How do you know when you are in menopause?Well, that's the million dollar question, isn't it. I've managed to offend several people by saying "well you must be in menopause" when they haven't recognised to themselves that they are, which is always a tiny bit awkward.The truth is, menopause quite often creeps up on you. Sometimes, you have an operation and they tell you that you will immediately go into menopause so that's fairly clear (albeit quite a shock at the time), but otherwise, you need to have a blood test by your GP to see if you are in the peri-menopausal stage. Of course, your symptoms may tell you what's going on, but most of us miss these until we've really had a wake up call and, just to be super helpful, some women just don't get any symptoms. The symptons can include:Changes to your periods, often not in a good way. They may take you by surprise or suddenly be a lot heavier, but they do change.Hot flushes. Now these are tremendous fun. Suddenly, you will feel very hot. I've spent entire winters in shorts and a t shirt so don't be surprised at however these take you. The worst is when you are dripping in sweat, but these can come along at any time, without warning.Night sweats - also, lots of fun. Get layers going on your bed and then throw off or add whatever you need. Difficulty sleeping - this can make you "tired or irritable". Yes it will, no surprise there.Reduced Sex Drive - this is often related to the changes in your hormones. Get help.Vaginal Dryness - this could mean pain or itching during sex, if you haven't lost your sex drive from the changes in hormones. There are lots more organic and natural creams out there these days so get something "clean" in terms of product ingredients.Headaches - likely to be hormone related as wellAnxiety or Low Mood - this is unbelievably common and can be really debilitating. Get help and don't let your doctor prescribe anti depressants for you before you've explored other, menopause related treatments.Palpitations - Heart beats become more noticeableMuscle loss - you can totally avoid this because you want strong muscle and bones as you move into midlife. Get on the strength training because of your health and not just because of your bikiniUrinary Tract Infections - such fun. Cystitis may become your new friend. Drink a ton of water as you would anyway, but it will really help in menopause.So you can see how some of these symptoms can be misdiagnosed. You can get at UTI and think it's just unlucky. You could feel anxious about any number of things, particularly right now with Covid, so you might not think it is the menopause. In short, knowing yourself that you have started the perimenopausal stage is tricky, but there is help.Megsmenopause.com by the lovely Meg Mathews (her of Britpop fame) is a superb resource. The NHS does a fair stab at it on their website, but bear in mind that your GP, in all their training, had about six hours on the Menopause so doesn't know as much as you can.My advice, if you think you are perimenopausal and want some real help from your doctor is to visit HERE . This is Meg Mathews brilliant GP checklist, so you can fill it in, take it along to your doctor so that you don't waste time trying to remember what symptons you have so that they can give you fast help. If you think you are perimenopausal don't just ignore. Go to your GP and see if there is any help if you are suffering from symptons and be sure that you start to make changes to your diet and exercise plans. Trust me, from someone on the other side of those challenges it will make all the difference to your experience. That and we're here to help, just ask.