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The conversation around menopause is getting louder. The recent Menopause in the Workplace report states that ’employers’ lack of support for menopausal symptoms is pushing highly skilled and experienced women out of work.’ The Womens and Equalities Committee is calling on the UK government to amend the Equality Act to include a duty for employers to support menopausal employees. They are also recommending menopause training for GPs and a visible public health campaign.

‘The omission of menopause as a protected characteristic under the Equality Act is no longer tenable, given that 51% of the population will experience menopause,’ said Caroline Nokes, chair of the committee, ‘ Menopause is inevitable. The steady haemorrhage of talented women from our workforce, however, is not. It is time that the government seizes the opportunity to enact change. It is time to support, and celebrate, these women.’

We all know about the familiar symptoms of menopause such as hot flushes and night sweats, but its effects are much more diverse than that…Those plummeting levels of oestrogen that come with menopause can affect almost all of your body’s systems, in some surprising ways. You may notice some symptoms and not realise that they could be connected to the big M. As well as the obvious link to the menstrual cycle and reproductive system, oestrogen affects the urinary tract, the heart and circulatory system, bones, breasts, skin, hair, mucous membranes, pelvic muscles and the brain. Pretty comprehensive, so it’s no wonder that the decline in oestrogen can knock us for six.

Some menopause symptoms

There’s no universally agreed list; estimates of the total number of symptoms can reach 40+. However, the average number that a woman experiences is… six, and quite possibly not all at the same time. Three-quarters of us have hot flushes (tick from me). Other common symptoms are night sweats (tick), difficulty sleeping (tick), irritability (big tick) and brain fog (no tick from me. Phew). The British Menopause Society says that a quarter of menopausal women describe symptoms as severe, and has a handy ‘find a menopause specialist’ search if that’s you.

More unusual menopause symptoms

You may experience issues that you wouldn’t connect with menopause. Take the sensation of ants crawling over or even beneath your skin (called formication after the Latin ‘formica’, meaning ants). Other skin complaints can include numbness, tingling or pins and needles, as well as more commonplace dryness and itchiness.

Aching joints can make you feel like your body is suddenly ageing. It’s caused by the drop in oestrogen which has an anti-inflammatory effect. Hips, knees, elbows and the back and neck can all be affected.

Forgetfulness is very frustrating and can give rise to alarming thoughts of early-onset dementia, but it’s important not to stress about it, as that makes trying to remember something harder. Take a breath, find another way to describe it and remember that other people rarely notice a pause as you speak. In time, the brain adapts to your lower oestrogen levels, and your memory improves.

Irritability may be the most common perimenopause symptom, affecting up to 70% of women. And feeling a bit miffed can suddenly escalate into anger, if not full-blown rage. This intensity of emotion can be a bit disturbing if you’re not used to it. It occurs because oestrogen has an important role in the production of serotonin, the feel-good hormone. As both of those hormones decline, you may find mood swings like this unpredictable and hard to handle, but at least there’s an explanation: you’re at the mercy of your hormones.

Managing stress, mindfulness and meditation can help keep you on more of an even keel, as can talking to a friend or colleague.

The hypothalamus can also cause increased sweat production which may cause body odour, or mean that you smell different. This is why perfume may no longer have the aroma you’ve grown to love. Good excuse to find a new one though.

Occasional dizzy spells and heart palpitations are caused by changes in the same systems responsible for hot flushes and night sweats, although they’re less common, and can be alarming if you’re not prepared.

And we’re all familiar with the idea of hot flushes, but menopause can bring on sudden chills too because menopause affects our brain’s temperature regulator, the hypothalamus. Some women also have chills following a hot flush as the body tries to regulate its temperature.

Tinnitus, or ringing in the ears, can be infuriating. Find self-help strategies from the British Tinnitus Society.

Saliva production is linked to oestrogen and its lack can cause a dry mouth or metallic taste, or burning mouth syndrome. See your GP, as a dry mouth can indicate other conditions, including diabetes, and there are specific treatments for burning mouth syndrome.

The standard advice of cutting down on stress, alcohol, spicy food and caffeine, stopping smoking, eating healthily and exercising can help with all of the above.

And the good news? We are in the middle of a menopause revolution. And with increased awareness, education and support from employers and GPs, the health and wellbeing of menopausal women will improve.

Adrienne Wyper is a health and lifestyle writer and regular TNMA contributor.