Menopause

Menopause is the stage when menstrual periods stop because the ovaries make much less oestrogen and progesterone.

It is confirmed after twelve months without a period when there is no other explanation. The transition before this point is called perimenopause; periods may become irregular and symptoms can fluctuate. Menopause may happen naturally or earlier after some surgery, medicines or treatments.

Common presentations include hot flushes, night sweats, vaginal dryness, lower sexual desire, mood changes, sleep disruption and difficulty concentrating. Changes in bleeding pattern often appear during perimenopause.

Symptoms can affect comfort, relationships, work and rest. Follow the symptom links for focused information on Hot Flushes, Night Sweats, Vaginal Dryness, Low Sex Drive, Menopausal Mood Changes, Menopausal Brain Fog and Periods Stopped.

Menopause results from a gradual loss of ovarian activity. Falling oestrogen can influence temperature control, the vaginal and urinary tissues, bone maintenance, sleep and mood. The timing varies between people.

Perimenopause can last for several years, with symptoms appearing, easing or returning as hormone levels change. After the final period, some symptoms settle while vaginal or urinary symptoms may continue without treatment. Any bleeding after menopause needs medical assessment.

Earlier menopause can be associated with family history, smoking, some autoimmune conditions, ovarian surgery, chemotherapy or pelvic radiotherapy. These factors do not determine exactly when menopause will occur.

For many people in the typical age range, the pattern of symptoms and periods is enough for a clinician to assess perimenopause or menopause. Blood tests are not always useful because hormone levels vary. Tests may be considered when symptoms begin unusually early, periods are difficult to interpret, or another condition is possible.

Care is tailored to symptoms, medical history and personal preferences. Hormone Replacement Therapy can replace oestrogen, with additional progestogen when needed to protect the womb lining. Non-Hormonal Menopause Treatment may help when hormones are unsuitable or declined. Vaginal Oestrogen Therapy targets dryness and urinary discomfort. Testosterone Therapy for Women may be discussed for persistent low sexual desire in selected circumstances.

Keep a record of bleeding, sleep and triggers for flushes so appointments are more focused. Layered clothing, a cooler bedroom, regular movement, pelvic floor exercises and vaginal moisturisers may improve day-to-day comfort. A clinician can help if symptoms affect work, intimacy or emotional wellbeing.

Lower oestrogen can contribute to bone thinning and changes in cardiovascular risk over time. Genitourinary symptoms may include recurrent discomfort or urinary problems. New severe symptoms, chest pain, sudden weakness or heavy bleeding require urgent medical attention.

Natural menopause cannot be prevented. Protecting bone and heart health includes not smoking, staying physically active, eating a varied diet and addressing blood pressure or cholesterol with a clinician. These habits do not stop symptoms but support health during the transition.

A family doctor, gynaecologist or menopause-trained clinician can review symptoms, bleeding, contraception needs and treatment risks. Bring a list of medicines and any history of clotting, breast disease, migraine or liver problems.