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Menopause

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read
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Menopause is when you stop having periods. It can vary in how it occurs with some people experiencing gradually changing periods, or missed periods, and others finding a sudden end to their periods. Once you have had one year without a period it can be confirmed that you have gone through menopause. Natural menopause is due to increasing age, where over time your ovaries produce less of the hormone estrogen, which in turn means your ovaries don’t release an egg (so you can no longer conceive naturally) and your periods subsequently stop. It happens to all women; however, exactly when menopause occurs, and the symptoms people experience during this time, vastly differ.

For most women menopause occurs between the ages of 45 and 55, however, it can regularly occur earlier or later than this. One in 100 women will go through early menopause which is defined as occurring before they are 40. You may also experience menopause due to having had surgery to remove your ovaries, having radiotherapy around the area of your ovaries, some chemotherapy treatment, or certain medical conditions.

Doctor’s advice

Symptoms of menopause

The symptoms of menopause can occur months or years prior to your last period and can last up to a similar amount of time after. The main symptoms of menopause include hot flushes, changes in your mood or irritability levels, a reduced sex drive, vaginal dryness, and difficulty sleeping or increased tiredness. One or a combination of the symptoms may be experienced, and there can be a wide range of severity. Around 1 in 5 women don’t experience any menopausal symptoms at all, while 1 in 4 women experience severe symptoms.

Just as a side note, if you have had a hysterectomy (your womb removed) but not your ovaries, you can still experience the symptoms of menopause, just without the classic sign of your periods stopping, as you will already not be experiencing periods.

Dealing with symptoms

If you are experiencing troublesome symptoms, there are various treatment options to help with these. The treatments may focus on one particularly bothersome symptom or a variety of symptoms. They can include medications, talking therapy, lifestyle-focused changes, or general hormonal treatment. Hot flushes, mood disturbance, and vaginal dryness are some specific symptoms that can be addressed.

One of the treatment options is hormone replacement therapy (HRT) which replaces the estrogen that has decreased naturally and is causing your symptoms. Depending on the symptoms, HRT can be taken orally in the form of tablets, as skin patches or gels, or if your symptoms are specifically vaginal dryness, then treatment can be via vaginal cream or ring. HRT, as with any medication, comes with its own risks, and your doctor will discuss these with you prior to you commencing it.

Postmenopausal women are at a higher risk of heart problems and also weakening of their bones, known as osteoporosis, as estrogen helps keep bones strong and helps protect the heart. Because of this, especially around menopause and after, it is important to eat healthily, exercise regularly, and avoid smoking or excessive alcohol to help prevent bone or heart issues. Having enough calcium in your diet and also getting enough vitamin D can also help protect your bones.

Can I still get pregnant if I am menopausal?

There is a small chance of getting pregnant as you go through menopause. If you are not trying to get pregnant, to be sure, you should still use contraception if you are sexually active until 2 years after your last period if you are 50 years old or under or a year after if you are over 50.

Seeing your doctor

It is best to get menopause diagnosed by your doctor through a routine doctor's appointment. They can diagnose it by listening to your symptoms and sometimes may utilize a blood test for more information.

There are other medical conditions that can stop your periods from occurring. It is important to see your doctor if your periods stop before you are 45, if you are having symptoms that are not the typical menopausal symptoms, or if you have had significant changes to your usual menstrual bleeding. If you are experiencing severe menopausal symptoms, you should also see your doctor in order for them to discuss treatment options with you.

If you have started bleeding again after you are post-menopausal (one year of having no periods), you should book an appointment to see your doctor. This is because bleeding after menopause usually needs investigating to ensure the lining of the womb (endometrium) is not abnormal.

Your doctor will ask you about your medical history and your current symptoms. They will also ask you about your periods and, if they have stopped when your last one was. They will take baseline health measurements such as blood pressure, and they may also do a blood test. They will then discuss any treatment options with you if you need it.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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