The Scottish Health Survey 2024 - volume 1: main report

3. Perimenopause and Menopause

Victoria Wilson

3.1     Introduction

Menopause refers to the time when menstrual periods stop due to loss of hormones produced by the ovaries. It is estimated that around 400,000 individuals in Scotland are of menopausal age[i].

Menopause usually occurs between 45 and 55 years of age, although for a small percentage of people menopause can happen early (before the age of 45) or prematurely (before the age of 40). This can be due to a number of different reasons including menopause being medically induced as a result of certain surgeries or cancer treatments[ii].

Perimenopause refers to the time leading up to the menopause and is when an individual begins to experience fluctuations in hormone levels and may start experiencing menopausal symptoms along with changes to their menstrual cycle.

The onset, duration and range of symptoms experienced during perimenopause and menopause are different for every person who menstruates. Some may experience few or mild menopausal symptoms. But for some, symptoms can be quite severe or long-lasting which can have a significant impact on everyday life[iii].

The impact of perimenopause and menopause can extend beyond the individual, and symptoms can affect work, relationships, family life and social interactions[iv]. It has been estimated that 14 million working days are lost each year due to perimenopause and menopause symptoms, while some individuals have reported considering leaving or have left work as a result[v].

3.1.1     Policy background

In August 2021, the Scottish Government published the Women’s Health Plan[vi], outlining a commitment to improving health outcomes and services for all girls and women in Scotland. One of the key priorities within the Plan was to ensure women who need it have access to specialist menopause services for advice and support on diagnosis and management of the menopause.

The Women’s Health Plan: Final Progress Report[vii], published in 2024, highlights positive changes made since the publication of the original Plan. This has included establishing a menopause specialist service in all mainland health boards and a buddy service for Island health boards; improving access to reliable, accurate information for women through launching a menopause resource on the NHS Inform Women’s Health Platform[viii]; and ensuring that training is available for healthcare practitioners with a new NHS Education for Scotland eLearning menopause module[ix]. Alongside this, the NHSScotland Menopause and Menstrual Health Policy[x] was developed and launched in October 2023 as an example of best practice, and aims to support NHS employees to experience good menstrual health and menopause at work, and provides advice and guidance on how they can be supported when they experience symptoms which affect their work.

3.1.2     Reporting on perimenopause and menopause in the Scottish Health Survey

In this chapter, the following data are presented for adults who self-reported that perimenopause/menopause was or would be applicable to them:

• Menopause and perimenopause symptoms
• Early menopause prevalence and reasons
• Contact with health professionals in relation to menopause or perimenopause symptoms
• Reasons for not contacting a health professional about menopause or perimenopause symptoms
• Management of menopause or perimenopause symptoms

Figures are reported by age.

For definitions of terminology used in this chapter and for further details on the data collection methods for perimenopause and menopause, please refer to the Scottish Health Survey 2024 - Volume 2: Technical Report.

3.1.3     Comparability with other UK statistics

The perimenopause and menopause questions were adapted specifically for SHeS, including feedback from testing and are, therefore, not completely comparable with other UK statistics on the subject.

​​​​​​3.2    Results

Summary points

In 2024:

• Just under three quarters of those aged 45-55 (72%) and around half of those aged 56 and over (53%) for whom questions on menopause and perimenopause were applicable had experienced symptoms of menopause or perimenopause in the last 12 months
• Around one in fourteen (7%) of those for whom questions on menopause and perimenopause were applicable had surgical/medical treatment or a medical condition that resulted in early menopause.
• Surgical intervention only was the most frequently reported reason for early menopause (57% of those who had experienced this) with a further 10% reporting the cause as both a surgical intervention and medical treatment and 12% as medical treatment only.
• Around six in ten of those who had experienced menopause or perimenopause symptoms had been in contact with a healthcare professional in the last 12 months (58%), with the largest proportion having consulted a General Practitioner (GP) (45%).
• The majority of those who had not contacted a healthcare professional about their menopause or perimenopause symptoms indicated that they felt able to manage symptoms themselves (58%). Around a quarter felt they had been able to manage symptoms in other ways (27%) and/or that it was too soon to seek advice (25%).
• Physical activity (40%), hormone replacement therapy (HRT) (38%), and use of vitamins, minerals or supplements (35%) were the most common ways used to manage symptoms of menopause or perimenopause.
• Significant variations were evident by age with regard to menopause or perimenopause symptom management. Those aged 45 and over were more likely to have used HRT (44%-45%) compared with those aged 30-44 (10%).

