Hot flashes are one of the best-known signs of menopause; only about two in five women experience the symptom in its early stages, new data shows.
Instead, other, more easily ignored problems, such as mood swings, digestive problems and sleep problems, become much more common.
Researchers asked 5,000 women about their experiences with perimenopause – the medical term for the period of hormonal fluctuations that lead to menopause.
This usually starts in the early 40s and lasts for five to 10 years, but it can also affect women in their 30s.
Experts hope the findings will help patients recognize the symptoms and seek help.
The findings come from a survey of 5,000 women by Forth, a home blood test provider, who asked them about their experiences with perimenopause.
Despite hot flashes, night sweats and vaginal dryness being considered classic symptoms of the change, only a fraction of women undergoing perimenopause experienced them. Stock image
According to the study, less than two in five (37 percent) of women experienced hot flashes during perimenopause.
Vaginal dryness or pain during sex was also in the minority, with only four in ten women saying they suffered from this.
And only about half of women (51 percent) said they experienced night sweats before the onset of menopause.
Irregular menstruation, another classic sign of both perimenopause and menopause, was only experienced by about three in five women (58 percent).
Instead, they were other problems that were much more common, easier to ignore as part of a stressful life while juggling career and family responsibilities.
Mood swings were the most common symptom among women in the study; more than four in five women (84 percent) experienced this change.
This was followed by digestive problems (78 percent), such as bloating, poor sleep (77 percent) and brain fog (77 percent), which were experienced by just over three in four women.
However, these symptoms can also indicate a host of other problems, from depression and stress to irritable bowel syndrome.
The research was conducted on behalf of home blood testing company Forth.
Dr. Thom Phillips, a GP and the company’s clinical lead, said women may benefit from hormone screening if they are concerned they are entering perimenopause.
“As women go through perimenopause, their levels of some hormones decrease while others increase,” he said.
‘Our advanced perimenopause hormone blood test maps these across the menstrual cycle to score women.’
This score can help indicate whether a woman is in perimenopause.
An important hormone that begins to fluctuate is estrogen.
Among many other functions, it helps regulate mood, fluctuations in which can cause mental health problems.
The NHS currently advises against routine testing of hormone levels to ‘diagnose’ perimenopause or menopause – because these can fluctuate so widely, even within a day, the results can be misleading.
Instead, health watchdog the National Institute for Health and Care Excellence suggests a diagnosis based on symptoms.
However, some tests may be offered if a woman is under 45 and has symptoms that make doctors suspect she is suffering from menopause.
If a woman has obvious symptoms of perimenopause, hormone replacement therapy may provide benefits.
The new findings come after a recent analysis found that 60,000 women in Britain are out of work with long-term menopausal symptoms.
These absences cost the economy £1.5 billion a year, according to an estimate by the NHS Confederation, which represents health organisations.
The report shows that women with severe mental or physical symptoms are less likely to be employed than the rest of the population, and are twice as likely to be economically inactive due to health problems.
Menopause occurs when a woman stops menstruating and can no longer become pregnant naturally.
It is a normal part of aging and is caused by a decrease in levels of the sex hormone estrogen.
Menopause typically begins between the ages of 45 and 55 for most women, although it can occur earlier either naturally or as a result of other health problems and treatments, such as those for cancer.
The number of HRT prescriptions for menopausal women has increased dramatically in recent years, with 11 million items distributed in 2022/2023 to help manage symptoms
Some women go through this period with few or no symptoms. Others experience hot flashes, sleep problems, mood swings and brain fog, which can last for months or years and change over time.
Women are advised to see their GP if their symptoms are severe and interfering with their daily life.
Treatments that doctors can provide are aimed at controlling symptoms and may include HRT.
HRT, which increases the levels of hormones that decrease with menopause, can help relieve symptoms such as hot flashes, night sweats, anxiety, reduced sex drive and memory problems.
Demand for HRT drugs has been so high that Britain has been hit by shortages of certain drugs.