menopause with fever

Overview

Menopause is the natural stage in life when menstrual periods stop, usually between the ages of 45 and 55. During this time, many women feel sudden waves of heat called hot flushes, also called hot flashes. These feel like a fever but are not a real fever. A real fever means your body temperature is truly above normal, usually because of an infection. Menopause itself does not cause a real fever.

Hot flushes are very common, affecting up to 8 in 10 women during menopause. However, having a true fever is not a normal part of menopause and is not common. If you have a true fever, it should be checked.

This applies to women and people who are going through menopause, typically in their late 40s or early 50s. Anyone in this age group can also get infections and develop a real fever, so it is important to tell the difference.

Symptoms

Common symptoms

• Hot flushes — sudden heat in the face, neck and chest, with sweating and flushed skin
• Night sweats — waking up soaked in sweat during the night
• A feeling of chills after the hot flush passes

Symptoms in children

• Not applicable — menopause happens in adults, not children.

Symptoms in older adults

• Older adults may have a lower fever response to infection. If you feel unwell but your temperature is only slightly raised, do not ignore it — see your doctor.
• An older person with a fever may be less energetic, confused, or have a change in appetite, even with a mild infection.

Causes

Main causes

• Menopause itself does not raise your body temperature to a true fever. Hot flushes are caused by changing hormone levels and the body's temperature control centre, but they are not the same as a fever.
• A real fever during menopause is usually caused by an infection — for example, a cold, flu, chest infection, or urine infection.
• Less common causes include inflammation in the body and, in rare cases, other underlying medical conditions that your doctor can check.

Risk factors

• Urinary infections are more common after menopause because lower oestrogen can thin the tissues around the urinary tract.
• A weakened immune system due to illness or medicines can increase the chance of infection and fever.
• Menopause symptoms like hot flushes are more likely if you smoke, are overweight, or are under a lot of stress.

When to see a doctor

See a doctor urgently if:

• If your fever stays above 39°C (102°F) after taking simple steps to cool down and rest
• If you have a fever and are already being treated for a long-term illness such as cancer
• If you have a fever and a known weak immune system

Book a routine appointment if:

• If you have a temperature of 38°C (100.4°F) or above that continues for more than three days
• If hot flushes and night sweats are interfering badly with sleep, work, or daily life
• If you are unsure whether your symptoms are hot flushes or fever — a check-up can put your mind at ease

Diagnosis

Your doctor will talk to you about your symptoms and check your temperature. They may also ask about your periods and any other symptoms. This helps them decide whether your symptoms are due to menopause or to a separate problem such as an infection.

Tests that may be done

• A reliable thermometer to check whether you have a true fever
• A urine test to look for a urine infection
• Blood tests to check for signs of infection and to see how well your organs are working
• If needed, a chest X-ray or other tests to find the cause of the fever

What to expect at your appointment

Most fevers are caused by a short-lived infection and settle with a few days of rest and fluids. Your doctor will explain the likely cause and give you a clear plan for what to do, including when to come back if you do not improve.

Treatment

The right treatment depends on whether you are dealing with hot flushes or a true fever. A true fever needs treatment for the underlying cause. Hot flushes can be managed with self-care and, if needed, prescription options to reduce them. Your doctor will discuss what is right for you.

Self-care at home

• Rest and drink plenty of water or clear fluids to stay hydrated
• Use a cool flannel, a desk fan, or take a lukewarm shower to cool down
• Dress in light layers so you can take off a layer when a hot flush hits
• Keep a symptom diary noting your temperature and what seems to trigger hot flushes

Medical treatments

If your doctor finds you have a bacterial infection, they may prescribe an antibiotic. Viral infections usually improve with rest and fluids. For bothersome hot flushes, doctors may discuss hormone therapy or other prescription medicines. Your doctor will explain the benefits and risks of any treatment so you can make an informed choice.

When is surgery considered?

Surgery is not needed for hot flushes. Surgery is only considered for a condition found to be causing a fever, such as an infected appendix or an abscess, but this is not related to menopause itself.

Living with this condition

Keep a good thermometer at home and know how to use it. That way you can tell the difference between a hot flush and a real fever. A hot flush usually fades after a few minutes, while a fever stays high and often makes you feel achy or unwell.

Lifestyle tips

• Wear light, breathable fabrics like cotton and use layers you can remove easily
• Limit alcohol, caffeine and spicy foods if you notice they bring on hot flushes
• Keep your bedroom cool at night and use moisture-wicking bedding if you get night sweats
• Carry a small fan or a bottle of water with you when you go out

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, wholegrains and enough calcium. Regular exercise such as walking, swimming or yoga can improve mood and sleep. Try not to exercise too vigorously right before bed, as this can sometimes make hot flushes worse.

Mental health and emotional wellbeing

Menopause can affect sleep and mood, and worrying about fever can add extra stress. Feeling anxious or low is understandable. Talk to your doctor if you are struggling — talking therapies and support can make a real difference.

Prevention

You cannot prevent menopause, and hot flushes cannot always be avoided. But a true fever caused by an infection can often be prevented with good hand hygiene, staying up to date with vaccinations, and avoiding close contact with people who are sick.

Vaccines

Staying up to date with vaccines such as flu and COVID-19 can help protect you from infections that cause fever. Ask your doctor or pharmacist which vaccines are recommended for you.

Screening programmes

During perimenopause and menopause, routine health checks are still important. These may include blood pressure checks, cervical screening, and breast screening. Your doctor can tell you which screenings you need.

Complications

If left untreated

• A bacterial infection that is not treated can spread and become more serious
• A high fever can lead to dehydration, especially in older adults
• Persistent fever without a diagnosis can cause anxiety and may hide a more serious underlying illness

Long-term outlook

For most people, menopause is a natural transition, and hot flushes usually become less frequent over time. If you do have a true fever, the outlook is very good once the cause is found and treated. With the right support from your healthcare team, you can stay healthy and confident through this life stage.

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