3.2.1   Just under three quarters of those aged 45-55 and around half of those aged 56 and over for whom questions on menopause and perimenopause were applicable had experienced symptoms of menopause or perimenopause in the last 12 months

In 2024, just over two-fifths of those for whom questions on menopause and perimenopause were applicable indicated that they had experienced the symptoms of menopause or perimenopause in the last 12 months (43%). Those aged 45-55 were most likely to report having experienced symptoms in the last 12 months (72%) followed by those aged 56 and over (53%), while lower proportions of those aged 30-44 (18%) and those aged 16-29 (2%) indicated that this was the case.

Figure 3A, Table 3.1

3.2.2     Around one in fourteen of those for whom questions on menopause and perimenopause were applicable had surgical/medical treatment or a medical condition that resulted in early menopause

In 2024, a small proportion of those for whom questions on menopause and perimenopause were applicable reported that surgical/medical treatment or a medical condition had resulted in early menopause (7%).

The most frequently reported reason for early menopause was surgical intervention only (57%).  A further 10% reported the cause as both a surgical intervention and medical treatment and 12% as medical treatment only.                                  

Table 3.2

3.2.3     Healthcare consultations for menopause or perimenopause symptoms were most likely to be undertaken with a GP

Around six in ten of those who had experienced any menopause or perimenopause symptoms indicated that they had been in contact with a healthcare professional in relation to their symptoms (58%) in 2024, with no significant variation by age.

Just over two-fifths of those who had experienced menopause or perimenopause symptoms in the last 12 months had consulted a General Practitioner (GP) (45%) while around a fifth (21%) had seen a nurse. No significant variations by age were recorded for these healthcare professionals among those who had experienced symptoms in the last 12 months.              

Table 3.3

3.2.4     Being able to manage symptoms independently was the most frequently cited reason for not contacting a health professional about menopause or perimenopause symptoms

In 2024, the majority of those who had not contacted a healthcare professional about their menopause or perimenopause symptoms indicated that they felt able to manage symptoms themselves (58%). Just over a quarter had been able to manage their symptoms in other ways (27%), a quarter were concerned that it was too soon to seek advice (25%), 17% spoke to family or friends, 15% did not want to burden the NHS/thought other people might need the service more, 13% were worried that they were imagining symptoms or others would think that they were, and 7% could not get an appointment with anyone in their general practice.

Figure 3B, Table 3.4

3.2.5     Physical activity, hormone replacement therapy (HRT), and vitamins, minerals or supplements were the most common ways used to manage symptoms of menopause or perimenopause

In 2024, around three-quarters of those who had experienced menopause or perimenopause symptoms indicated that they had utilised one or more ways of managing their symptoms (76%). The largest proportions had utilised physical activity (40%), Hormone Replacement Therapy (HRT) (38%) and/or vitamins, minerals or supplements (35%) to manage their symptoms.

Significant variations by age were evident with those aged 45 and over more likely to report having used HRT (44%-45%) compared with those aged 30-44 (10%) while those aged 56 and over were more likely to have used vaginal estrogen (bought without prescription) (6%) compared with 1% of those aged 30-44.

Figure 3C, Table 3.5

Table List

Table 3.1  Menopause or perimenopause symptoms, 2024, by age

Table 3.2  Early menopause and reasons for early menopause, 2024

Table 3.3  Contact with health professional in relation to menopause or perimenopause symptoms, 2024, by age

Table 3.4  Reasons for not contacting a health professional about menopause or perimenopause symptoms, 2024, by age

Table 3.5  Management of menopause or perimenopause symptoms, 2024, by age

References and notes