Breathing difficulties

A feeling that you cannot get enough air in, or cannot take a full breath. It sits on Greene's Climacteric Scale, a standard list of menopause symptoms published in 1998, which is why Roshara's symptom score asks about it.

That is as far as the evidence goes. A symptom scale records what women report. It does not say why it happens, and none of the guidelines Roshara follows, from NICE, the NHS or the Pakistan Menopause Society, names breathlessness as a menopause symptom or explains it. So this page describes it and tells you when to get it checked. It makes no claim about the cause.

A breath that stops halfway, as if your lungs will not open the rest of the way. Needing to sigh or yawn to get enough air. Breath running short on the stairs you used to take two at a time. Noticing your own breathing when you never used to think about it.

If it comes with a hot flush, a racing heart or a rush of panic, note that down. The pattern helps whoever examines you. Heart palpitations and anxiety have their own pages.

In Urdu the everyday words are saans phoolna, my breath swells. It is a phrase people use after climbing stairs, so it can sound too ordinary to mention. Mention it anyway.

Breathlessness has many causes, and some are serious. The NHS shortness of breath page does not mention the menopause, and it says plainly not to try to work out the cause yourself.

Get emergency help now if you have severe difficulty breathing (gasping, choking, or unable to get your words out), your chest feels tight or heavy, pain spreads to your arms, back, neck or jaw, your lips or skin turn very pale, blue or grey, or you feel suddenly confused. Those are the NHS website's emergency signs. The Pakistan Menopause Society's recommendations also list chest pain, swelling in one leg and sudden shortness of breath among the red flags that need evaluation or referral (section 2.3).

Get urgent advice if you are more short of breath than usual, feel or are being sick, are coughing up blood, have pain or swelling in one leg, or have palpitations, according to the NHS website.

See a doctor soon if breathlessness gets worse with your normal activities or when you lie down, comes with swollen ankles, or you have had a cough for three weeks or more. The NHS website lists asthma, a chest infection, being overweight, smoking and a panic attack among the common causes, and heart and lung conditions among the serious ones.

The NHS website also says you are not wasting anyone's time by getting breathlessness checked. We would underline that.

If you are the one who looks after everyone else, you may be the last to admit you cannot catch your breath, especially when it sounds like something everyone gets on the stairs. If someone at home notices you stopping halfway up, or catching your breath at the sink, let them push you to see a doctor.

At taraweeh, or carrying shopping home in the heat, it is easy to put breathlessness down to tiredness. If it keeps happening, it is worth a check, whatever you think the cause is.