Womens health

Nikki Porges, registered nurse

Menopause: the symptoms, self-help and treatment

11 August 2023

Given the array of symptoms that can be experienced before, during, and after the menopause, it’s little wonder that in a survey by the British Menopause Society, “more than half said it had a negative impact on their lives.”1

From hot flushes to brain fog and night sweats, the menopause can be an unsettling time in a woman’s life. However, by being aware of the symptoms and what treatments are available or lifestyle changes you can make, it doesn’t have to be something to fear.

Nikki Porges, a registered nurse in our 24/7 health support line for members, explores what the symptoms of this life stage can be, how to help navigate them and what treatments might be available to help you through it.

What is the menopause?

Menopause refers to the time when a woman’s ovaries are no longer producing eggs and her periods have stopped. Officially it is said to have occurred 12 months after the last period.

Women may begin to experience symptoms in the run up to the menopause, during what's known as the perimenopausal period. They are caused by changes to hormone levels, as the ovaries start to produce fewer eggs and oestrogen levels fluctuate and drop.

>Find out some common misconceptions around the menopause in our mythbuster series.

The average age when menopause occurs is around 51 years of age2, but it’s worth bearing in mind that the menopause can begin both before and after 51 years, typically at any time between the ages of 45-55.

If menopause happens before the age of 45 it’s referred to as an early menopause, and in these scenarios, it sometimes needs quite specific management, depending on how young a person is, to help mitigate the loss of oestrogen from the body.

Regardless of when menopause occurs, the symptoms and their severity vary from person-to-person. Some might experience many of the emotional and physical symptoms whereas other might only experience one or two.

Menopause signs and symptoms

Listed below are some common symptoms experienced by women during the menopause:

  • Brain fog,
  • Loss of confidence,
  • Hot flushes,
  • Night sweats,
  • Sleeplessness,
  • Vaginal dryness,
  • Loss of interest in sex,
  • Mood swings, low mood, anxiety,
  • Joint pains,
  • Memory loss and poor concentration,
  • More frequent urinary infections, urinary incontinence.

All the common symptoms of the menopause are associated with a decrease in the body’s production of oestrogen. Reduced levels of this hormone can affect many parts of the body, including the brain, causing changes in emotional wellbeing; as well as physical symptoms such as thinning hair and dry skin.

Long-term health considerations

Once the ovaries have stopped producing oestrogen other changes take place, which may have an effect on long-term health. Most commonly these changes affect the strength and density of bones, increasing the risk of the bone-thinning disease osteoporosis.

The bones depend on oestrogen to maintain their strength and resistance to fracture. However, while other signs of depleted oestrogen, such as hot flushes or vaginal dryness are apparent, osteoporosis has no obvious symptoms – the first sign is usually the fracture of a bone.

>Our article on osteoporosis and bone health takes a more in depth look at this common condition and what you can do to help build stronger bones throughout your lifetime.

There is also evidence that oestrogen-deficiency can make post-menopausal women vulnerable to heart disease and stroke as the protective effect of oestrogen is lost.3

Help is available

The good news is that there is help available and having a chat with your GP or a menopause specialist can be a good first step to take. There are also plenty of things you can do for yourself to help improve your long-term future health and quality of life in later years.

A healthy lifestyle can minimise the effects of the menopause, helping to keep the heart and bones strong, and many women feel that this is a good time to review how they look after their health.

Here, Nikki shares her tips on how to manage your symptoms and continue to live life to the full, through this transitional period and long after the menopause has become a distant memory.

Consider your diet

With oestrogen levels falling, causing a potential increase in the risk of heart disease and osteoporosis, a healthy diet is therefore essential.

Try to keep it low in saturated fat and salt to reduce blood pressure, and rich in calcium and vitamin D to strengthen bones. Some women take dietary supplements to help get the balance right.

>Our article on Women’s vitamins, minerals and supplements may help you decide is this is something for you to consider.

Stay active

Some women experience increased anxiety during the menopause. Regular exercise helps to convert stress into positive energy, while guarding against heart disease. It also helps us to maintain bone mass.

For peri-menopausal/menopausal women strength training is important alongside moderate aerobic exercise, such as swimming, cycling or brisk walking. This is because it’s been found that menopausal women undertaking high intensity exercises tend to secrete more cortisol (the stress hormone) which works against them. So, a regular, varied programme is best, for example a mix of: cycling, swimming, strength training, running or aerobics.

Stop smoking

Smoking has been shown to lead to an earlier menopause and trigger hot flushes. If you smoke you also run a higher risk of developing osteoporosis and coronary heart disease (CHD), which is a leading cause of death in women4.

>See our article on quitting smoking for more information and support, should you choose to give up.

