Menopause does not look the same for every woman. Symptoms can begin earlier than expected, vary significantly in severity and affect areas of the body that women may not immediately associate with hormonal change.
Alexander Clementine founder Alex Perry spoke with Dr Lwin Mar Than, a London-based menopause and lifestyle specialist GP, about some of the misconceptions surrounding menopause, unexpected symptoms, changes to the skin, the importance of support and what women can do when they first notice something changing.
Dr Lwin has completed advanced menopause specialist training with the British Menopause Society and is the founder of Leniter Wellness, where her work includes menopause education, workplace wellbeing and lifestyle medicine.
Key takeaways
Menopause can begin earlier than averages suggest; Dr Lwin says symptoms last around 7–10 years on average; skin irritation or prickling can be an unexpected symptom; declining oestrogen can affect hydration, collagen and elasticity; and her advice is to track changes, avoid comparison and seek early support
What is the biggest misconception about menopause?
For Dr Lwin, one of the biggest misconceptions is the idea that someone can simply be too young to be experiencing menopause-related changes.
She explains that while UK data puts the average age of menopause at around 51–52, averages do not define every individual experience.
“The age is just, let's say, the database, but everybody is individual.”
Dr Lwin says younger women can experience symptoms similar to perimenopause and menopause and should speak to a doctor rather than assuming age rules it out.
Her point is simple:
“You can't put everybody in a box.”
She also notes that women experiencing typical menopause or perimenopause symptoms before the age of 40 require medical attention because this may represent premature menopause or premature ovarian insufficiency.
How long can menopause symptoms last?
The menopause transition can be much longer than people might expect.
Dr Lwin explains that symptom frequency and intensity vary. Some women experience mild or moderate symptoms, while a smaller proportion experience symptoms severe enough to significantly disrupt quality of life, relationships or employment.
When Alex asks how long symptoms can continue, Dr Lwin says:
“The average is 7 years to 10 years.”
She describes the first five to ten years after menopause as an important period in which the body is responding to declining hormone levels, while also emphasising throughout the interview that every woman's experience is individual.
What are some of the more unexpected symptoms of menopause?
Brain fog and changes to periods are increasingly recognised, but Dr Lwin says there are other symptoms women may not immediately connect with menopause.
One example is:
“Some skin irritation or prickling of the skin.”
She also discusses worsening allergy symptoms in some women and what she describes as histamine intolerance becoming more noticeable around perimenopause and hormonal change.
Dr Lwin is careful to point out that this does not affect every woman.
Her wider message is that some menopause-related changes can be less obvious and therefore harder to connect with hormonal changes.
How can menopause affect the skin?
Skin health becomes a significant part of the conversation.
Dr Lwin explains that oestrogen receptors are present in tissues including the skin, and that declining oestrogen during perimenopause and menopause can affect how skin cells function.
She describes changes including:
- reduced hydration
- reduced elasticity
- reduced collagen
- easier bruising
- increased irritation
As she explains:
“There can be lack of hydration, and easier to bruise or irritated.”
She also says that elasticity and collagen production can decline, with women potentially noticing skin changes during the first five years after menopause.
Importantly, Dr Lwin does not suggest this happens identically to everyone.
She repeatedly stresses individual variation, explaining that lifestyle, diet, skincare and other factors can influence a woman's experience.
“We can't really just say, like, a direct proportionate to the hormone, and then menopause age, and then how the skin will change, because it's very individual.”
Her approach to skin health is therefore not simply external. While skincare products can have a role, she also believes it is important to consider what is happening internally and to look at health more holistically.
What should men understand about menopause?
As a male founder working within women's health, Alex asks Dr Lwin what message she would give to men during menopause.
Her answer focuses on understanding, listening and avoiding assumptions.
Some women may not initially realise that they themselves are going through hormonal changes, she explains, which can make the experience difficult for those around them to understand too.
Her advice to men is:
“Do not make assumptions, and do not compare.”
One woman may experience very mild symptoms while another experiences them much more intensely. Seeing one person's experience therefore shouldn't be used as a benchmark for somebody else's.
Instead, Dr Lwin recommends remaining open-minded, listening and asking how someone would like to be supported.
“It's always nice to stay open-minded, and then just not make assumptions, and then ask open questions.”
She also talks about the importance of supportive environments from peers, colleagues and family members, and believes basic menopause education should extend beyond women themselves.
Dr Lwin agrees with Alex that menopause education should begin earlier, saying:
“I think you're right, it should be part of the curriculum.”
What is Dr Lwin's approach to supporting women through menopause?
Dr Lwin's particular area of interest is using lifestyle medicine alongside conventional menopause care.
She describes her approach as looking at the whole picture rather than focusing on one intervention alone.
“Looking at the whole picture and holistic approach, for the individual patient or client that I'm seeing in my menopause clinic.”
Her work through Leniter Wellness also focuses heavily on education through workshops, events and workplace menopause programmes.
For Dr Lwin, early awareness and education can make it easier for people to have conversations about menopause and understand where support might be needed.
She also stresses the importance of continuing education as new menopause research and data emerge.
What is Dr Lwin's biggest advice for someone starting their menopause journey?
Dr Lwin's first piece of advice is not to assume that changes in how you feel have one single explanation.
If you start feeling different physically or mentally, she recommends speaking to someone with appropriate expertise.
She also gives a particularly practical suggestion: keep track of what is happening.
“If you want to keep a diary for your symptoms, it's a very sensible thing to do.”
Dr Lwin says tracking symptoms can make it easier for a healthcare professional to see the overall picture when you seek support. She recommends doing this for at least three months.
Another important part of her advice is not to measure your experience against somebody else's.
“Try not to compare yourself with other people, too.”
Women may naturally discuss treatments or experiences with friends, but Dr Lwin emphasises that what works for one person may not work for another.
“One thing work for other people might not work for you, so it's always come down to very personalised approach.”
That individuality runs through almost every part of the interview.
Symptoms, lifestyle, circumstances and responses to treatment can differ, so Dr Lwin advocates looking at the whole person rather than following somebody else's experience.
Her closing message captures that approach particularly well:
“Early support, early awareness and speak to someone.”
Early awareness, individual support
There is one idea Dr Lwin returns to throughout the conversation: menopause is individual.
Age averages do not tell the whole story. Symptoms vary. Skin changes vary. One woman's menopause cannot be used to judge another's. And an approach that works for one person will not necessarily be right for someone else.
Her advice is therefore to notice changes, track what is happening, seek appropriate support and avoid making comparisons.
Or, in Dr Lwin's own words:
“You can't put everybody in a box.”
About Dr Lwin Mar Than
Dr Lwin Mar Than is a menopause and lifestyle specialist GP based in London. She has completed advanced menopause specialist training with the British Menopause Society and founded Leniter Wellness, which provides menopause and wellbeing education, workshops and workplace talks with a particular focus on lifestyle medicine.
This interview forms part of Alexander Clementine's Expert Conversations, speaking directly with professionals working across menopause and women's health about the questions women — and the people around them — are asking.
