What is menopause?

Often referred to as ‘the change’, menopause marks the end of the monthly cycle of menstruation for women and your reproductive years. It means that you have run out of eggs (as females are born with all the eggs they will ever have during their lifetime), and as you’ll no longer have periods you won’t be able to conceive a child.

When does menopause happen?

Most women reach menopause between the ages of 45 and 55, with an average age around 51. The table below summarises the different stages of the menopause transition.

Natural menopauseThe permanent cessation of menstruation resulting from the loss of ovarian follicular activity (no more eggs are left in the ovaries). You will know the menopause has taken place if you have not had any bleeding for 12 months and there is no other obvious cause. This is referred to as the final menstruation period (FMP).
PerimenopauseRefers to the period immediately before the menopause (when the hormonal, biologic, and clinical features of approaching menopause commence) and the first year after menopause.
Menopausal transitionThe period before the FMP when variability in the menstrual cycle usually increases.
PremenopauseRefers to either the one or two years immediately before the menopause, or to the whole of the reproductive period before the menopause.
Induced menopauseThe cessation of menstruation that follows either surgical removal of both ovaries (with or without hysterectomy) or iatrogenic ablation of ovarian function (usually by chemotherapy or radiation).
PostmenopauseThe period dating from the FMP, regardless of whether the menopause was induced or natural.
Premature menopauseMenopause that occurs at an age two standard deviations below the mean estimate for the reference population. In practice, the age of 40 years is frequently used as an arbitrary cut-off point, below which menopause is said to be premature.

What changes can I expect?

During menopause, most women experience both emotional and physical symptoms, and some can greatly affect your quality of life. Around a third to a quarter of affected women will seek medical attention.

Some common symptoms include:

  • Hot flushes
  • Night sweats
  • Insomnia
  • Mood swings
  • Aches and pains
  • A sensation of ‘ants’ crawling under the skin
  • Vaginal dryness
  • Light-headed
  • Headache

The postmenopausal phase of life is associated with adverse long-term health problems such as increased bone loss (osteoporosis) and an increased risk of cardiovascular disease (heart disease and strokes).

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How are menopause symptoms treated?

Most women will simply put up with symptoms unless they are severe or persistent. However we think it’s a good idea to discuss what you are feeling with one of our doctors and we can use our years of expertise to guide you through effective management of your menopause symptoms.

Until recently, standard HRT involved combining natural oestrogen with a synthetic progestin to protect the uterus from cancer. Unfortunately, the progestin slightly increased breast cancer risk. Body identical HRT involves combining natural oestrogen (oestradiol) with micronised natural progesterone. This approach protects the uterus from cancer and is linked to a significantly lower risk of breast cancer than HRTs containing progestin. Please see our News section for more details on this newly-available treatment.

The initial consultation will take around 30 minutes, and will uncover details about your medical history to help us better understand your circumstances. This will include gathering information on your menstrual cycle, sleep patterns, contraception, and the menopause symptoms you are currently experiencing. To determine how much discomfort your menopause symptoms are causing you, we’ll typically use the form below, using a scale of 0-6 where 0 is “not bothered at all” and 6 is “extremely bothered”.

scale-img

SYMPTOMS

0

123456

Hot flushes or flashes

       

Night sweats

       

Sweating

       

Being dissatisfied with my personal life

       

Feeling anxious or nervous

       

Accomplishing less than I used to

       

Feeling depressed, down or blue

       

Being impatient with other people

       

Feelings of wanting to be alone

       

Flatulence (wind) or gas pains

       

Aching in muscles and joints

       

Feeling tired or worn out

       

Difficulty sleeping

       

Aches in the back of neck or head

       

Decrease in physical strength

       

Decrease in stamina

       

Feeling a lack of energy

       

Drying skin

       

Weight gain

       

Increased facial hair

       

Changes in appearance, texture or tone of your skin

       

Feeling bloated

       

We can then recommend the best course of action for managing your symptoms. In many cases, some simple lifestyle changes may be all that’s needed to reduce the severity of your symptoms. These include a healthier, varied diet, more exercise, quitting smoking and thinking positively.

In others, we may recommend herbal remedies, hormonal treatments or non-hormonal therapies, and arrange a follow up appointment in around six to eight weeks to see how you are progressing.

Helpful resources

If you’d like more information you can view the health information fact sheets below or browse our Health Information page.

You can also complete this questionnaire at home to help you decide if you need to come in and see us.

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References

1. Sherman S. Defining the menopause transition. American Journal of Medicine 2005; 118(12B): 35-75

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