Find ways to calm the mind and remain positive

Hormone imbalance during the menopause can result in added stress and even depression. Relaxation techniques, such as mindfulness and counselling can be helpful in coping with anxiety.

Try and make time to do something you enjoy, this is a time when it’s particularly important to practice self-care.

It’s good to talk

If you’re an AXA Health member you can speak to one of our nurses, pharmacists or counsellors, all with experience in supporting individuals through this period, via our 24/7 health support line.

Non-healthcare members can also access support though our Ask the Expert service – submit your query online and an appropriate member of the team will respond when they become available.

Above all else don’t be afraid to talk about what is happening to you, whether it’s with your partner, your GP, employer, a trusted friend or a group of friends, or via the online resources and forums available to you, including your EAP (Employee Assistance Programme), if you have one.

Asking for support and sharing your experience with others can be powerful steps towards managing your symptoms and coming out the other side stronger and better equipped to live your life to the full, for many more years to come.

Hormone Replacement Therapy

Hormone replacement therapy (HRT) is the most effective and widely used treatment for menopausal symptoms. As its name suggests, it’s simply a way of replacing the hormone oestrogen that’s lost during the menopause.

HRT aims to relieve those symptoms related to oestrogen deficiency, such as hot flushes, vaginal dryness and osteoporosis. Benefits of HRT also include:

  • reducing hot flushes,
  • helping stop sleep disturbances,
  • improving vaginal symptoms and
  • improving mood.

Some women experience unwanted side effects when taking HRT for the first time. These may include:

  • breast tenderness,
  • leg cramps,
  • nausea,
  • bloating,
  • irritability
  • and depression.

Usually, these symptoms resolve after a few months, but a change in route/type (oral/tablet, transdermal/patch or gel) or dose of HRT may be required to find a combination that’s right for you.

Although there have been concerns raised about HRT and the potential risks to various aspects of women’s health, the latest evidence – as reflected in current clinical guidelines5 – shows that although not entirely risk-free, HRT remains the most effective solution for the relief of menopausal symptoms.

For anyone thinking about starting HRT, the recommendation is to discuss the benefits and risks of HRT with your GP on an individual basis. Overall, the balance of benefit to harm always needs to be assessed.

>Find out more about HRT in our HRT guide

Cognitive Behavioural Therapy (CBT)

CBT counselling has been proven to help relieve hot flushes and help women manage their symptoms and often lessen them; so, it may be something you may want to try.

CBT helps people to develop practical ways of managing problems and provides new coping skills and useful strategies…it can be a helpful approach to try because the skills can be applied to different problems, and can improve wellbeing in general.6

Complementary and alternative therapies

These have become a popular choice and many women use them, although limited scientific research has been done to support their effect or safety. They may sometimes help with troublesome symptoms but are unlikely to have a significant impact on bone strength, the heart or blood vessels.

Choosing a complementary or alternative therapy can be a challenge as there are so many, but they can include:

  • acupuncture,
  • aromatherapy,
  • herbal treatments,
  • homeopathy,
  • hypnotherapy,
  • yoga and reflexology

all of which can be helpful during menopause. Use of vaginal lubricants can also help to overcome vaginal dryness and soreness in some women.

Black cohosh and red clover extract have been found to be effective in helping to relieve certain menopausal symptoms and unlike some other supplements, have been subjected to research trials.7

In the case of red clover extract, it does need to be taken for six to nine months before it’s full effectiveness can be felt, so you need to be patient, but it can be worthwhile persisting with.

As with any dietary supplements, you should always consult your GP before taking them to make sure they’re safe for you.

Menopausal women may feel overwhelmed with the type of symptoms they experience leading up to and during the menopause. If you’re battling with your symptoms, start to keep a symptom diary and make a note each day of how you’re feeling, scoring any symptoms according to how bad you’re finding them.

This can help form the basis of a chat with your GP or menopause specialist to discuss your symptoms and look at ways these can be managed and treated.

If you’re going through the menopause, take time to do something that makes you happy every day, even if it’s only for ten minutes. Read, dance, listen to your favourite music, speak to a friend or go for a run – whatever it is that lifts your mood, make sure to schedule it in.

Please also be aware that the inclusion of information on a particular health topic or condition in our health and wellbeing pages does not indicate its eligibility for treatment under the terms of our healthcare plans. For more information please refer to our editorial policy.


  1. A woman’s relationship with the menopause is complicated - British Menopause Society
  2. What is Perimenopause - The Meyer Menopause Clinics
  3. Menopause and heart disease – British Heart Foundation
  4. Life Course Exposure to Smoke and Early Menopause and Menopausal Transition - National Library of Medicine
  5. Benefits and risks of HRT - NICE
  6. CBT for Menopausal Symptoms – Menopause Matters
  7. Botanical and dietary supplements for menopausal symptoms – National Library of Medicine

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