What is menopause?

Menopause (or The Change) is the time in life when you stop having monthly periods. This marks the natural end of the reproductive stage of your life.

You have reached menopause when you have gone 12 months without having your period.

Most Australian females experience menopause between 45 and 60 years of age. The average age of menopause is 51 years.

Some females experience early menopause. This may be due to health conditions, such as primary ovarian insufficiency (where your ovaries stop working normally).

Menopause can also occur after surgery to remove your ovaries or uterus, or cancer treatment.

Everyone experiences menopause differently. You may only have minor discomfort, or you may have more severe symptoms. Menopause symptoms are usually short lived, but sometimes they can last for many years.

What are the symptoms of menopause?

Menopause symptoms often start before your periods stop. Your symptoms may include:

• physical symptoms
• mood and emotional symptoms

Physical symptoms

Some common physical symptoms are:

• irregular periods
• hot flushes and night sweats — are experienced by more than 1 in 2 females
• sleep problems — are experienced by about 1 in 4 people
• exhaustion and fatigue
• weight gain due to a slower metabolism

Other physical symptoms that you may get are:

• sore breasts
• itchy, crawly or dry skin
• headaches or migraines
• aches and pains
• bloating

You may also get bladder, vaginal and vulval problems, such as:

• dry vagina
• loss of libido (sex drive)
• urinary (wee) problems

Mood and emotional health

At menopause, you may notice that you:

• feel you can’t cope as well as you used to
• have difficulty concentrating
• are more forgetful
• can be more irritable or frustrated
• feel anxious
• have a low mood or mood swings

Your symptoms may be worse if your menopause is caused by surgery or cancer treatment.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes menopause?

Menopause occurs due to the number of eggs in your ovaries decreasing. This can lead to changes in your hormone levels. This is called perimenopause. After menopause, you have a drop in levels of oestrogen.

Early menopause

You may get early (or premature) menopause. This is when menopause happens before the age of 45 years. It can occur due to:

• medical treatments that stop your ovaries from functioning, such as chemotherapy. or radiotherapy. for cancer
• surgery to remove your ovaries (oophorectomy) — for example, to prevent or treat ovarian-cancer or breast cancer
• surgery to remove your uterus (hysterectomy)
• primary ovarian insufficiency — due to certain genetic, autoimmune or metabolic conditions

However, the cause of early menopause is often unknown.

When should I see my doctor?

You should speak with your doctor if your menopause symptoms are interfering with your daily life.

You should also see your doctor if you experience vaginal bleeding after not having your period for a year.

Any abnormal bleeding needs to be checked by a doctor.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is menopause diagnosed?

There isn’t a specific test for menopause. Your doctor will help you work out if you are menopausal based on your symptoms and medical history.

Menopause is the time 12 months after your last period. Blood tests aren’t usually done unless:

• your doctor suspects that you have early or premature menopause
• you have had a hysterectomy (surgery to remove your uterus)

Your doctor may also suggest other health checks. such as a:

• mammogram
• pelvic examination
• cervical screening test

How is menopause treated?

There is a range of treatments that your doctor might suggest to help manage your menopause symptoms. Your doctor will work with you to find the best treatment for you.

Hormone replacement therapy

Your doctor may suggest menopausal hormone therapy (MHT). This is also called hormone replacement therapy (HRT), or hormone therapy.

MHT contains the hormone oestrogen to treat your menopausal symptoms. It may also contain a progestogen if you haven’t had a hysterectomy (your uterus removed). This is to protect the lining of your uterus from cancer.

MHT:

• reduces hot flushes and night sweats by about 80%
• helps protect against osteoporosis and bone fractures
• reduces your risk of cardiovascular disease

MHT can be:

• taken as tablets
• applied to your skin as a gel or patch
• placed under your skin as an implant
• applied vaginally as a cream, pessary or tablet — for symptoms confined to your vagina and bladder

Side effects of MHT

Like all medicines, MHT can have side effects. These can include:

• breast tenderness
• fluid retention
• mood changes
• vaginal spotting and bleeding

If you get any of these side effects, you should talk with your doctor.

MHT does not cause weight gain.

Treatment length

There is not a certain length of time that you should take MHT. But stopping MHT may cause your menopausal symptoms to come back.

You should have a yearly wellness check with your doctor. This will help to work out whether you should continue with MHT.

Who can’t use MHT?

MHT may not be recommended if you have:

• a history of breast cancer
• a history of blood clots
• a history of heart disease or stroke
• untreated high blood pressure
• abnormal vaginal bleeding

Non-hormone medicines

Prescription medicines that can help hot flushes and night sweats include:

• certain antidepressants — venlafaxine, escitalopram, citalopram, paroxetine
• gabapentin — which can be used to treat chronic pain
• clonidine — a blood pressure medicine

Unfortunately, these medicines do not help with vaginal dryness.

LOOKING FOR A MEDICINE? — To search by brand name or active ingredient, use the Medicines information search feature.

Other treatments

Other treatments that have been shown to reduce the impact of hot flushes and night sweats are:

• hypnotherapy
• cognitive behaviour therapy
• acupuncture

Complementary therapies

You may want to try complementary therapies to manage menopause symptoms such as hot flushes and night sweats. Complementary therapies include things like:

• black cohosh
• red clover
• phytoestrogens (plant-based oestrogens) found in soy
• Chinese traditional medicine

There is little research to support these therapies. If you don’t see a response in 6 weeks, it’s best to stop taking them.

Similarly, black cohosh can cause liver side effects, so this should be stopped after 6 months.

Complementary medicines can cause side effects. They may also interact with other medicines that you’re taking. It’s important to tell your doctor and pharmacist if you are using complementary therapies.

It’s important to seek medical advice before trying any treatment — including herbal therapies. Some remedies may be expensive and unproven, or they may interact with other treatments.

Living with menopause

There are some changes that you can make to help manage the symptoms of menopause, such as:

• avoiding caffeine, alcohol and hot environments to help reduce hot flushes
• dressing in layers that you can easily remove if you’re feeling hot
• sleeping in a cool room

Here are some other lifestyle changes that you can make to improve your health at this time:

• get regular exercise, since this will help with feelings of low mood
• eat a healthy diet
• avoid smoking
• reduce stress

Can menopause be prevented?

Menopause is a life stage and cannot be prevented.

You can read more about life post-menopause here.

What are the complications of menopause?

Menopause occurs alongside a range of metabolic changes that can lead to complications, such as:

• Heart disease — menopause increases your risk of getting heart disease.
• Osteoporosis — after menopause, your body starts to break down bone more quickly than it replaces it.

Pregnancy during menopause

To avoid pregnancy, it’s recommended that you continue to use contraception for:

• 2 years after your last period — if you’re younger than 50 years
• 1 year after your last period — if you’re older than 50 years

Resources and support

To read more about the time after menopause, visit healthdirect’s post-menopause page.

To find an Australian doctor who specialises in menopause, visit the Australasian Menopause Society website.

For more information and support, you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.

Other languages

Do you speak a language other than English?

• Jean Hailes for Women’s Health has fact sheets on menopause in several community languages.
• The International Menopause Society has videos explaining menopause, subtitled in Vietnamese, Cantonese and Mandarin.