__By Dr. Milad Hilli, Livi GP and Menopause Specialist __
*This Menopause Awareness Month, it's time we talked honestly about the transition that affects 13 million women in the UK yet remains poorly understood by both patients and sometimes, even by healthcare providers. * __The 10-Year Window You Didn't Know About
Here's something that might surprise you: menopausal symptoms can begin up to 10 years before your final period. With the average UK menopause age being 51, this means women as young as 35 could start experiencing perimenopause symptoms.
Yet in my practice, I regularly see women whose symptoms have been dismissed, misdiagnosed, or attributed to stress, depression, or "just getting older." This needs to change.
The Symptoms Hiding in Plain Sight
We all know about hot flashes, but the full spectrum of menopausal symptoms is vast and often unrecognised:
Early warning signs (can start in your 30s):
- Period changes (cycles 7+ days shorter/longer than usual)
- Increased anxiety or mood changes
- Brain fog and word-finding difficulties
- Disrupted sleep patterns
- Joint aches and morning stiffness
- Dry eyes and skin
- Heart palpitations.
Later symptoms:
- Classic hot flashes and night sweats
- Vaginal dryness and discomfort
- Reduced libido
- Memory issues
- Severe mood swings
- Weight gain around the middle.
The tragedy? Many women endure these symptoms for years without realising they're connected to hormonal changes.
The Diagnostic Gap
Blood tests for menopause are largely unreliable, especially during perimenopause when hormone levels fluctuate wildly. The diagnosis is primarily clinical, based on your symptoms and cycle changes.
Yet according to recent UK research:
- 44% of women waited more than a year for their perimenopause and menopause diagnosis [Womensgrid]
- A third of women waited at least three years for their symptoms to be correctly diagnosed as menopause symptoms, while a further 18% visited their GP six times or more before receiving help [Newson Health research]
- A 2020 survey by Mumsnet and Gransnet found that many respondents did not trust GPs to diagnose the perimenopause (39%) and the menopause (25%) correctly.
This educational gap in healthcare is slowly improving, but women cannot wait for the system to catch up.
A Global Perspective on Menopause
Interestingly, menopause experiences vary dramatically across cultures, highlighting how environment, diet, and societal attitudes influence this transition:
Japan: Japanese women report significantly fewer hot flashes, possibly due to soy-rich diets and cultural attitudes that view menopause as a natural, respected life stage.
Mediterranean cultures: Women consuming traditional Mediterranean diets rich in olive oil, fish, and vegetables report milder symptoms and better bone health post-menopause.
Western cultures: UK and US women report higher rates of severe symptoms, potentially linked to processed diets, sedentary lifestyles, and negative cultural messaging around ageing.
India: Traditional Ayurvedic approaches emphasise herbal remedies and lifestyle modifications, with menopause viewed as a transition to wisdom and spiritual authority.
These cultural insights remind us that menopause doesn't have to be suffered through, it can be supported and even embraced.
The UK Reality Check
Current statistics paint a concerning picture:
- Three in five menopausal women are negatively affected at work according to a CIPD survey
- 17% have considered leaving work due to lack of menopause support, with 6% actually leaving [Government 2024 progress report]
- Only around 14% of menopausal women currently take HRT, though this varies dramatically by region - as low as 2% in some UK areas according to NCBI
- BUPA research found that almost 900,000 women in the UK had left their jobs because of menopausal symptoms.
Too many women are being failed during one of their most vulnerable life transitions.
Your Menopause Action Plan
If you're 35+, start paying attention:
- Track your cycles - note any changes in timing, flow, or symptoms
- Monitor your mood - unexplained anxiety or depression could be hormonal
- Listen to your body - joint pain, sleep issues, and brain fog aren't "normal ageing".
If you recognise symptoms:
- Keep a symptom diary - document everything for 2-3 months
- Research your options - HRT isn't the only solution, but it's highly effective
- Seek specialist care - don't accept dismissive responses from healthcare providers.
Regardless of your stage:
- Prioritise bone health - weight-bearing exercise and adequate calcium/vitamin D
- Focus on heart health - cardiovascular disease risk increases post-menopause
- Build your support network - connect with other women experiencing similar journeys.
The Power of Preparation
Menopause is not a disease to be cured, but a natural transition to be supported. Women who approach it informed and prepared report significantly better experiences and outcomes.
The perimenopause years, from around 35-50, represent a crucial window for women to pause and invest in their long-term health. This isn't about anti-ageing; it's about optimising your health for the next 30-40 years of life.
Breaking the Silence
Every month, approximately 13,000 UK women reach menopause. Yet it remains shrouded in silence, shame, and medical dismissal. This Menopause Awareness Month, let's commit to changing that conversation.
Whether you're experiencing early symptoms at 35, navigating perimenopause in your 40s, or seeking support post-menopause, expert help is available. You don't have to guess your way through this transition or suffer in silence.
Ready to take control of your menopausal journey? Book a consultation with a Livi clinician through the Livi app. Our clinicians provide personalised care and treatment options tailored to your needs. Download the Livi app today and take the first step towards feeling like yourself again.
