NICE guideline NG23 diagnosis and NHS care
NICE guideline NG23 specifies that in healthy women aged 45 and over, perimenopause and menopause are diagnosed clinically based on symptoms alone, without the need for routine blood tests (such as FSH levels), which fluctuate widely.
The average age of menopause in the UK is 51. NHS primary care emphasizes symptom management, including lifestyle modifications, cognitive behavioural therapy (CBT), and Hormone Replacement Therapy (HRT).
British Menopause Society (BMS) guidelines confirm that for the majority of symptomatic women under 60 or within 10 years of menopause, the benefits of HRT significantly outweigh potential risks.
Worked example: NHS perimenopause assessment
A 47-year-old patient in the UK notices periods varying by 10 days along with night sweats.
Under NICE NG23, this represents clinical perimenopause. Her estimated natural menopause age is 51.2 years.
UK menopause inputs
Cycle Changes
Current menstrual pattern and symptoms.
CALCULATOR QUESTIONS
NICE NG23 perimenopause & menopause predictor questions
Do I need a blood test from my NHS GP to diagnose menopause?
Under NICE guidelines, blood tests are not recommended for women over 45 with typical symptoms because hormone levels fluctuate daily. Blood tests are only recommended for women under 45 or under 40.
How long do perimenopause symptoms last in the UK?
On average, perimenopause symptoms last approximately 4 to 7 years, though some women experience symptoms for up to 10 years.