Menopause symptoms: signs of perimenopause and when to talk to a doctor online
Hot flushes, poor sleep, mood changes and irregular periods are common signs of perimenopause and menopause. Here is what to look out for, and what an online doctor can do about it.
Common menopause symptoms include hot flushes, night sweats, poor sleep, mood changes, brain fog, vaginal dryness, joint aches and changes to your periods. Perimenopause symptoms can start 7 to 10 years before periods stop. Speak to a doctor if symptoms are affecting your daily life, if they start before 45, or if you are unsure they are menopause at all. In a video consultation, an Irish-registered doctor reviews your symptoms and cycle history, considers other causes, decides whether any tests are needed and talks through a management plan with you.
The basics
Perimenopause and menopause: what the terms mean
The HSE describes menopause as the point when a woman stops having periods completely, and perimenopause as the time when you have symptoms before your periods have stopped.
You reach menopause when you have not had a period for 12 months; the Department of Health adds that this applies when you are not using hormone-containing contraception. Menopause usually happens between 45 and 55, and the HSE gives 51 as the average age in Ireland.
The HSE says perimenopause symptoms can start 7 to 10 years before periods stop, often while periods are still regular. Most symptoms last around four years from your last period, but around 1 in 10 people have them for up to 12 years.
Sources: HSE — Menopause; HSE — Menopause symptoms; Department of Health — Menopause explained.
Signs of menopause
Common perimenopause and menopause symptoms
Symptoms vary in type, length and severity. The HSE lists these as common.
- Vasomotor: hot flushes and night sweats.
- Sleep: difficulty sleeping.
- Mood: low mood, anxiety, mood swings and irritability.
- Thinking: problems with memory or concentration (brain fog).
- Vaginal and urinary: dryness, itching or discomfort, discomfort during sex, reduced sex drive and recurring urinary tract infections.
- Body: joint aches, headaches, palpitations, loss of muscle and weight gain.
- Periods: shorter or longer cycles, lighter or heavier flow, and skipped periods.
Because tiredness, anxiety or joint pain are not unique to menopause, they are easily put down to stress. If your periods are irregular and you have had sex without contraception, the HSE advises checking whether you are pregnant.
Sources: HSE — Menopause symptoms; Department of Health — How to know if you are in menopause.
Other causes
When symptoms may not be menopause
Fatigue, low mood, palpitations and irregular bleeding have other possible causes, so a doctor should look at the whole picture.
A thyroid problem, a low blood count, depression, medicine side effects or a change in contraception can all overlap with perimenopause. A doctor asks about your general health, medicines and the timing of each symptom before deciding whether menopause is the likely explanation.
Blood tests are not always needed. UK guidance from NICE says that in otherwise healthy women aged 45 or over, perimenopause and menopause can be diagnosed from the clinical history alone, because hormone levels fluctuate; a blood count or thyroid tests may still be needed if another cause is suspected. The HSE says menopause can usually be confirmed from your symptoms, sometimes with a hormone blood test.
Sources: NICE QS143 — Diagnosing perimenopause and menopause (UK); HSE — Menopause, diagnosing menopause.
Under 45
Early menopause symptoms: why age matters
If your periods become less frequent or stop before the age of 45, and you are not pregnant, it is worth being assessed.
The HSE defines early menopause as periods stopping before 45, and menopause before 40 as premature ovarian insufficiency (POI), which affects around 1 in 100 women. Symptoms are the same as menopause, although some women have none. Often the cause is not known; it can follow some cancer treatments or removal of the ovaries, and can run in families.
The HSE says premature menopause increases the risk of osteoporosis and cardiovascular disease, and that diagnosis in this group involves blood tests to check hormone levels. A doctor may involve a specialist.
Sources: HSE — Early and premature menopause; HSE — Menopause.
Online care
What a menopause consultation by video covers
Most of a menopause assessment is a careful conversation, which works well over a secure video call.
Our Women's Health Consultation is with an Irish-registered doctor at GP level and typically covers:
- Symptoms and cycle history: what you have noticed, how your periods have changed and how it affects sleep and work.
- Medical background: past health, medicines, contraception and family history.
- Other causes: whether thyroid, blood count or other factors need checking.
- Tests only where useful: referral for blood tests where indicated, for example if you are under 45.
- Lifestyle measures: practical steps for sleep, hot flushes, mood and bone health.
- Treatment options: which may include hormone replacement therapy (HRT), at the doctor's professional discretion after assessing your suitability.
- Follow-up plan: when to review progress and what ongoing care fits you.
Some things cannot be done by video, such as a pelvic or breast examination; if you need one, or specialist input, the doctor will say so and coordinate a referral. Consultations are confidential and also available in Portuguese, Spanish, Czech and Romanian. See online and in-person care.
Managing symptoms
What helps with menopause symptoms
The HSE says not all women need treatment, but treatment is available if symptoms are difficult.
HSE lifestyle advice includes a healthy diet with calcium-rich foods, regular exercise, regular sleep routines, not smoking and staying within low-risk alcohol guidelines. For hot flushes, light clothing, a cool bedroom and cutting down on triggers such as spicy food and caffeine may help. Cognitive behavioural therapy (CBT) can help with low mood and anxiety, and also with hot flushes and sleep.
The HSE describes HRT as the main medicine treatment for menopause symptoms, with other options depending on your symptoms. The right approach depends on your symptoms, history and preferences, and risks and benefits should be discussed with a doctor first, as should herbal supplements.
Sources: HSE — Things you can do; HSE — Menopause treatment.
Safety
Symptoms that need prompt attention
Most menopause symptoms are not dangerous, but some changes need prompt checking.
Sources: HSE — Menopause symptoms, postmenopausal bleeding; Department of Health — Menopause explained.
Care in Ireland
Talk to a doctor about your symptoms
A video consultation with an Irish-registered doctor can help you understand your symptoms and agree a plan, including when an in-person visit is needed.
Think you may be in perimenopause?
Talk through your symptoms with an Irish-registered doctor by secure video call and leave with a clear plan.
Sources
Guidance behind this article
Sources verified on 8 October 2026.
This article summarises HSE and Department of Health information on menopause as published on 8 October 2026, with UK NICE guidance on diagnosis. It describes symptoms and what a consultation can cover; it does not recommend a specific treatment, and any treatment decision is made by a doctor after individual assessment.
Questions
Common questions about menopause symptoms
What are the first signs of perimenopause?
Often a change in your periods, such as shorter or longer cycles, heavier or lighter flow, or skipped periods. Some women first notice hot flushes, poor sleep, low mood or brain fog while their periods are still regular.
Do I need a blood test to confirm menopause?
Not always. Over 45, a doctor can usually diagnose perimenopause or menopause from your symptoms and history. Blood tests are more likely to be needed if you are under 45 or another cause is suspected.
Can I discuss HRT in an online consultation?
Yes. Your doctor can discuss treatment options, including HRT, after assessing your symptoms, medical history and suitability. Any recommendation is made at the doctor's professional discretion.
