Explore Liverpool John Moores University research on hormone therapy, midlife physical symptoms and the critical need for personalized clinical conversations.
If you or someone you know is in immediate danger, please call 911. You can also dial 988 and press 1 for the Veterans Crisis Line, or text 838255 for support. Arranging with a clinician or trusted friend to safely store medications and firearms provides crucial protection.
On 21 September 2026, ITV News Granada published a report detailing new research from Liverpool John Moores University on hormone replacement therapy. The study examined severe psychological distress during the menopausal transition, focusing on how timely hormonal treatments affect wellbeing and why many women still face barriers to care.
For more than two decades, medical hesitation has heavily shaped the standard of care for midlife women. Professor Pooja Saini told ITV that some clinicians remain influenced by outdated interpretations of a 2002 study, which widely associated hormone treatments with cancer risks. Because of this entrenched caution, doctors often treat menopausal symptoms as separate, unrelated ailments. Consequently, women experiencing significant mood changes are frequently offered antidepressants rather than receiving a comprehensive evaluation of their hormonal health and overall midlife transition.
Physical shifts during midlife follow a gradual timeline rather than appearing abruptly. According to the ITV report, the average age at which women begin the menopause transition is 46. During these transitional years, known as perimenopause, estrogen and progesterone levels fluctuate unpredictably. This specific period can last from several months to more than a decade, typically spanning four to eight years.
Menstruation usually stops by age 51. The clinical definition of menopause is reached exactly 12 months after a woman experiences her last period. Understanding this extended timeline helps women recognize that physical and emotional changes are part of a lengthy biological process rather than a sudden event.
The physical signs of this transition are extensive and can significantly disrupt daily routines. Women often notice shifts in their sleep, energy and physical capability long before their periods stop entirely. An Ipsos MORI survey commissioned for the British Menopause Society, as reported by ITV, found that 79 percent of women experience hot flushes. Additionally, 70 percent of women experience night sweats.
The ITV report identifies other common symptoms including heavy bleeding, emotional instability, vaginal dryness and recurring bladder problems. These challenges highlight the need for clear, evidence-based guidance. Reading through dedicated perimenopause and menopause resources can help women map their symptoms. Recognizing these signs early allows women to approach their healthcare providers with accurate information and a clearer understanding of their own bodies.
The Liverpool John Moores University study involved more than 1,000 women and highlighted several critical observations:
While the reported 92 percent reduction in suicidal thoughts is a striking figure, interpreting medical research requires careful context. The ITV article does not provide the study’s full methodology, comparison group or follow-up duration. Therefore, this statistic represents a reported study finding rather than a guaranteed treatment effect for everyone experiencing midlife distress. Menopause can clearly contribute to low mood, anxiety and sleep disruption.
However, suicidal thoughts require urgent psychiatric support and should not be managed solely as a routine hormonal symptom. The ITV report discussed the death of Helen McGaw as a personal case. It explicitly noted that menopause was only one contributing factor in her death, and it remains unestablished whether hormone treatments alone would have prevented it. Maintaining mental fitness and confidence during midlife often requires a combination of clinical care, lifestyle adjustments and professional psychological support when symptoms become severe.
When considering medical intervention, understanding the different types of hormone therapy is highly useful. Systemic hormone replacement therapy treats symptoms throughout the body by replacing the estrogen lost during the menopause transition. This therapy can be prescribed as estrogen alone, or it can be combined with a progestogen. Delivery methods include tablets and patches along with gels, sprays and implants.
NHS Lothian guidance describes systemic therapy as a first-line option for medically eligible people experiencing vasomotor, mood, cognitive and musculoskeletal symptoms. However, these decisions require personalized discussions regarding benefits and potential risks. The guidance highlights the need to discuss considerations regarding breast cancer, ovarian cancer and oral-estrogen thrombotic risks. Women who have a womb should always ask their doctors how progestogen is being used alongside systemic estrogen in their treatment plan.
Systemic therapy is not the only clinical approach to managing midlife physical changes. Low-dose local vaginal estrogen provides targeted relief and operates differently from systemic treatments. According to NHS Lothian guidance, this local treatment can be highly effective for urogenital atrophic symptoms. The ITV report specifically highlights vaginal dryness and bladder problems as common issues that can affect daily comfort and intimate relationships.
