The Menopause Symptoms No One Talks About

Menopause and perimenopause are often reduced to hot flushes and mood swings. But for many women, the experience is far more complex, more confusing, and often much less openly discussed.

This is a topic that comes up often in conversation with my clients. Many are already moving through perimenopause or menopause, some are beginning to notice changes, and others are simply trying to understand what may lie ahead. It is also something I relate to personally. At 38, I have experienced symptoms myself, and after being told in my early 30s that I had a low egg count, I have long anticipated what I thought might be an early menopause. That personal awareness, alongside the honest conversations I have with women every day, is one of the reasons this subject feels so important to talk about more openly.

Before we talk about symptoms, it helps to understand what perimenopause and menopause actually are. Perimenopause is the transition phase leading up to menopause, when hormone levels begin to fluctuate and the body starts moving towards the end of the reproductive years. Menopause is reached when a woman has gone 12 consecutive months without a period.

During perimenopause, the ovaries gradually begin producing less oestrogen and progesterone. These hormones do far more than regulate the menstrual cycle. They also influence sleep, mood, brain function, body temperature, metabolism, bone health, skin, muscles, libido, and how the nervous system responds to stress. When those hormone levels begin to shift, the whole body can feel the effects.

This is why symptoms can seem so wide-ranging and, at times, unexpected. It is not just about periods changing or stopping. It is about the body adapting to major hormonal changes that can affect both physical and emotional wellbeing.

What is also not talked about enough is when perimenopause can begin. For some women, symptoms can start in their late 30s. For others, it may happen later. There is no single timeline, and no universal experience. Perimenopause can last for years, which is one reason so many women spend a long time feeling confused, dismissed, or unsure of what is happening in their own bodies.

There are symptoms that can feel isolating because no one warned us about them. The sudden loss of confidence. The brain fog that makes simple tasks feel harder than they should. The anxiety that seems to arrive out of nowhere. The disrupted sleep, the joint pain, the irritability, the overwhelm, the strange sense of no longer quite feeling like yourself.

For many women, this stage of life is not just physical. It can affect identity, relationships, work, energy, motivation, and emotional wellbeing. And yet so many still suffer quietly, wondering if they are imagining it or simply expected to push through.

The symptoms we do not hear enough about

While hot flushes may get the headlines, many women also experience:

• Brain fog and forgetfulness

• Anxiety or low mood

• Poor sleep or waking in the night

• Joint aches and muscle stiffness

• Reduced confidence

• Sudden fatigue and low motivation

• Changes in body composition

• Increased sensitivity to stress

• Vaginal dryness and reduced libido

• Feelings of frustration, grief, or disconnection

  
  

These symptoms can arrive gradually or all at once. They can be subtle, disruptive, emotional, or deeply physical. Most importantly, they are real.

Why these symptoms happen

Many of these symptoms are linked to fluctuating and declining hormone levels, especially oestrogen. Oestrogen helps regulate serotonin and other brain chemicals linked to mood, which is why anxiety, irritability, or low mood can become more noticeable. It also plays a role in temperature regulation, which is why hot flushes and night sweats happen.

Changes in progesterone can affect sleep and contribute to feeling more wired, restless, or emotionally sensitive. Lower hormone levels can also affect muscles, joints, and bone density, which may explain increased stiffness, aches, and slower recovery.

At the same time, the nervous system can become more reactive to stress, and the body may handle blood sugar, energy, and recovery differently than before. This is why women often say they suddenly feel less resilient, more tired, or unlike themselves, even if nothing obvious has changed in their routine.

How exercise can help

Movement is not about punishing the body. During perimenopause and menopause, it becomes a tool for support, stability, and strength.

The right kind of exercise can help:

• Improve mood and reduce stress

• Support better sleep

• Maintain muscle mass and bone health

• Ease stiffness and joint discomfort

• Help regulate weight and energy

• Build confidence and resilience

  
  

A balanced approach often works best:

• Strength training to support muscles, bones, and metabolism

• Walking for stress relief, cardiovascular health, and mental clarity

• Pilates or yoga for mobility, posture, and nervous system support

• Gentle stretching to reduce tension and improve recovery

• Rest and recovery to avoid burnout and honour changing energy levels

  
  

The key is consistency, not intensity. Listening to the body matters more than following punishing routines.

Lifestyle choices that make a real difference

Small daily choices can have a powerful impact during this stage of life.

Helpful foundations include:

• Prioritising protein, fibre, and whole foods

• Reducing excess alcohol and highly processed foods where possible

• Supporting blood sugar balance with regular meals

• Creating a calming evening routine for better sleep

• Managing stress through breathwork, walking, journalling, or time outdoors

• Asking for support rather than trying to carry everything alone

  
  

This is not about perfection. It is about creating a lifestyle that supports the body rather than fighting against it.

A note for the men reading this

If you are a husband, partner, son, brother, friend, or colleague, your support matters more than you may realise.

Many women going through perimenopause or menopause are trying to navigate symptoms they do not fully understand themselves. What helps most is not fixing everything. It is listening, learning, and responding with patience.

You can support the women in your life by:

• Taking their symptoms seriously

• Learning more about what perimenopause and menopause can involve

• Being patient with changes in mood, energy, or confidence

• Encouraging rest, movement, and open conversation

• Offering practical help without judgement

• Reminding them they are not alone and not losing themselves

  
  

Compassion goes a long way. So does curiosity.

This chapter deserves more honesty

Perimenopause and menopause are not something to be hidden, minimised, or laughed off. They are significant life transitions that deserve better conversations, better support, and far more understanding.

For women, this can be a time to reconnect with your body in a new way, to move differently, to care for yourself more deeply, and to ask for what you need.

For the people around you, it is a chance to show up with empathy.

No woman should feel she has to go through this quietly.

And no one should underestimate how much support, movement, and lifestyle choices can help make this transition feel more manageable, more informed, and far less lonely.