Hot flushes and night sweats are not the only signs that you’re hitting the menopause. In fact you may not have these common symptoms at all. Dr Heather Currie of Menopause Matters explains: ‘The hormone oestrogen has an impact on just about every body system – so it’s not unusual for women to go to their doctor about all manner of problems, not realising that they’re all linked to the fact that their levels of oestrogen are now dwindling as they come to the end of their reproductive life.’

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A sensation of ants crawling over your skin, or even under it, is called formication and caused by receptors in the skin adapting to the withdrawal of the normal levels of oestrogen they’ve been used to. Though ultimately harmless, the sensation can be exasperating – starting during perimenopause (the lead-up to your periods ending) or after your periods have come to an end. (Menopause is defined by having gone a whole year with no periods if you’re over the age of 50, or two years with no periods before that age.) Other skin symptoms include itching (caused by skin becoming thinner and dryer) and pins and needles (parasthesia). ‘The good news is that most symptoms, however frustrating, will get better after your body has adapted to the new hormone levels – but, if you can’t wait that long, consider HRT to replace the oestrogen that your body is craving,’ says Dr Currie. Less likely medical causes such as a thyroid disorder could also be to blame, so it’s always worth checking with your doctor. A good diet, rich in omega-3 fatty acids (from salmon, walnuts and fortified eggs) and plenty of water can help keep skin healthy. Avoid hot showers, which are drying. Use gentle soaps and bath products and moisturise your skin to further prevent dryness.

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Creaking knees and feeling less flexible in your yoga class are not always a sign of worse joint problems to come as you age. ‘They can also be caused by lack of oestrogen around the menopause,’ says Dr Rod Hughes, consultant rheumatologist at St Peter’s Hospital, Chertsey, Surrey. ‘The following joints are most likely to become sore: the base of the thumbs, the elbows, both knees and the back and neck. Perimenopausal women can also get a lot of hip pain, in particular over the outside of the hips. These pains are not, in fact, anything to do with the hip joints, which still move freely, but are the result of tenderness in tissues between muscles (trochanteric bursa or gluteal bursa pains) – and they’re the direct result of oestrogen levels falling, causing stiffness and some inflammation in the soft tissues around joints.

‘Stretching exercises – such as yoga and Pilates – can help, as can losing weight and building more muscle (with weight training).  It’s also worth trying the unique rose-hip component GOPO® (£17.99 for 120 capsules, www.gopo.co.uk) which is proven to help with this kind of pain and inflammation.

‘The good news is that as the menopause passes so do these pains - and flexibility returns.’ 

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Names are eluding you and you tell friends you’d forget your own head if it wasn’t screwed on. It’s easy to blame your age – but around the age of 50 it’s more likely to be your hormones that are causing mischief with your mind. ‘Research has shown that changes in cognitive brain function – including how we remember things – can be an early symptom of menopause,’ says Dr Currie. ‘It’s another sign of the body adapting to lower levels of oestrogen, but this is a symptom that nearly always improves with time. The most likely explanation is that the brain gradually accepts and adapts to the oestrogen deficiency.’

If you’re struggling with forgetfulness at this time of your life, HRT can help. If that’s not for you, try memory exercises – for example writing a shopping list in your head, using a different room in your house for each item that you need to buy. The more visual the mental images you create, the better. For example imagine a bottle of milk spilling in the kitchen, or visualise eating a bowl of cereal in the lounge. When you get to the shop, mentally run through the rooms of your house to recall the items on your list.

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Feeling suddenly giddy or light-headed can be alarming, but yet again during menopause this is a sign of oestrogen deficiency. ‘The hormone affects our nervous system, circulation and temperature control. These are the systems that also trigger more common hot flushes or night sweats – but you don’t have to suffer with those to experience the more unusual dizzy spells,’ says Dr Currie. ‘No two women are the same and this is why menopausal symptoms can be so different and varied. One thing we do know however is that, whatever your symptoms, they’re likely to be exacerbated by unhealthy lifestyle choices. Smoking, alcohol, caffeine, stress and being overweight can all make symptoms worse on their own – but together they have a cumulative effect. The more of those boxes you tick, the rockier your ride is likely to be. We always recommend a healthy lifestyle to make menopause easier to cope with – as it can make such a profound difference.’

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Palpitations are heartbeats that become more noticeable – so you feel as if your heart is pounding, fluttering or beating irregularly, but usually just for a few seconds or minutes. While alarming, they are usually not a sign of a problem with your heart – although you should always see your GP - especially if you have accompanying symptoms such a tightness in your chest. ‘Stress, alcohol, smoking, and even spicy foods can trigger palpitations, but around menopause they’re also caused by the same changes to the nervous and circulatory system that can trigger dizzy spells or light-headedness. Again take a look at any lifestyle tweaks you can make to improve things,’ says Dr Currie.

‘For all these unusual symptoms – along with the more usual signs of menopause – HRT can help by replenishing dwindling oestrogen supplies, and for most women under the age of 60 the benefits outweigh the risks. Using oestrogen alone risks thickening the lining of the womb, which can lead to cancer, but this can be countered by using progestogen alongside oestrogen. For example you could use an oestrogen gel or pill, with a Mirena coil (the same hormonal coil used as a contraceptive), or a pill or patch containing both hormones. If you’ve had a hysterectomy and no longer have your womb, then the progestogen treatment is unnecessary.’

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