The menopause can cause a wide range of physical and psychological symptoms.

The first symptom is usually a change in the pattern of your monthly periods.

The start of the menopause is known as the perimenopausal stage, during which you may have light or heavy periods (menorrhagia).

The frequency of your periods may also be affected. You may have one every two or three weeks, or you may not have one for months at a time.

Other menopausal symptoms include:

• hot flushes and night sweats
• loss of libido (sex drive)
• vaginal dryness and pain, itching or discomfort during sex
• palpitations (heartbeats that suddenly become more noticeable)
• headaches
• mood changes, such as depression, anxiety or tiredness
• sleeping problems, such as insomnia
• urinary tract infections (UTIs)

It's difficult to predict how long the menopause will last because it affects each woman differently.

The severity of symptoms and the overall duration of the menopause will vary depending on a number of factors including genetics, lifestyle, diet, stress and overall health.

The perimenopause (the initial stage) may only last for a few months or for some women it may continue for as long as 10 years. The average duration of the perimenopause is around four years. The perimenopause ends when a woman has gone 12 months without having a period.

Vaginal symptoms, such as dryness, can sometimes persist and get worse with age.

If you experience the menopause suddenly, rather than gradually, your symptoms may be worse. 

Hot flushes and night sweats

A hot flush is a sudden feeling of heat in your upper body. It can start in your face, neck or chest, before spreading upwards and downwards.

The skin on your face, neck and chest may become red and patchy, and you may start to sweat. You may also feel a change in your heart rate. It may become very rapid, or it may be irregular and stronger than usual (palpitations).

Hot flushes that occur at night are called night sweats. Most hot flushes only last a few minutes, and they're most common in the first year after your final period.

Sleep problems

Many menopausal women have trouble sleeping because of night sweats. Sleep disturbances may also occur, as a result of anxiety.

You may find that a lack of sleep makes you irritable and that you have problems with your short-term memory and ability to concentrate.

Vaginal symptoms

During the lead up to the menopause, you may experience vaginal dryness, itching or discomfort. This can make sex difficult or painful (dyspareunia). These symptoms combined are known as vaginal atrophy.

About a third of women experience vaginal atrophy shortly after the menopause, with slightly more women having them later on. In some cases, vaginal atrophy can last for more than 10 years after your final period.

If you have vaginal symptoms, it's likely they will continue or get worse unless they are treated.

Urinary symptoms

During the menopause, you're more likely to have recurring lower UTIs, such as cystitis. You may also feel an urgent and frequent need to go to the toilet.