(097) More Than Hot Flushes: The Menopause

Abstract Introduction While vasomotor symptoms such as hot flushes and night sweats are often viewed as the hallmark of menopause, clinical experience indicates that these are only one aspect of a much broader and more complex symptom profile. Many women experience a diverse array of physical, cognitive, and psychological changes that can affect mood, energy levels, concentration, memory, and motivation. These symptoms can substantially impair daily functioning, interpersonal relationships, and overall quality of life. Yet, conventional perceptions and much of the clinical focus remain centred on vasomotor disturbances, potentially overlooking the full extent of menopausal impact. This under-recognition may contribute to delayed diagnosis, under-treatment, and the misconception that menopause is primarily a physical or short-lived condition. A more comprehensive understanding of the range and severity of menopausal symptoms is essential to inform holistic management and to support women more effectively. Objective This study aimed to explore the range, frequency and severity of menopausal symptoms reported by patients attending a private menopause clinic in the United Kingdom. Methods We conducted a retrospective cohort study of new patients attending a specialist menopause clinic between March and May 2025. All participants completed a comprehensive menopause symptom questionnaire developed by senior clinicians and refined through patient feedback. The questionnaire included 70 symptoms covering physical, psychological, cognitive, and social domains. Each symptom was rated on a Likert scale from 0 (not at all) to 3 (severe). Results Among 674 respondents, the most frequently reported symptoms were fatigue/low energy, memory problems, irritability, feeling anxious, and difficulty concentrating. In contrast, hot flushes ranked 47th in frequency. When analysing symptoms rated as severe (score of 3), the most severe symptoms were loss of interest in sex, fatigue/low energy, feeling anxious, low motivation, and not feeling yourself. Hot flushes ranked even lower, at 52nd. Emotional, cognitive, and social impacts such as low self-worth, relationship strain, and reduced ability to work were also prominent. Conclusions Menopause encompasses a much broader and more complex symptom profile than vasomotor disturbances alone. Emotional, cognitive, and functional symptoms were highly prevalent and often severe, suggesting that diagnosis and treatment of menopause must extend beyond managing hot flushes. A holistic, individualised approach that addresses psychological well-being, cognition, relationships, and lifestyle impact is essential to improve outcomes and quality of life for menopausal women. Disclosure No.