What is menopause?
Menopause, also known as ‘the change of life’, marks the end of the monthly cycle of menstruation in a woman’s life. It is a natural occurrence and marks the end of the reproductive years, just as the first menstrual period during puberty marked the start. You will know that the menopause has taken place if you have not had any menstrual bleeding for 12 months. Most women reach menopause between the ages of 45 and 55, the average being around 51. Menopause before the age of 40 is called ‘premature menopause’ and before the age of 45 it is called ‘early menopause’.
Hormone levels fluctuate leading to menopause
As you approach menopause, the production of ‘female’ hormones (oestrogen and progesterone) by the ovaries starts to slow down. Hormone levels tend to fluctuate and you may notice changes in your menstrual cycle such as:
- cycles may become longer, shorter or totally irregular
- bleeding may become lighter
- bleeding may become unpredictable and heavy (seek advice from your doctor).
Eventually, your hormone levels will fall to a point where your ovaries stop releasing eggs, your menstruation (periods) cease altogether and the menopause is reached.
Although fertility after the age of 45 is low, you still need to use contraception to prevent pregnancy (even if only barrier contraception such as male condoms), until you have had one year without a natural period if you’re over 50 years old, or two years without a natural period if you’re under 50.
Symptoms of menopause
Some of the symptoms that women may experience include:
- hot flushes
- night sweats
- aches and pains
- crawling or itching sensations under the skin
- lack of self-esteem
- reduced sex drive (libido)
- difficulty sleeping – wakefulness or waking hot and sweaty
- urinary frequency
- vaginal dryness
- discomfort with sexual intercourse.
Long-term health risks with menopause
A decrease in female hormones after menopause may lead to:
- thinning of the bones (osteoporosis) and an increased risk of fractures
- an increase in the risk of heart attack and heart disease, high blood pressure and stroke.
Management of menopause symptoms
Unpleasant symptoms of the menopause can often be reduced by:
- healthy diet
- regular exercise
- looking after your mental health
- reducing your stress levels
- getting enough good quality sleep
- using light-weight pyjamas and bedding to help with night sweats
- avoiding the things that trigger your hot flushes
- quitting smoking
- hormone replacement therapy.
Healthy diet and menopause
Suggestions for maintaining good health through diet at the time of menopause include:
- Choose a wide variety of foods, including plenty of fresh vegetables, fruits, cereals, whole grains and small portions of lean meat, fish or chicken
- Increase fluids and eat low-fat dairy foods with high calcium content
- Decrease caffeine and limit alcohol (aim for one to two standard glasses or less per day).
Exercise and menopause
Regular exercise is important. At least 30–45 minutes on most days of the week will:
- maintain your heart health and improve your general health
- keep your bones healthy and prevent bone density loss through osteoporosis – particularly weight-bearing and strength training activities
- help maintain good balance and reduce the risk of injury from falls
- provide a feeling of relaxation and wellbeing
- possibly help improve hot flushes.
Mood and menopause
Some women experience mood changes such as mild depression and irritability with the menopause. These symptoms are often related to physical changes such as hot flushes, night sweats and poor sleeping.
Changes in mood may also arise due to how you are feeling about reaching this stage of your life – particularly if you are experiencing early menopause.
Mood changes can also be related to stressors that women are often coping with in their lives around the time that they experience menopause, such as:
• physical signs of ageing
• changes to libido
• health issues
• changes to the family unit (such as children leaving home, or divorce)
• caring for ageing parents
• career changes
• financial worries.
Talk to your doctor or a psychologist if you are experiencing significant or persistent changes in mood that last longer than two weeks, as you could be experiencing depression. The good news is, depression is treatable. The sooner a person with depression seeks support, the sooner they can recover.
Smoking and menopause
Smokers may have an earlier menopause than non-smokers. It’s also important to avoid smoking because of the associated risk of osteoporosis, coronary heart disease and lung cancer.
For help to quit smoking, call the Quitline on 13 7848.
Hormone replacement therapy
Hormone replacement therapy (HRT) – also known as or hormone therapy (HT), or Menopause Hormone Therapy (MHT) – effectively reduces many of the unpleasant effects of symptoms of menopause, and may be appropriate for use in women with moderate to severe menopausal symptoms.
Discuss the advantages and disadvantages of hormone therapy with your doctor.
If you are one of the 10 per cent of women who have severe symptoms lasting 10 years or more, you may continue longer-term use of HRT. It is important to have a check-up once a year to assess the specific risks and benefits you may experience as a result of the therapy.
These can benefit some women, but it is important to remember that ‘natural’ herb and plant medications can have unpleasant side effects in some women, just like prescribed medications. A registered naturopath may provide long-term guidance and balance through the menopausal years.
Herbal therapies can often be taken in conjunction with hormone therapy. It is important to let both your doctor and naturopath know exactly what each has prescribed, and to consult your doctor before taking any herbal treatments or dietary supplements. Some natural therapies can affect or interact with other medications you may be taking.
Health checks and menopause
It is recommended that women who have reached menopause have:
Understand your body’s changes at menopause
It is important to understand the changes your body is going through before, during and after the menopause. There are many different sources of information available. Make sure you seek out credible websites and brochures that provide up-to-date, non-biased information from organisations that specialise in women’s health.
Some examples include:
Where to get help
This page has been produced in consultation with and approved by:
Jean Hailes for Women's Health
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.