What is menopause symptoms?
The menopause is the point at which periods stop permanently, reached at an average age of 51 in the UK, though the perimenopause — the transition phase with fluctuating hormones — can begin years earlier. Falling oestrogen levels cause a wide range of symptoms, from hot flushes and night sweats to anxiety, low mood, brain fog, joint aches and vaginal dryness. Symptoms last around four to eight years on average and vary enormously between women; about one in four experiences severe symptoms.
Diagnosis in women over 45 is based on symptoms alone — blood tests are usually unnecessary and can be misleading. In younger women, hormone blood tests help confirm early menopause. Assessment also covers bone and heart health, which oestrogen protects.
Common symptoms
- Hot flushes and night sweats
- Difficulty sleeping
- Anxiety, low mood or irritability
- Brain fog and poor concentration
- Irregular then absent periods
- Vaginal dryness and discomfort during sex
- Joint and muscle aches
How long will you wait?
Most menopause care happens in general practice, but NHS specialist menopause clinics are scarce and referrals for complex cases commonly wait several months to a year depending on the region.
Privately, you can typically see a menopause specialist within 3–7 days, with any blood tests or bone density scanning completed within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Hormone replacement therapy (HRT). Replaces oestrogen, usually with progesterone to protect the womb, and is the most effective treatment for most menopausal symptoms.
- Vaginal oestrogen. Low-dose creams, pessaries or rings that treat dryness and urinary symptoms locally, safe for most women long term.
- Non-hormonal medication. Options such as certain antidepressants, gabapentin or newer drugs for hot flushes, useful when HRT is unsuitable or unwanted.
- Cognitive behavioural therapy. Evidence-based talking therapy that reduces the impact of hot flushes, sleep problems and low mood.
- Lifestyle measures. Regular exercise, weight-bearing activity, limiting alcohol and stopping smoking support symptom control and long-term bone and heart health.
What does private treatment cost?
As a guide, a private menopause consultation typically costs £250–£400, with follow-ups around £150–£250; private HRT prescriptions add roughly £15–£40 a month depending on the preparation.
Does health insurance cover menopause symptoms?
Private medical insurance handles menopause inconsistently. Some insurers now include menopause consultations or dedicated support services, and investigations for symptoms such as abnormal bleeding are usually covered. However, the menopause itself is a natural life stage rather than an acute illness, so ongoing management — including HRT prescriptions and routine reviews — is usually not covered. Check whether your policy includes a specific menopause benefit.
Frequently asked questions
Is HRT safe?
For most healthy women starting within ten years of the menopause, the benefits of HRT for symptom relief and bone protection outweigh the risks. There is a small increased risk of breast cancer with combined HRT that rises with duration of use, and transdermal oestrogen (patches or gel) avoids the clot risk of tablets. Decisions should be individual, weighing your history and preferences with a clinician.
Do I need a blood test to diagnose menopause?
Usually not. If you are over 45 with typical symptoms and changing periods, the diagnosis is clinical and hormone tests add little because levels fluctuate day to day. Blood tests are useful in women under 45, where premature or early menopause needs confirming, and occasionally where the picture is unclear — for example after a hysterectomy or with contraception masking periods.
How long do menopause symptoms last?
On average, vasomotor symptoms such as hot flushes last around four to eight years, but the range is wide: some women have symptoms briefly, while roughly one in ten experiences them for a decade or more. Vaginal dryness tends to persist and often worsens without treatment. There is no need to simply endure symptoms — effective treatments exist at every stage.