Why does the menstrual cycle stop during menopause?

A menstrual cycle depends on coordinated signals between the brain, ovaries and uterus. Oestrogen helps the uterine lining grow, while progesterone changes it after ovulation. During the transition to menopause, the ovaries respond less predictably and these hormones fluctuate. Periods may therefore vary in timing and flow before stopping. Once ovulation has ended and twelve months have passed without bleeding, menopause has been reached. Symptoms such as hot flushes, night sweats, vaginal dryness, low sex drive or mood changes can occur alongside this transition.

Record bleeding dates, flow, pain and other symptoms. If you are sexually active and pregnancy is possible, ask how to manage contraception during the transition because ovulation can occur before menopause is confirmed. A clinician can help distinguish menopause from thyroid problems, medication effects, pregnancy or other causes of missed periods. Treatment can target symptoms that affect sleep, comfort, relationships or daily activities.

Arrange an assessment for bleeding after twelve months without a period, very heavy or prolonged bleeding, bleeding after sex, or pelvic pain. Seek urgent help for fainting, severe pain or bleeding that makes you feel weak or unwell. Missed periods with possible pregnancy also need appropriate testing. These checks help identify causes that require separate treatment, including pelvic organ prolapse or other pelvic conditions when symptoms point that way.

Does my cycle history show that menopause has been reached? Do I still need contraception? Should another cause of missed or unusual bleeding be investigated? Which options could ease my other symptoms?