Local treatments target these areas directly, making them an appropriate option even when systemic therapy is unsuitable or unwanted. Noticeable improvements from vaginal estrogen may take three to six months to appear, and the treatment may need to be continued long term to prevent symptoms from returning. Vaginal dryness and pain during sex are legitimate medical issues, not inevitable signs that a woman must stop sexual activity. For more context on navigating these shifts, our sexual wellbeing and intimate confidence articles examine the broader landscape of midlife physical intimacy.
Clinical treatments are most effective when paired with sustainable daily habits. The ITV report recommends practical lifestyle adjustments such as maintaining regular sleep, eating a healthy diet and securing social support. Engaging in regular exercise and weight-bearing activity is also strongly advised to support overall physical capability. Women are also encouraged to consume calcium-rich foods, avoid smoking and stay within recommended alcohol limits.
Relaxation practices such as yoga or tai chi are specifically highlighted by ITV for their pelvic-floor benefits. These activities can help manage physical changes while supporting mental resilience. However, lifestyle measures should be framed as supportive tools rather than absolute substitutes for clinical assessment. While they support strength and mobility, they may not adequately control severe vasomotor symptoms or significant psychological distress on their own.
While midlife brings expected physical changes, it is crucial to distinguish between typical transition symptoms and issues requiring immediate medical attention. Using moisturizers or lubricants can temporarily support intimate comfort. However, women should seek professional medical advice if vaginal dryness, pain, bleeding or recurrent urinary symptoms persist beyond these efforts. Pelvic-floor exercises or a referral to a specialized physiotherapist may be highly useful for managing urinary or sexual symptoms.
Persistent leakage, significant pain, blood in the urine or unexplained bleeding always deserves a comprehensive clinical assessment. Adopting a mindset that prioritizes proper medical evaluation protects against serious conditions being mistakenly dismissed as ordinary midlife changes.
Approaching a medical consultation with organized information can significantly improve the quality of care received. Women should track their periods, hot flushes and night sweats alongside sleep quality and mood changes. It is also necessary to note vaginal comfort issues, sexual pain or urinary urgency. During an appointment, ask whether these symptoms reflect perimenopause, another condition or a combination of factors.
Since the ITV report raises concerns about misdiagnosis regarding antidepressants, requesting a thorough hormonal evaluation is a reasonable step. Patients should ask separately about systemic therapy for hot flushes and local vaginal estrogen for intimate discomfort, as these represent different treatment questions. Entering the clinic prepared helps transform a frustrating visit into a productive, individualized conversation about the safest and most effective options for managing midlife transitions.
Navigating the abundance of conflicting health information requires a balanced and critical mindset. Women are frequently overwhelmed by absolute claims that either dismiss their pain or push unnecessary products. The most productive approach is to recognize that not every midlife symptom is purely hormonal, nor is hormone therapy inherently dangerous. Instead, these complex symptoms deserve a proper assessment and a highly personalized discussion of medical options.
Recognizing the overlap between aging, hormonal shifts and lifestyle factors allows women to make confident, informed decisions. Finding a healthcare provider who listens to symptom histories without rushing to prescribe antidepressants or dismiss concerns is a crucial step. With clear communication and a firm grasp of the evidence, women can advocate effectively for their own physical and mental wellbeing.
As emerging research frames midlife as a complex physiological transition rather than a brief collection of symptoms, clinical practice must evolve to offer women personalized hormonal assessments instead of generalized caution and default antidepressant prescriptions.
While your gynecologist or primary care physician handles your clinical prescriptions day to day, answering questions about desire, comfort, intimacy and sexual confidence that are often ignored or sensationalised is simpler when Refemina clarifies the research. We address the frustration of dismissed symptoms and outdated medical assumptions, helping you navigate the biological shifts of midlife and advocate for highly personalized treatment options. Explore Resources
Follow Refemina for research-led insights on menopause, strength, metabolism, nutrition, skin, intimacy and confidence through midlife. New articles turn complex topics into clear, useful context.
Keep learning about the changes that shape energy, strength, confidence and wellbeing through midlife.
Explore Resources