When 'menopause symptoms' are something else

When 'menopause symptoms' are something else

When those ‘menopause symptoms’ are something else: Hot flushes, night sweats, and mood disorders can sometimes be caused by other health conditions, experts say

  • Experts say some symptoms linked to menopause may in fact be something else 
  • Hot flushes, night sweats and mood disorders can stem from other conditions 
  • It’s risky to assume menopause is behind every ill affecting women in mid-life

One of the problems with getting an accurate diagnosis of menopause is that the typical signs, including hot flushes, night sweats, heavy irregular bleeding and mood disorders, can sometimes be caused by other health conditions.

And it’s important to rule these out.

‘Of course, if a woman is aged over 45 and has tell-tale symptoms that her oestrogen levels are declining, such as these characteristic symptoms, it’s probably perimenopause or menopause, but it’s not always so straightforward,’ says Dr Karen Morton, a consultant gynaecologist who runs a menopause clinic in Guildford, Surrey, and online.

Many women going through the perimenopause and menopause experience low mood (stock photo used)

Tests typically aren’t needed to diagnose menopause, but your doctor may recommend checking levels of follicle-stimulating hormone (FSH) and oestrogen (specifically estradiol, the most common type of oestrogen); FSH levels increase and estradiol levels decrease as menopause occurs.

While you can get FSH home tests (these check levels in your urine; doctors check levels in your blood), it’s unwise to self-diagnose, says Sid Dajani, a pharmacist at Bishopstoke in Hampshire.

He says there is a risk in assuming the menopause is to blame for every ill that affects women in mid-life.

‘For example, heavy bleeding during periods may be a sign of uterine fibroids,’ he says.

Irregular bleeding, which women so often think is a normal part of the menopause, may be a sign of cancers, explains Dr Morton.

‘We always look out for red flags that suggest there may be a malignancy.’

In some cases periods stopping could actually be pregnancy. ‘You should always ask the question: ‘Could I be pregnant?’ ‘ says Sid Dajani.

‘Menopause’ symptoms can have many other causes.


Kelly Swingler, 41, an executive business coach and psychologist, lives in Peterborough with her partner and twin sons, aged 21, and stepsons, aged 18 and 11.

Within two months of starting on HRT, the anxiety and ‘burnout’ I’d suffered on and off for eight years had vanished.

My periods had stopped after a minor op on my uterus in 2013. I wasn’t too concerned: I was 32 and had suffered with heavy periods since my teens, and had already had my children.

Kelly Swingler from Coates, Cambridgeshire. She says: ‘Now my energy is 100 per cent better and my brain fog is lifting. My night sweats and anxiety have disappeared, too’

But in 2015 I began experiencing disrupted sleep and night sweats, I put on weight and started feeling anxious and emotional.

Older female colleagues said this could be menopause but my GP said I was too young and prescribed antidepressants.

I took them in the hope they’d make me feel ‘normal’. But my mood kept sinking and that Christmas Eve, I wanted to take my own life.

I decided I had to start helping myself. I stopped taking the antidepressants and improved my diet. I did more yoga and began, slowly, to feel better.

But in 2017, I started to feel overwhelmed by the same symptoms, which I put down to ‘burnout’ at work again. I felt I really needed to fix this in my own head.

Therapy helped, but by 2019, the cycle was repeating itself and by 2020 when the pandemic hit, I felt I didn’t know what planet I was on.

But after I watched Davina McCall’s documentary on the menopause last May I recognised the symptoms and knew it wasn’t me going crazy: it was the menopause.

Then two friends mentioned a private doctor who’d put them both on HRT. I saw their doctor in October 2021 and was prescribed oestrogen patches and a daily progesterone pill; within weeks I felt completely different.

Now my energy is 100 per cent better and my brain fog is lifting. My night sweats and anxiety have disappeared, too.

I was wary of HRT and the potential side-effects. But I feel any risk outweighs the risk of me not taking HRT. I can’t believe what a difference it’s made to my life.

Interview by JILL FOSTER

HIGH BLOOD PRESSURE: Recent research published in the European Heart Journal found that many middle-aged women may be living with undiagnosed hypertension because symptoms — including chest pain, exhaustion, headaches and heart palpitations — are blamed on the menopause instead.

This is because the way coronary arteries age ‘is different among women and men, and this starts around menopause’, says Angela Maas, lead author of the study and a professor in women’s cardiac health at Radboud University Medical Center in Nijmegen, Netherlands.

IRREGULAR HEARTBEAT: A racing heart (occurring alongside hot flushes and other symptoms) can be a sign of the menopause — there are oestrogen receptors in the heart, explains gynaecologist Dr Heather Currie, former chair of the British Menopause Society.

But it’s important not to miss heart rhythm problems due to electrical faults in the heart which are more common as we age.

Dr Morton adds: ‘People think it is just the menopause when actually it could be the heart developing a funny rhythm which is nothing to do with hormones.’

THYROID PROBLEMS: These are also relatively common and can cause menopause-like symptoms such as hot ftlushes and rapid heart beat. Thyroid problems can be detected with a simple blood test.

DEMENTIA: A recent study in Scientific Reports found that menopause affects a woman’s brain structure and the way that brain cells connect.

‘Some women may wrongly fear they’re suffering from early stage dementia,’ says Dr Morton.

But unlike the ‘brain fog’ associated with menopause, Alzheimer’s is a progressive disease and gets worse over time.

Brain fog affects around two-thirds of women going through the perimenopause and menopause, possibly because there are also oestrogen receptors in the brain.

ARTHRITIS: Pain is another health concern that worsens with menopause, but persistent discomfort which doesn’t fluctuate may be caused by other conditions such as arthritis.

‘Don’t assume it’s the menopause. You should see your doctor if you have concerns,’ says Sid Dajani.

DEPRESSION: Perhaps one of the more common areas of confusion is about whether it’s the menopause or depression.

Many women going through the perimenopause and menopause experience low mood.

‘The causes of mood swings in menopausal women are complex but oestrogen has a role in many brain functions, so falling levels during the perimenopause may affect psychological wellbeing in some women,’ says Dr Morton.

Yet unfortunately some are misdiagnosed with depression and given antidepressants when they really need hormone therapy, says Dr Currie.

‘Fortunately, there is a growing awareness among doctors that low mood and anxiety can be hormonally based.’

How to sit on a sofa…without spine suffering

Prolonged sitting is bad for your posture and health. Now a new book by yoga teacher Suzy Reading shows you how to sit properly — even when you’re lounging…

When you’re relaxing on the sofa in front of the TV, it’s important to think about your sitting position.

l watch out for sinking sofas which force the spine into a C-shape, putting pressure on the joints.

When you’re relaxing on the sofa in front of the TV, it’s important to think about your sitting position

Support the natural curve of your spine and joints by sliding a cushion behind the small of your back or tucking a rolled-up blanket under your knees, which can help ease back strain if your legs are outstretched.

  • Consider getting cushions re-stuffed with foam inserts (foam is more supportive than feathers).
  • Use ad breaks as a reminder to get up and move.
  • If you’re stuck at your desk, stand up regularly.
  • Suggest walking rather than seated meetings, stand when you drink water and use a small glass or bottle that you need to get up and repeatedly fill.
  • Setting a reminder on an alarm to prompt you every 30 minutes might also help.
  • If prolonged periods of sitting are unavoidable, check regularly that you’re not slipping into bad habits.

Sit To Get Fit by Suzy Reading (Aster, £12.99). To order for £11.69, go to mailshop.co.uk/books or call 020 3176 2937. Offer price valid until February 22.

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