What Is Menopause?

Menopause marks the end of your reproductive years and is officially diagnosed after you’ve gone 12 consecutive months without a menstrual period. The transition leading up to this point is called perimenopause, which typically begins in your mid-40s but can start earlier or later for some women. During this time, your ovaries gradually produce less oestrogen and progesterone, the hormones that regulate your menstrual cycle and affect many other body systems.

The hormonal changes during perimenopause and menopause can trigger a wide range of symptoms that vary significantly from one woman to another. Some women experience few symptoms, while others find that menopause significantly impacts their daily life, relationships, and work. Understanding these symptoms is the first step toward managing them effectively.

Sore Legs and Muscle Discomfort in Menopause

One symptom that often surprises my patients is leg pain or discomfort during menopause. Muscle aches and joint pains are common physical symptoms of menopause and perimenopause. Many women describe experiencing aching, throbbing, or restless sensations in their legs, particularly at night. This can manifest as general muscle soreness, cramping, or even restless legs syndrome – an overwhelming urge to move your legs, often accompanied by uncomfortable sensations.

The declining levels of oestrogen during menopause affect muscle and bone health, which can contribute to these uncomfortable sensations. Some women notice their legs feel heavier, more tired than usual, or experience tingling and crawling sensations that can be particularly disruptive to sleep. When leg discomfort robs you of quality rest, it can contribute to the fatigue and low energy that many menopausal women report.

“I frequently see patients who struggle with less typical symptoms such as sore legs. Often patients undergo various blood tests and imaging before we realise that the menopause is the main factor!”

Managing leg discomfort often involves a combination of approaches. Staying well-hydrated is important, as dehydration can worsen cramping. Regular gentle exercise, such as walking or swimming, helps maintain circulation and muscle tone. Some women find relief through stretching exercises before bed, while others benefit from magnesium supplementation (though it’s important to discuss this with your GP first). If leg symptoms are severe or affecting your sleep significantly, there may be medical treatments that can help.

Water Retention and Bloating During Menopause

Another frequently reported symptom is bloating and water retention. Many of my patients describe feeling uncomfortable, with clothes fitting more tightly around the abdomen, and a general sense of puffiness or swelling. This isn’t simply about weight gain – it’s about fluid retention and changes in how your body processes and stores water.

Oestrogen plays a crucial role in regulating water balance in your body. As oestrogen levels fluctuate during perimenopause, your body tends to retain more water, leading to that bloated feeling. Hormonal changes can also affect your digestive system, slowing down the movement of food through your gastrointestinal tract, which further contributes to bloating and abdominal discomfort.

“I am a huge proponent of optimising lifestyle factors to manage menopause symptoms. Simple changes in diet and mild exercise can really improve factors like water retention” 

There are several practical steps that can help reduce bloating and water retention. Watching your salt intake is important, as excessive sodium encourages water retention. The NHS recommends consuming no more than 6g of salt daily. Staying physically active helps stimulate circulation and can reduce fluid build-up. Drinking plenty of water might seem counterintuitive when you’re retaining fluid, but staying hydrated actually helps your body regulate fluid balance more effectively. Some women also find that reducing caffeine and alcohol consumption helps minimize bloating.

Hot Flushes and Dizziness: Understanding the Connection

Hot flushes are sudden feelings of hot or cold in your face, neck and chest which can make you dizzy. These are perhaps the most well-known menopause symptom, but that doesn’t make them any less challenging to manage. A hot flush can strike suddenly, causing your face, neck, and chest to feel intensely warm, often accompanied by sweating, a rapid heartbeat, and sometimes dizziness or lightheadedness.

The dizziness associated with hot flushes can be particularly unsettling. You might feel off-balance, as though the room is spinning, or experience a sensation of faintness. This occurs because the sudden dilation of blood vessels during a hot flush can temporarily affect blood flow and blood pressure, leading to these dizzy spells. For some women, the dizziness is brief, while for others it can last several minutes.

“Hot flushes can be so debilitating for many women. I’ve had some great results managing flushes, sweats and dizziness with HRT for those whom lifestyle factors aren’t effective. Please do have a go with the strategies below and consider medications if needed.”

When hot flushes strike, there are several strategies that can help. Dressing in layers allows you to remove clothing quickly when a flush begins. Keeping a handheld fan nearby, whether at home or in your bag, provides immediate relief. Identifying triggers – such as spicy foods, caffeine, alcohol, or stress – and avoiding them when possible can reduce the frequency of hot flushes. If you experience dizziness, it’s important to sit or lie down immediately until it passes to prevent falls. For many women, hot flushes improve over time, though symptoms can last for months or years.

Itchy Skin: An Often-Overlooked Menopause Symptom

Skin changes including dry and itchy skin are common physical symptoms of menopause. Many women notice changes in their skin during menopause – it may become drier, feel tighter, or develop persistent itchiness. This can affect any part of the body but is often particularly noticeable on the face, arms, and legs.

