Ramadan, fasting and menopause

Fasting from dawn to sunset for a month is part of life for many Muslim women, and perimenopause can change how that month feels in the body.

We have looked for a clinical guideline that covers perimenopause and fasting together and have not found one. What does exist is general guidance on fasting with medicines and health conditions, and the Pakistan Menopause Society asking doctors to consider how symptoms affect prayer. That is what this page draws on.

What women describe, and ask about, tends to fall into a few groups.

The heat. A hot flush in the hour before Maghrib, in a hot kitchen, with no water until the adhan. Night sweats that leave you thirsty before the day has started.

The nights. Waking at suhoor after a night already broken by sweats or worry, then taraweeh, then work or the school run. See sleep hygiene.

The medicines. Whether a tablet usually taken in the morning can move to suhoor or iftar, and who decides. Whether a patch or a gel is different from a tablet. Whether a blood pressure or diabetes medicine changes things.

The bleeding. Periods that come early, late, heavy or not at all, and the questions that raises about counting fasts and prayers.

And the feeling underneath: missing fasts you have kept since childhood, and not knowing whether to say so.

On medicines

Guy's and St Thomas' NHS Foundation Trust has a leaflet on taking medicines during Ramadan. It does not mention menopause. It asks patients to talk to their healthcare team or pharmacist before Ramadan, or as soon as they can, and not to change how they take a medicine before talking to a healthcare professional.

It suggests asking about:

• the risks of fasting with your health condition
• the sick day rules for your medicines
• who to contact if you feel unwell while fasting
• when to break a fast for medical reasons.

For people who are not able to fast, the leaflet points them to their local imam or a religious scholar to ask what they can do instead.

On health conditions

Diabetes UK asks anyone with diabetes who plans to fast to talk to their healthcare team first. The British Menopause Society notes that South Asian women have a higher rate of diabetes, high blood pressure and fat around the middle during the menopause transition, so for some women these conversations overlap.

On symptoms and worship

The Pakistan Menopause Society's 2026 recommendations ask doctors to assess how symptoms affect daily life, naming prayer alongside sleep, work and relationships (2.2). The same recommendations describe salah, dhikr and dua as daily practices that help regulate emotion (4.2.4.7). So prayer belongs in the consultation, and the health side of these questions can be raised there. For fluids between iftar and suhoor, see hydration.

Guy's and St Thomas' asks anyone who takes medicines regularly, HRT included, to talk to their healthcare team or pharmacist before Ramadan, and to ask again each year, because a condition and the advice can change. Diabetes UK says the same for anyone with diabetes who plans to fast. Take the questions on this page with you.

During the month, if you feel unwell while fasting, follow what your doctor told you about when to break a fast for medical reasons, and contact your healthcare team.

Almost every question here splits in two.

The health half goes to a doctor, nurse or pharmacist: what this heat is, whether fasting is safe for your body, whether a medicine needs a different time of day.

The faith half goes to a qualified scholar: what your situation means for your fast, your prayer, or making up missed days. Roshara does not answer these, and will not. If you would rather ask a woman scholar, that is a fair thing to look for.

At home, a husband or family who know what is happening can make the month gentler: a cooler room, a hand in the kitchen before iftar, less said about a missed fast. Telling them is your choice to make.