Summary
Read the full fact sheet- Menopause is when your periods stop.
- Around the time of menopause, changing levels of hormones can cause physical and emotional symptoms.
- Menopausal hormone therapy (MHT) is an effective way to manage symptoms.
- Talk to your doctor about your symptoms and whether MHT is right for you.
On this page
- What is menopause?
- What is menopausal hormone therapy (MHT)?
- MHT and premature or early menopause
- MHT for menopausal symptoms
- Added benefits of MHT
- Side effects of MHT
- MHT-related health risks
- MHT and contraception
- Other treatments for menopausal symptoms
- When to see your doctor
- More information
- Where to get help
What is menopause?
Menopause is your final period. As you approach menopause, your reproductive hormones (e.g. oestrogen) drop. Most women reach menopause between the ages of 45 and 55. In Australia, the average age to reach menopause is 51 to 52.
What is menopausal hormone therapy (MHT)?
MHT is medicine that contains oestrogen, progesterone and sometimes testosterone. It is used to manage the symptoms of menopause when they interfere with your daily life.
MHT is available in different doses and forms. For example, pills, patches, gels, vaginal creams and intrauterine devices (IUDs).
MHT and premature or early menopause
Women who go through premature or early menopause will benefit from MHT.
Premature menopause is when you have your last period before the age of 40.
Early menopause is when your final period happens between the ages of 40 and 45.
Premature or early menopause results in reduced levels of oestrogen. This can increase the risk of long-term health conditions such as:
- cardiovascular disease
- osteoporosis (a disease that makes your bones less dense and more fragile)
- dementia.
MHT should be taken until the expected age of menopause to reduce these risks.
MHT for menopausal symptoms
MHT is effective for relieving symptoms such as:
- hot flushes
- vaginal dryness
- disturbed sleep with night sweats
- joint pain
- itchy skin.
It may also improve:
- skin and hair health
- headaches
- aches and pains
- irritability
- sleeplessness
- sex drive
- balance
- dizziness and vertigo.
Added benefits of MHT
Depending on the dose and duration, MHT can reduce the risk of some chronic conditions that may affect postmenopausal women, including:
- osteoporosis and bone fractures
- heart disease
- endometrial cancer
- bowel (colon) cancer
- type 2 diabetes
- cataracts.
Side effects of MHT
Everyone reacts differently to MHT. Some people may not have any side effects. Others may experience symptoms such as:
- nausea
- fluid retention
- sore breasts
- vaginal bleeding (see your doctor if bleeding continues after 6 months of taking MHT).
Most symptoms settle within the first 3 months of taking MHT.
MHT-related health risks
MHT is an effective and safe treatment to relieve menopausal symptoms in healthy women. The data showed that MHT had low risks for women aged 50 to 60, or when used within 10 years of their final period.
Like all medications, there are some risks associated with MHT. These risks depend on:
- when you start using MHT
- how long you use MHT for
- the type and dose of medicine
- your medical history.
MHT is not recommended if you have had hormone-dependent cancer (e.g. breast cancer and some uterine cancers). Your doctor may also advise you not to use MHT if it could increase your health risks. For example, if you have undiagnosed vaginal bleeding or heart disease.
MHT and contraception
MHT is not a form of contraception. While your fertility declines as you get older, it’s still possible to get pregnant before your periods stop. You can't get pregnant after menopause.
If you are younger than 50, you should use contraception for at least 2 years after your final period. If you are aged 50 and older, you should use contraception for at least one year after your final period.
Other treatments for menopausal symptoms
There are many other treatment options for women who can’t or don't want to use MHT. These include:
- non-hormonal prescription medications such as antidepressants, epilepsy medications and medications for high blood pressure (these have been shown to reduce hot flushes and sweating)
- cognitive behavioural therapy (CBT)
- hypnotherapy
- lifestyle changes (e.g. exercise, healthy diet and weight loss)
- complementary medicine and therapies, and over-the-counter products (although there isn't enough evidence to prove they are effective).
When to see your doctor
See your doctor if:
- your menopausal symptoms interfere with your daily life
- your symptoms affect your sleep
- you have strong emotions, anxiety or low mood.
More information
For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women’s Health.
Where to get help
- Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86, 53-58.
- Hickey M, Elliott J, Davison SL 2012, Hormone replacement therapy, British Medical Journal, vol. 344, e763.
- The 2022 hormone therapy position statement of The North American Menopause Society, 2022, Menopause, vol. 29, no. 7, pp. 767-794.
- Stuenkel CA, Davis SR, Gompel A et al. 2015, ‘Treatment of symptoms of the menopause: an endocrine society clinical practice guideline’. Journal of Clinical Endocrinology and Metabolism vol. 100, no. 11, pp. 3975–4011.
- Baber RJ, Panay N, Fenton A, IMS Writing Group 2016, ‘2016 IMS recommendations on women's midlife health and menopause hormone therapy’, Climacteric, vol. 19, no. 2, pp. 109–50.
- Guideline on the management of premature ovarian insufficiency, European Society of Human Reproduction and Embryology.
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