Menopause

Menopause is the natural, permanent end of menstrual periods, marking the end of a woman’s reproductive years, typically occurring around the age of 45–55. It results from a natural decline in ovarian hormone production and is confirmed after 12 consecutive months without a period.

• Irregular menstrual periods in the lead-up to menopause, eventually stopping altogether
• Hot flushes and night sweats
• Vaginal dryness and discomfort during intercourse
• Mood changes, difficulty sleeping, and reduced concentration in some women
• Symptoms vary widely in severity between individuals, and some women experience very few symptoms

• Results from the natural, gradual decline in oestrogen and progesterone production by the ovaries as a woman ages.
• Can also occur earlier than usual (early or premature menopause) due to surgical removal of the ovaries, certain medical treatments, or, less commonly, other underlying conditions.

• Usually diagnosed based on the woman's age, symptom pattern, and 12 consecutive months without a menstrual period, without needing specific testing in most cases.
• Blood tests for hormone levels may be used to support the diagnosis in women with early or unclear symptoms, or after surgical removal of the ovaries.

Many women manage menopausal symptoms with lifestyle measures alone, such as dressing in layers, avoiding known triggers for hot flushes (such as caffeine, alcohol, or spicy food), and regular exercise.

Hormone replacement therapy can be an effective option for bothersome symptoms such as hot flushes and vaginal dryness, and is discussed individually with a health worker weighing benefits and risks based on personal and family health history.

Vaginal moisturisers or, where needed, local vaginal oestrogen can help with vaginal dryness specifically.

Bone health becomes an increasing consideration after menopause, given the effect of reduced oestrogen on bone density, so adequate calcium, vitamin D, and weight-bearing exercise are recommended.

Ongoing routine health screening, including for cardiovascular risk and bone health, is important in the years following menopause.

• Engage in regular weight-bearing exercise and ensure adequate calcium and vitamin D intake to support bone health.
• Identify and, where possible, avoid personal triggers for hot flushes, such as caffeine, alcohol, or spicy foods.
• Attend routine health screening appropriate for this life stage, including cardiovascular risk assessment.
• Discuss troublesome symptoms with a health worker, as effective treatment options are available rather than needing to simply endure symptoms.