Sleepless nights, racing heart, unexpected aches — small changes can signal a bigger shift in your health journey ahead.
The NHS will add menopause questions to routine Health Checks from 2026, but your body may be sending signals already. Knowing what to watch for, and when to seek help, can spare months of worry and help you feel like yourself again.
What changes now for people aged 40 to 74
From 2026, routine NHS Health Checks in England will include questions about menopause and perimenopause. The checks run every five years for adults aged 40 to 74. The aim is earlier recognition, clear information and timely care for symptoms that disrupt work, sleep and relationships.
Officials expect millions to benefit as awareness rises and conversations shift from hush to action. Women who report symptoms will be signposted to support, including discussion of treatment options such as HRT and lifestyle measures.
New NHS questions on menopause will appear in five‑yearly Health Checks for people aged 40 to 74 from 2026.
Perimenopause and menopause: what they mean
Menopause means periods stop permanently and fertility ends. Clinicians diagnose it after 12 consecutive months without a period. Perimenopause is the lead‑up phase. Hormone levels fluctuate. Cycles change. Symptoms can start even while periods continue.
The timing varies. Most women reach menopause between 45 and 55. Some transition earlier, and some experience few or no symptoms. Patterns often change over time as hormones settle.
Early signs that creep in before periods stop
No two experiences match, but clusters of symptoms tend to appear in midlife. Keep an eye on subtle shifts that build over weeks.
- Cycles that shorten, stretch out or become heavier than usual
- Sudden warmth or flushing that rises to the face and chest
- Night sweats that drench sheets and disrupt sleep
- Sleep that fragments, with early waking or restless nights
- Headaches or migraines that become more frequent or severe
- Heart flutters or palpitations without clear triggers
- Weight settling around the middle and a changing body shape
- Aches in joints and muscles that feel new or persistent
- Drier, itchier skin that needs more care
- Vaginal dryness or discomfort, including pain during sex
- A drop in libido that feels out of character
- Recurrent urinary symptoms, including infections or urgency
- Bleeding gums, tooth sensitivity or mouth soreness
- Anxiety, low mood or mood swings that feel harder to steady
- Brain fog with lapses in memory or concentration at work
Track patterns for at least six weeks. A simple diary often reveals links between cycle changes, sleep and mood.
When is it early or premature?
Doctors describe menopause before 45 as early and before 40 as premature. It can happen naturally. It can also follow medical treatment, such as chemotherapy or pelvic radiotherapy. Removal of the ovaries brings an immediate surgical menopause. Smoking, starting periods at a young age and being underweight can raise the chance of an earlier transition.
How long symptoms may last
Duration differs. Some people see symptoms fade within months. Others face waves that roll on for years. Around eight in ten women report symptoms at some point. Roughly a quarter describe severe effects that interfere with daily life. Heat symptoms often settle, while joint pain, vaginal dryness and sleep problems can linger.
If symptoms stop you living the life you want, seek help. Relief exists, and you deserve to feel well.
Treatments and self‑care that actually help
Hormone replacement therapy, or HRT, replaces oestrogen and, if you still have a womb, progesterone. It eases hot flushes, night sweats, mood symptoms and vaginal dryness for many women. Oestrogen also supports bone strength, which matters for future fracture risk.
Healthcare teams tailor HRT to your needs. You may try more than one option before it clicks. Local vaginal oestrogen treats dryness, soreness and recurrent urinary symptoms with minimal whole‑body absorption. Non‑hormonal medicines, such as certain antidepressants or neuro-modulators, can relieve hot flushes when HRT does not suit.
Common forms of HRT
- Tablets taken by mouth
- Skin patches worn on the body
- Gels or sprays applied to the skin
- Implants placed under the skin
- Intrauterine system (IUS) providing progesterone in the womb
Daily habits that make a difference
- Build calcium and vitamin D into meals to protect bones
- Move most days: brisk walking, strength work and balance drills
- Cut smoking; moderate alcohol to steady sleep and hot flushes
- Prioritise sleep: steady bedtimes, cooler rooms, fewer screens late
- Consider CBT techniques to manage anxiety and mood shifts
- Use a vaginal moisturiser and lubricant for comfort and sex
- Practise pelvic floor exercises to reduce leaks and improve support
Fast fixes for common problems
| Problem | What helps now | What to discuss with your GP |
|---|---|---|
| Night sweats | Layer bedding, cool the room, limit alcohol late | HRT options; non‑hormonal medicines if HRT is not for you |
| Brain fog | Task lists, focused blocks of work, regular breaks | Thyroid and iron checks if symptoms persist |
| Joint pain | Gentle strength training, anti‑inflammatory diet patterns | Review HRT suitability; rule out other joint conditions |
| Vaginal dryness | Moisturisers twice weekly, lubricant during sex | Local oestrogen; screening if bleeding occurs after sex |
When to see your GP and what to ask
You will receive an invite for an NHS Health Check from age 40. You do not need to wait until 2026 if symptoms bother you now. Book a routine appointment and explain what has changed. Your GP may order tests to rule out other causes and talk through options, including HRT and local treatments.
Do not wait for a letter. If symptoms affect work, relationships or wellbeing, ask for help today.
Prepare for your appointment
- Keep a two‑month symptom diary and a period tracker
- List medicines, supplements and any allergies
- Note family history of breast cancer, heart disease or osteoporosis
- Write questions on HRT benefits and risks for you
- Ask about contraception during perimenopause
- Discuss bone health and whether a fracture risk assessment is needed
- Request workplace advice if symptoms affect performance
Work and daily life: why this matters
Untreated symptoms can push experienced people out of jobs they love. Employers increasingly recognise this and offer flexible policies, cooler uniforms and private spaces. Ask your line manager or HR for adjustments. Small changes help you stay productive and comfortable.
Red flags that need prompt assessment
- Bleeding after sex or after 12 months without a period
- New chest pain or persistent palpitations with dizziness
- Severe headaches with visual changes
- Unintentional weight loss or persistent pelvic pain
Unusual bleeding always deserves a timely review. Speak to a clinician without delay.
Extra pointers to widen your options
Contraception still matters during perimenopause. Pregnancy remains possible until you go a full year without a period if you are over 50, or two years if you are under 50. A hormonal IUS can provide contraception and endometrial protection with HRT.
Think about long‑term health at the same time. Menopause shifts cardiovascular risk. Ask about blood pressure, cholesterol and lifestyle targets during your check. Many clinics use simple tools to estimate fracture risk and decide if you need a bone density scan. A 10‑minute discussion today can prevent a fracture years down the line.
Create a simple action plan. Set one sleep goal, one movement goal and one nutrition goal for the next fortnight. Review what worked. Tweak and repeat. Small, steady steps reduce symptoms and raise energy.
If you feel unsure about choices, ask for a follow‑up. Shared decisions work best when you have time to weigh benefits and risks. Bring a friend or partner if that helps you remember details and feel supported.
If I’m 42 with irregular cycles and heart palpitations, should I wait for the 2026 NHS check or book with my GP now? Also curious about HRT vs SSRIs if migraines are part of the picture.