Changes in periods, sleep, mood, memory and physical comfort can happen during perimenopause and menopause. This checklist helps you record what has changed and prepare for a conversation with your GP or menopause clinician. The number of symptoms you tick cannot diagnose menopause or tell you which treatment you need.
Menopause is usually identified after 12 months without a period when you are not using hormonal contraception. Hormonal treatments, contraception and a hysterectomy can make it harder to use periods as a guide. Your clinician considers your circumstances and symptoms. NICE: identifying perimenopause and menopause.
Symptom group 01
Physical symptoms
Hot flushes and night sweats
A sudden feeling of heat, often across the face, neck or chest, sometimes with sweating. When this happens at night, it may interrupt your sleep.
Joint and muscle pain
Aching joints, stiffness or muscle soreness can occur around menopause. Describe new or persistent pain to your clinician rather than assuming it has a single cause.
Headaches and migraines
Headaches or migraines may change around menopause. Let your clinician know if their pattern changes or they are affecting daily life.
Heart palpitations
A racing, fluttering or pounding heartbeat can have several causes. Discuss palpitations with your GP, particularly if they keep returning or last more than a few minutes. See the advice below about getting urgent help. NHS: heart palpitations.
Changes to skin and hair
You may notice drier or itchier skin, or thinning hair. These changes are worth discussing if they concern you. NHS: menopause and perimenopause symptoms.
Weight changes
Changes in weight or body shape, including around your middle, may be part of your experience. Note the pattern and any other changes you want to discuss.
Symptom group 02
Sleep and energy
Difficulty sleeping
Trouble falling asleep, waking repeatedly or waking earlier than you want can affect your energy and wellbeing. Night sweats may contribute, but sleep problems are not always caused by menopause. NHS: sleep problems around menopause. For a closer look at broken sleep and early waking, read why perimenopause can disrupt sleep.
Fatigue
Tiredness can occur around menopause and may be affected by poor sleep. It can also have other causes, including medicines or another health condition. Speak with your GP if it persists, affects daily life or you do not know why it is happening. NHS: tiredness and fatigue.
Symptom group 03
Emotional and cognitive
Anxiety
You may feel more anxious or unsettled than usual. Anxiety can occur during perimenopause, but it should not automatically be attributed to hormones.
Low mood
Feeling flat, tearful or unlike yourself is worth discussing, especially if it continues or affects daily life.
Brain fog
Difficulty concentrating, remembering things or finding words may affect work and everyday tasks. Describe what happens and how it affects you.
Irritability
You may notice less patience or a change in how you respond to everyday situations. Record whether this happens alongside changes in sleep or mood.
HSE: mood, memory and concentration changes. Symptoms vary between people; your clinician can help assess the pattern.
Symptom group 04
Sexual and urinary
Vaginal dryness and discomfort
Dryness, irritation, itching or discomfort during sex can happen around menopause. You can discuss intimate symptoms and treatment options with your clinician.
Low libido
Reduced interest in sex can be part of your experience. Mention any discomfort, tiredness, mood changes or other concerns alongside it.
Urinary symptoms
Urgency, needing to pass urine more often, leakage or recurring urinary tract infections deserve assessment. Do not assume new urinary symptoms are caused by menopause.
Symptom group 05
Menstrual changes
Irregular or absent periods
Periods may become more or less frequent, heavier or lighter. Some people still have regular periods during perimenopause. Pregnancy remains possible; missed periods are not always due to menopause. HSE: changes to your periods.
When to seek medical advice
Speak with your GP if symptoms worry you or affect daily life. You do not need to wait for periods to stop. Symptoms before age 45 also deserve assessment. HSE: when to contact your GP.
Bleeding after menopause: Contact your GP about any vaginal bleeding after menopause, even once or if it is only spotting. Do not assume it is simply another menopausal symptom. HSE: postmenopausal bleeding.
Urgent help: If you have palpitations that do not go away, or palpitations with chest pain, breathlessness, feeling faint or fainting, call 999. Do not wait for a routine appointment request to be answered. NHS: when palpitations need emergency help.
How to use this checklist
Record what you notice, when it started, how often it happens and its effect on sleep, work, relationships or daily activities. Include changes to periods, medicines and any treatments you have tried.
Our private interactive Menopause Symptom Scorecard helps you record your experience. Complete it online, then print or save a summary to bring to your own GP or a consultation with us. It is not a diagnostic test.
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Frequently Asked Questions
How many symptoms of menopause are there?
Symptoms vary widely. A longer list or a higher checklist total does not establish a diagnosis. What matters is your pattern of symptoms, medical history and how you are affected.
Can I have menopause symptoms without hot flushes?
Yes. People experience different combinations of symptoms. Changes to mood, sleep or intimate comfort may be what prompts you to seek advice. HSE: symptom variation.
When should I see a doctor about menopause symptoms?
Ask for advice when symptoms concern you or affect daily life. The section above explains situations where medical assessment or urgent help is needed.
Do these symptoms mean I need HRT?
Not necessarily. Treatment choices depend on your symptoms, medical history and preferences. HRT is one option; a consultation helps you discuss suitable alternatives as well. NICE: discussing management options.
Sources
Sources checked on 8 November 2026: HSE menopause and postmenopausal bleeding guidance; NHS menopause symptoms, tiredness and palpitations information; and NICE guideline NG23. Links beside the relevant sections provide the supporting detail.
This checklist is general information to help you prepare for a conversation with a clinician. It cannot diagnose or rule out perimenopause or menopause.
Continue reading
Perimenopause: 15 Symptoms Women in Ireland Often Miss
Read more about changes that may be part of perimenopause and when to discuss them with a clinician.
Read the perimenopause guide