Common Symptoms
| Category | Symptoms |
|---|---|
| Vasomotor | Hot flushes, night sweats |
| Psychological | Mood swings, anxiety, low mood, brain fog |
| Physical | Vaginal dryness, joint aches, sleep disturbance, irregular periods |
| Longer-term risks | Osteoporosis, increased cardiovascular risk |
When Blood Tests Are Needed
For women over 45 with typical symptoms, diagnosis is usually clinical (based on symptoms) without needing blood tests. FSH testing may be used in women under 45 with symptoms, or to help distinguish perimenopause from other causes in uncertain cases.HRT Types and Considerations
| Type | Who It's For |
|---|---|
| Oestrogen-only | Women who've had a hysterectomy (no womb) |
| Combined (oestrogen + progestogen) | Women with a womb — progestogen protects against womb lining cancer |
| Vaginal oestrogen | Local symptoms (dryness) — very low systemic absorption, often used long-term |
| Body-identical HRT | Increasingly preferred — molecularly identical to natural hormones |
HRT Risks vs Benefits
| Consideration | Detail |
|---|---|
| Breast cancer risk | Small increase with combined HRT after several years; oestrogen-only has minimal/no increased risk |
| Cardiovascular | Generally neutral or beneficial if started within 10 years of menopause ('window of opportunity') |
| Bone protection | Significant benefit — reduces osteoporosis and fracture risk |
| Symptom relief | Highly effective for hot flushes, mood, sleep, vaginal symptoms |
The Window of OpportunityStarting HRT within 10 years of menopause (or before age 60) is associated with more favourable cardiovascular outcomes compared to starting later — this timing consideration is often discussed when weighing HRT decisions.
Is HRT safe?
For most women without specific contraindications (certain cancers, unexplained bleeding, active blood clots), the benefits of HRT generally outweigh the risks, particularly when started around the time of menopause. Individual risk assessment with your doctor is important.
How long can I take HRT for?
There's no fixed time limit — many women take HRT for as long as needed for symptom control and bone protection, with regular review, rather than a mandatory stop at a specific age or duration.
Do I need blood tests to diagnose menopause?
Not usually if you're over 45 with typical symptoms — the diagnosis is clinical. FSH testing is more useful in younger women or uncertain cases.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.