Picture this. Lately, you’ve not been feeling yourself, sex has become painful and your periods are haywire. You’re feeling anxious, depressed and all ’round things just don’t feel right. Your hair is thinning, you’re forgetting things, having heart palpitations, migraines and hot flushes. The worst part, you don’t know why.

Menopause usually begins between the ages of 45-55, with perimenopause (the period of time before menopause where symptoms begin) starting up to 15 years beforehand. While menopause usually hits in middle age, some people will experience it before the age of 40 – this is known as early menopause and affects 5% of women.

A recent study conducted by the Women’s Health Journal in 2022 found that a staggering 90% of participants had never been taught a single thing about menopause. As a result, 60% reported feeling unprepared and uninformed.

Common themes emerged in the study relating to knowledge gaps and the impact and severity of symptoms. Being unaware of menopause comes from a lack of education and social taboo surrounding “women’s troubles”. Those of us who experience menopause are more likely to speak to a friend about symptoms than their partner, or even a doctor.

It’s perhaps unsurprising, then, when HuffPost UK sat down to speak with Dr Shirin Lakhani, an award-winning cosmetic doctor and intimate health specialist, that she tells us; “When I was growing up, my grandma, and my mom never talked about going through menopause, they never talked about the symptoms they experienced.”

Menopause is caused by the natural biological decline in female fertility. Egg reserves run out, oestrogen production fizzles as the ovaries become less functional and, slowly but surely, the female reproductive organs cease to function the way they used to. Periods stop and pregnancy is no longer possible.

Dr Helen O’Neill, CEO and Founder of Hertility Health, says that; “The main perimenopausal symptoms are changes in menstrual cycles, often accompanied by hot flushes and night sweats (known as vasomotor symptoms).”

But this natural wind down doesn’t end in a soft landing for everyone.

“For men, hormones decline like a gentle stroll down a hill. For women, we fall off a cliff,” says Dr Lakhani.

The sudden onset of menopause symptoms can be debilitating.

“Perimenopause and menopause affect many other parts of the body, and cause symptoms such as mood changes, memory issues, joint pain, vaginal dryness and sexual dysfunction,” says Dr O’Neill.

For many menopausal people, it can have a huge impact on their relationships and careers.

Shelly Hatfield, Middlesbrough Manager at LUSH and Menopause CN Chair, tells me that for her, menopause almost made her resign. “At one point I was going to throw in the towel and pack in my job because I was having a hard time,” she says, “And then I realised it was just that I wasn’t being open enough about it.”

Shelly isn’t alone in this. Shame can prevent many women from reaching out to employers for help. Up to 10% of people leave the workplace because of menopause despite the fact that those in this age group are typically at the peak of their careers. This is because employers are failing those experiencing menopause. Eight out of ten women say their employer hasn’t shared information, trained staff, or put in place a menopause absence policy.

Shelly knew she would have to take it upon herself to make change happen. “I started talking to the right people, and people were listening and very interested so we set up the menopause network community and soon we had 66 members,” she tells HuffPost UK.

Her proactive thinking has now meant LUSH sales assistants have received specialist training on menopausal symptoms and are able to recommend products that can help with symptoms like restless leg syndrome, general aches and pains and sleep disturbances.

This training has normalised conversations surrounding menopause, creating space for their customers to feel supported and seen. Additionally, staff at LUSH now have access to training materials and internal support systems that create something of a safety net for menopausal employees.

Education on menopause is seriously lacking, and the workplace is only one location that needs more resources. Dr Lakhani tells HuffPost UK that, in her opinion, schools should be teaching menopause as part of the sex education curriculum. “I think you need to have the education in place to understand what’s happening to your bodies,” she says.

And yet, menopause isn’t something we learn about in school, despite 86% of women reporting that they would very much like it to be.

Truth is, little is done proactively to assist those experiencing menopause symptoms across the board. Sometimes this is because of cultural taboos, but there is also discrimination at play.

One 2023 study found that doctors were significantly more likely to prescribe HRT (hormone replacement therapy) for white women than for other ethnicities. Highlighting the need for more education surrounding racial bias and menopause amongst GPs.

“You’re never too young to start learning about menopause,” says Dr Lakhani, who is of the belief that having as much knowledge as possible on what symptoms can look like, and being in tune with how those symptoms appear in your body is of great importance.

She says that most people think of hot flushes and the absence of periods when they think of menopause. But, when it comes to seeking support, these symptoms are the last thing on their mind. She explains that while the physical symptoms can be an inconvenience for her patients, and in some cases quite debilitating, most of them can take it in their stride.

“What they’re not prepared for, is the mental health issues that go along with the hormonal changes. Anxiety, depression, losing all their confidence, feeling like they don’t belong in the environment that they’re in, they get impostor syndrome,” Dr Lakhani lists.

Explaining further, Dr Lakhani says that the best way to prepare is to get to know your base level of normal and monitor any symptoms you feel creeping up on you. Be that achy joints or sudden feelings of anxiety or depression (especially if you’ve never experienced these things in the past).

If you’re concerned you’re beginning perimenopausal, the best thing to do is speak with your GP about your symptoms. “A thorough medical evaluation and discussion of symptoms with a healthcare professional are vital steps in understanding your menopausal transition,” advises Dr O’Neill.

Dr O’Neill explains that there are several tests that can provide valuable information on where you’re up to. “Hormone level testing, such as measuring follicle-stimulating hormone (FSH) can help determine if you’re approaching menopause. Other hormones (such as oestradiol and luteinising hormone) can also be helpful to assess whether you are going through menopause,” she says.

Continuing, she states that, importantly, these tests should be analysed along with your menstrual cycle patterns and symptoms. “This is why you cannot diagnose menopause in people who are using hormonal contraception, as these medications skew natural levels of FSH as well as affect your menstrual cycles,” she says.

Her advice to anyone worrying about menopause, or wanting to know more, is to learn about the symptoms, available treatments and lifestyle adjustments you can make.

“They will empower you to manage this phase effectively,” she encourages. “By fostering open dialogue and eradicating the stigma associated with menopause, we empower women to take charge of their health and well-being during this significant life transition.”