Oestrogen plays a vital role in maintaining skin health. It helps your skin produce collagen and natural oils that keep it supple and moisturized. As oestrogen levels decline, your skin produces less collagen and becomes thinner and drier, making it more prone to itching and irritation. The reduced oil production means your skin’s natural barrier function is compromised, making it more vulnerable to environmental factors and more sensitive overall.

“Another often overlooked change in menopause. You’re not alone! Simple changes in soaps, detergents and moisturisers can make a huge difference. If you have any rashes that you’re worried about, please do check in with your GP.”

Managing itchy, dry skin requires a gentle approach. Using a mild, fragrance-free moisturizer regularly – ideally twice daily – helps restore the skin’s moisture barrier. Taking shorter, cooler showers or baths prevents further drying, as hot water strips natural oils from the skin. Avoiding harsh soaps and switching to gentle, pH-balanced cleansers can make a significant difference. Pat your skin dry rather than rubbing it, and apply moisturizer while your skin is still slightly damp to lock in moisture. If itching is severe, over-the-counter hydrocortisone cream (1% strength) can provide relief, though it’s best to discuss persistent skin problems with your GP.

Hormonal Treatment Options for Menopause

When lifestyle changes aren’t enough to manage menopause symptoms, hormone replacement therapy (HRT) is often an effective treatment option. HRT works by replacing the oestrogen (and sometimes progesterone) that your body is no longer producing in sufficient quantities. It can significantly improve many menopause symptoms, including hot flushes, night sweats, mood changes, sleep disturbances, and vaginal dryness.

There are different types of HRT available, including tablets, patches, gels, and vaginal preparations. The right type for you depends on your individual symptoms, medical history, and personal preferences. For women who still have their uterus, combined HRT (containing both oestrogen and progestogen) is typically prescribed to protect the lining of the womb. Women who’ve had a hysterectomy usually take oestrogen-only HRT.

“Prescribing HRT is one of the most satisfying interventions that I make as a GP. Patients often have struggled for some time with their symptoms and have lost hope. Then in many cases they feel so much better after a few months of medication and can get back to enjoying life! There are of course some risks and it’s not for everyone, but it’s worth a discussion.” 

It’s important to understand that HRT isn’t suitable for everyone. Your GP will need to assess your individual circumstances, including your medical history, to determine whether HRT is appropriate for you and which type would be most suitable. For some women, the benefits of HRT in improving quality of life significantly outweigh the risks. For others, non-hormonal alternatives may be more appropriate.

Beyond HRT, there are other medical treatments that can help with specific symptoms. For example, certain antidepressants can reduce hot flushes, while vaginal moisturizers and lubricants can help with vaginal dryness. Cognitive behavioral therapy (CBT) has been shown to help with mood changes and sleep problems associated with menopause.

The Importance of Seeking Support

Menopause and perimenopause symptoms can have a big impact on your daily life, including relationships, social life, family life and work. Yet too many women suffer in silence, unsure whether their symptoms warrant medical attention or believing they simply have to “put up with” the discomfort.

I want to emphasize that you don’t have to struggle through menopause alone. Getting advice early can help reduce the impact perimenopause and menopause have on your health, relationships and work. Whether you’re experiencing one troublesome symptom or multiple symptoms that are affecting your quality of life, there are treatments and strategies available to help.

“We are here to help with menopause! You do not need to accept the symptoms and struggle alone. Whether its lifestyle advice or HRT, we are here to help. I’ve had many patients whose lives are on hold for years who wish they came in earlier. Don’t make the same mistake.”

When to See Your GP

You should consider booking an appointment with your GP if:

• You think you’re experiencing perimenopause or menopause symptoms
• Your symptoms are affecting your daily life, relationships, or work
• You’re struggling to manage symptoms with lifestyle changes alone
• You’re experiencing symptoms like persistent leg pain, severe dizziness, or skin changes that concern you
• You’d like to discuss whether HRT or other treatments might be appropriate for you
• You’re currently using hormonal contraception and are unsure whether you’re experiencing menopause

Your GP practice is here to support you through this transition. We can assess your symptoms, discuss your treatment options, and create a management plan tailored to your individual needs and circumstances. You can also speak to a pharmacist for advice about over-the-counter treatments and lifestyle modifications that may help.

Book Your Appointment Today!

Don’t let menopause symptoms control your life. Every woman deserves to feel comfortable, confident, and supported during this natural life transition. If you’re experiencing any of the symptoms discussed in this article – whether it’s sore legs keeping you awake, persistent bloating, disruptive hot flushes, troublesome itchy skin, or any other menopause-related concerns – I encourage you to reach out to our practice.

We understand that talking about menopause symptoms can feel uncomfortable or embarrassing, but please know that these conversations are a routine part of our work as GPs. There’s no symptom too small or concern too trivial to discuss. The sooner we can assess your symptoms and discuss management options, the sooner we can help you feel like yourself again.

Contact our practice today to book an appointment. We’re here to listen, support, and help you navigate menopause with confidence. Your wellbeing matters, and effective help is available – you just need to take that first step of reaching out.