Understanding menopause

Perimenopause is the transition leading up to that point. During it, cycle timing and flow can change as ovarian hormone production fluctuates.

Menopause can present with hot flushes, night sweats, interrupted sleep, vaginal dryness, discomfort during sex, lower sexual desire, mood changes, difficulty concentrating, headaches or joint aches. Some people notice few symptoms, and the combination can shift over time.

A missed period is not enough by itself to establish menopause because pregnancy, medicines, stress, weight change, thyroid conditions and other health issues may alter bleeding. The clinician uses age, menstrual history, symptoms and relevant medical circumstances to decide whether testing is useful.

Keep a brief record of bleeding, flushes, sleep, mood and vaginal or urinary symptoms. This makes it easier to identify the changes that interfere most with daily life. Regular movement, a consistent sleep routine, lighter bedding and reducing personal flush triggers may improve comfort.

Treatment is individual. Options may include hormone therapy, non-hormonal medicines, vaginal moisturisers, lubricants or local vaginal hormone treatment, depending on the symptom and medical history. A clinician should review benefits, cautions and medicine interactions with you rather than treating every menopause experience in the same way.

Arrange medical assessment for any vaginal bleeding after menopause has been established, even if it is light or happens once. During the transition, seek advice about bleeding that is very heavy, occurs after sex, repeatedly happens between periods or differs markedly from your usual pattern.

Get prompt help for chest pain, sudden breathlessness, new weakness on one side, thoughts of self-harm or a severe sudden headache. Persistent pelvic pressure, a vaginal bulge, ongoing pain during sex, recurrent urinary symptoms or mood changes affecting daily function also merit an appointment.

Discuss whether your history is sufficient to identify menopause, whether another cause of symptoms should be checked, and which treatment targets your main concern. Share any migraine, clot, cancer, liver, bleeding or heart history and ask how each option may affect vaginal comfort, sleep, mood and bone health.