening according to age, previous results and individual risk.
Review and adjustment
Reassess symptom benefit, bleeding, side effects and evolving health rather than using a fixed plan forever.
Menopause FAQs
Brief answers for a complex transition.
01What is the difference between perimenopause and menopause?
Perimenopause is the transition while cycles and symptoms change. Menopause is confirmed retrospectively after 12 consecutive months without a period when there is no other cause.
02Is hormone therapy safe for everyone?
No treatment suits everyone. Benefits are often favourable for healthy, symptomatic people near the menopause transition, but personal history of clotting, stroke, breast or endometrial cancer, liver disease and unexplained bleeding changes the discussion.
03Do I still need contraception?
Pregnancy becomes less likely but remains possible during perimenopause. Continue contraception until menopause is reliably established according to age, method and clinical guidance.
04Should bleeding after menopause be checked?
Yes. Any bleeding after menopause should be assessed, even if light or occurring only once. Most causes are not cancer, but cancer or precancer must be excluded.
05Will menopause treatment prevent heart disease?
Hormone therapy is not prescribed solely to prevent heart disease. Blood pressure, glucose, cholesterol, tobacco, activity and individual cardiovascular risk should be managed directly.