Menopause marks the end of menstruation, usually between ages 45 and 55. For many women, the years leading up to it (perimenopause) bring symptoms that affect sleep, mood, work and relationships. Nursing is a female-majority profession, so many nurses are themselves navigating menopause while working demanding shifts. Yet menopause is still rarely discussed openly in many cultures and workplaces.
Key terms
- Perimenopause: the transition, often several years, with irregular periods and symptoms.
- Menopause: diagnosed after 12 months without a period.
- Premature ovarian insufficiency: menopause before 40, which needs medical assessment and usually hormone treatment.
- Surgical menopause: after removal of the ovaries.
Common symptoms
- Hot flushes and night sweats.
- Sleep problems and fatigue.
- Mood changes, anxiety, low mood, irritability.
- “Brain fog”: poor concentration and memory.
- Joint and muscle aches.
- Vaginal dryness, pain during sex, recurrent urinary symptoms.
- Reduced libido.
- Irregular or heavy periods during perimenopause.
Treatment options
Hormone replacement therapy (HRT)
- The most effective treatment for hot flushes and many other symptoms.
- Women with a uterus need oestrogen plus a progestogen (to protect the womb lining); women without a uterus can usually take oestrogen alone.
- Transdermal oestrogen (patches, gels, sprays) carries a lower clot risk than tablets.
- Risks and benefits depend on age, timing, type, and individual history. For most women under 60 with symptoms, guidelines such as NICE’s say the benefits generally outweigh the risks, but a small increased breast cancer risk with combined HRT should be discussed.
- Not suitable for some women (e.g. certain cancers, past clots, liver disease); individual assessment is needed.
Other options
- Vaginal oestrogen for dryness and urinary symptoms: very low dose, safe for most women.
- Non-hormonal medicines for hot flushes, prescribed by a clinician.
- Cognitive behavioural therapy (CBT) helps with hot flushes, sleep and mood.
- Lifestyle: exercise, healthy weight, limiting alcohol and caffeine, stopping smoking, layered clothing, cool sleeping environment.
- Be cautious with unregulated herbal products, which can interact with medicines.
Long-term health
- Bone health: falling oestrogen increases osteoporosis and fracture risk. Weight-bearing exercise, calcium and vitamin D, and assessment of fracture risk help.
- Heart health: cardiovascular risk rises after menopause. Check blood pressure, cholesterol and blood sugar.
- Continue cervical and breast screening.
- Any bleeding after menopause needs prompt assessment.
Nurses working through menopause
- Hot wards, heavy uniforms, PPE and night shifts can worsen symptoms.
- Many employers now have menopause policies: adjustments such as lighter uniforms, fans, access to water and toilets, flexible shifts.
- Talk to occupational health or your manager; it’s a health issue, not a weakness.
- Support colleagues with understanding rather than jokes.
See also intimacy in long marriages.
Based on NICE NG23 (Menopause: identification and management, updated 2024), the British Menopause Society and WHO menopause fact sheet. Educational content: individual decisions should be made with a clinician.