Hot flushes are one of the most famous signs of the menopause, only about two in five women experience the symptom in the early stages, new data suggests.
Instead, other more easily dismissed problems like mood changes, digestive problems and issues sleeping are far more common.
Researchers asked 5,000 women about their experiences of perimenopause — the medical term for the period of hormonal fluctuation leading to the menopause.
This typically starts in the early 40s, lasting for between five to 10 years but it can hit women in their 30s.
Experts hope the findings well help patients recognise the signs and seek help.
The findings are from a survey of 5,000 women by home blood test provider Forth who asked them for their experiences of the perimenopause
Despite hot flushes, night sweats, and vaginal dryness being perceived as the classic symptoms of the change only a fraction of women undergoing perimenopause experienced these. Stock image
According to the survey, fewer than two in five (37 per cent) of women experienced hot flushes during the perimenopause.
Vaginal dryness or pain during sex was also in the minority, with only four in 10 women saying they suffered this.
And only about half of women (51 per cent) said they experienced night sweats before the onset of menopause.
Irregular periods, another classic sign of both the perimenopause and the menopause was only experienced by about three in five women (58 per cent).
Instead, it was other problems, easier to dismiss as part of living a stressful life while juggling career and family responsibilities, which were far more common.
Mood changes were the most common symptom among women in the survey with over four out of five women (84 per cent) experiencing this change.
This was followed by digestive issues (78 per cent) such as bloating, poor sleep (77 per cent) and brain fog (77 per cent), experienced by about just over three in four women.
However, these symptoms can also indicate a host of other issues from depression and stress to irritable bowel syndrome.
The survey was carried out on behalf of home blood test company Forth.
Dr Thom Phillips, a GP and the firm’s clinical lead said women might benefit from taking a hormone screening if they are worried they might be entering the perimenopause.
‘As women go through perimenopause their levels of some hormones decline, while others increase,’ he said.
‘Our advanced perimenopause hormone blood test maps these across the menstrual cycle to provide women with a score.’
This score can help indicate whether a woman is perimenopausal.
One key hormone that begins to fluctuate is oestrogen.
Among many other functions, it helps with the regulation of mood, which is why fluctuation may cause mental health issues.
The NHS currently recommends against routinely testing hormone levels is order to ‘diagnose’ perimenopause or menopause — as these can fluctuate so widely, even within a day, results can be misleading.
Instead, health watchdog the National Institute for Health and Care Excellence suggests diagnosis based on symptoms.
Some tests may be offered, however, is a woman is younger than 45 and suffering symptoms that lead doctors to suspect she is suffering the menopause.
If a woman is suffering clear symptoms of perimenopause, hormone replacement therapy may offer benefit.
The new findings come as a recent analysis found 60,000 women in Britain are off work with long-term menopause symptoms.
These absences cost the economy £1.5 billion a year, analysis by the NHS Confederation, which represents health organisations, estimated.
The report found that women suffering severe mental or physical symptoms are less likely to be in employment compared with the rest of the population, and twice as likely to be economically inactive due to health problems.
Menopause occurs when a woman stops having periods and is no longer able to get pregnant naturally.
It is a normal part of ageing and caused by levels of the sex hormone oestrogen dropping.
Menopause typically starts between the age of 45 and 55 for most women, though it can occur earlier both naturally and as a result of other health problems and treatments, like those for cancer.
HRT prescriptions for menopausal women have soared over the past few years, with 11million items handed out to help deal with symptoms in 2022/23
Some women go through this time with few, if any, symptoms. Others suffer from hot flushes, sleeping difficulties, mood swings and brain fog, which can last for months or years and might change over time.
Women are advised to see their GP if their symptoms are severe and disrupt their day-to-day life.
Treatments doctors can provide focus on managing the symptoms and can include HRT.
HRT, which boost levels of hormones that drop off due to menopause, can help relieve symptoms like hot flushes, night sweats, anxiety, reduced sex drive and memory problems.
Demand for HRT drugs has been so great that the UK has been hit by shortages of some medications.
