Here's a startling statistic. Most women in midlife have menopause symptoms, yet studies suggest only around 1 in 4 get any treatment for them. A 2025 US survey of nearly 5,000 women aged 45 to 60 found more than three-quarters had symptoms, and most had never sought care (Mayo Clinic (opens in a new tab)).
If your low mood seems linked to menopause, it's worth knowing what UK guidance says: consider hormone therapy or talking therapy such as CBT, and don't treat antidepressants as the automatic first choice unless depression has been diagnosed (NICE (opens in a new tab)).
You deserve better than that. And you don't have to wait until things feel unbearable to ask for help.
Book an appointment if you have#
- Unusual bleeding: very heavy periods, clots, bleeding between periods, or any bleeding after menopause. This must be checked before starting hormone therapy, to rule out other causes.
- No periods and menopause symptoms before 40, or symptoms in your early 40s. Early diagnosis matters. Early menopause raises the risk of weak bones and heart disease, and hormone treatment, usually until around the average age of menopause, helps protect against them (NHS (opens in a new tab)).
- Symptoms getting in the way of life: hot flashes, poor sleep, mood changes, brain fog, pain, or vaginal and urinary symptoms that bother you.
- Repeat urinary infections after menopause.
- Persistent low mood, anxiety or loss of interest in things you used to enjoy.
- Had your ovaries removed, especially before your mid-40s.
What your doctor may check#
Menopause symptoms can look a lot like other conditions. Depending on your symptoms, your doctor may check things like thyroid function, iron levels and a full blood count, blood sugar, and sometimes vitamin D before putting everything down to menopause, with other tests, for example for arthritis, only if your symptoms point that way (Medicine Today, 2021 (opens in a new tab); Mayo Clinic (opens in a new tab)). Hormone levels are often less useful in perimenopause because they swing so much.
Ask about your heart too: blood pressure, cholesterol, blood sugar and a formal heart risk assessment, which the North American Menopause Society recommends for all midlife women.
From the researchWhen can you stop contraception?#
Pregnancy is still possible in perimenopause, as the WHO points out. UK guidance from the Faculty of Sexual and Reproductive Healthcare, as set out by the NHS (opens in a new tab), says:
| Your situation | When contraception can usually stop |
|---|---|
| Last natural period before age 50 | 2 years after that period |
| Last natural period at 50 or older | 1 year after that period |
| Any woman | At 55, even if still having some periods |
If you use hormonal contraception that stops your periods, your doctor may suggest a blood test after 50, or simply continuing until 55.
Your appointment prep checklist#
Questions worth asking#
- Could my symptoms be perimenopause or menopause?
- What else could be causing them?
- Is hormone therapy an option for me? What are my personal risks and benefits?
- Would a patch or gel suit me better than tablets?
- What can I do about vaginal or urinary symptoms?
- What's my heart disease risk, and should I check my bone health?
- Do I still need contraception?
- If hormone therapy isn't right for me, are there non-hormonal medicines or CBT options available here?
