Menopause

Menopause is diagnosed when a woman has gone 12 consecutive months without a period. A natural biological process, menopause's symptoms vary in intensity and duration for every woman. Menopause symptoms, due to the decline in hormone levels, particularly oestrogen and progesterone, usually occur for around seven years between the ages of 45 and 55 although hormones start fluctuating during the perimenopause meaning many women experience these symptoms earlier.


The most common menopause symptoms include:

  1. Night sweats, sudden spreading feeling of warmth, often in the upper body and head, sweating, flushed skin and hot flashes leading to sweating and disrupted sleep.

  2. Menstrual cycle changes with periods becoming irregular, lighter or heavier in flow as menopause approaches.

  3. Vaginal symptoms including reducing oestrogen which can cause thinning and dryness of vaginal tissues, discomfort or pain during intercourse, bladder infections and reduced or lack of libido.

  4. Mood swings, brain fog, irritability, depression, anxiety and premenstrual exacerbation of these symptoms due to hormonal fluctuations.

  5. Sleep disturbances including trouble falling asleep or staying asleep, often linked to night sweats.

  6. Frequency or intensity of headaches during perimenopause becoming more frequent or intense. Some women may develop migraine symptoms for the first time.

  7. Hormonal changes can lead to weight gain, slowing of metabolism and increased fat storage around the abdomen.

  8. Thinning hair and dry skin as well as irritated skin and dry eyes.

What is menopause?

Menopause treatments

HRT (Hormone replacement therapy)

Usually the most effective treatment to relieve symptoms of menopause, HRT works by supplementing the body with oestrogen and progesterone, as well as protecting the bones from osteoporosis. Options include pills, patches, gels and creams – I always tailor the treatment to your own individual needs and monitor the results. Reduced libido typically improves with oestrogen supplementation but some women may also require testosterone replacement. HRT isn't suitable for all and I am always careful to address increased risks such as blood clots and certain cancers for each patient.

Lifestyle changes

There is a range of lifestyles adaptions which could be key to patients minimising symptoms during menopause transition. I will look at areas of your life including regular exercise, a balanced diet and weight loss to improve all symptoms of menopause. Quitting smoking can reduce the risk of osteoporosis, heart disease and the risk of blood clots. 

HRT & bespoke migraine management advice

I can work with you to develop a bespoke treatment plan to manage hormonal headaches more effectively and improve overall quality of life. This may include hormonal treatments for menstrual migraine like combined contraceptive pills or progesterone only pills or bespoke HRT options for perimenopausal symptoms and premenstrual syndrome. This may also involve combining hormonal options with migraine preventative treatments for more optimal control of both migraine and hormonally triggered symptoms.

Please note these appointments will take place at Hove Therapy Rooms, 69 Church Road, Hove, BN3 2BB

“My migraines became more frequent and debilitating as I approached menopause. When I saw Dr Manukyan I felt understood and listened to for the first time. She is very empathetic and has an excellent knowledge. Her expertise in menopause support has been helpful in informing my treatment plan. I am now in a much better position managing my migraines and feel that I have my life back.”

KIM, 57, SURREY