Women 50+: menopause and the middle years

The change does not arrive all at once, and most writing about it starts too late. This section covers the years of inconsistent, confusing symptoms before periods stop, and the decades after them.

Start here: Perimenopause — what is happening, and when it starts

What this section covers

• What perimenopause is, when it typically begins, and how it is recognised
• Hot flushes and night sweats: what the evidence supports, and what it does not
• Sleep in midlife: why it breaks, and what helps
• Bone health after menopause: protecting what you cannot feel
• Mood, identity and the middle years — the “I do not feel like myself” years
• Understanding treatment options before an appointment, with no recommendation either way

Nothing here tells you what to do about your own symptoms. It explains what published guidance says, so that the conversation with your clinician starts from a better place.

Guidance differs between countries. Where that matters, we say which country’s guidance we are quoting.