Menopause

Menopause simply means the end of a woman’s menstrual periods. It is a significant hormonal milestone that offers a good opportunity to assess your health and plan for the next phase of your life.

Key points

  1. Menopause is a normal part of life; you are said to have reached menopause after 12 months in a row of no further periods.
  2. The usual age is between 45 to 55 years. The average in NZ is 52 years. 
  3. About 70% of women have significant symptoms with menopause and 40% will see a doctor because of their symptoms.
  4. Symptoms vary hugely in severity with some women having very little discomfort, while others are affected to the extent of being unable to carry out their normal everyday activities.
  5. In the long term, after menopause you are more at risk of developing osteoporosis (thinning of bones) and heart disease, though lifestyle measures help to reduce this risk. 
  6. Discuss ongoing symptoms or particular concerns with your doctor.

What happens during menopause?

During menopause your body stops preparing every month for a baby: your ovaries stop releasing eggs, they make less and less of the female hormones oestrogen and progestogen, and eventually, your periods stop.

The reduction in female hormones can cause symptoms such as hot flushes, mood swings, night sweats, anxiety, palpitations, depression, decreased libido, sleep problems and vaginal dryness. 

Read our FAQs about menopause

women drinking coffee on a deck

Types and stages of menopause

There are three types of menopause:

  • Natural menopause, which happens between the ages of 40 and 55 (usually late 40s or early 50s).
  • Early or premature menopause, which happens before 40 years of age. This can be due to genetics, is more common in women who smoke, who have been ill or had surgery or drug treatments that affect the blood supply to their ovaries, however it can also occur for no obvious reason.
  • Artificial menopause, which occurs when the ovaries have been removed or after cancer treatment.

Menopause can be divided into two stages:

  • Perimenopause: during the year or years before your periods stop completely (perimenopause) your periods will change; they may get shorter, longer, lighter or heavier. They may be closer together, or further apart. This may go on for a year or more. Eventually, your periods will stop altogether.
  • Postmenopause: a woman is considered "postmenopausal" one year after her last menstrual period.

What are the signs of menopause?

For some women, a change in their periods is all they notice as they go through menopause. However, because the female hormones affect other parts of your body, you may also have any of the following symptoms:

  • Hot flushes; these feel like someone has poured hot water into your veins. They can start in your face and neck and spread all over your body or be a sudden feeling of heat all over. Many people feel embarrassed and think others will notice, but it's usually not noticeable.
  • Sweats, which often go with flushes and are common at night.
  • Loss of libido (sex drive).
  • Dryness in your vagina and around your urethra can lead to uncomfortable sex, bladder infections or wetting your pants sometimes.
  • Sleep problems.
  • Palpitations – your pulse or heart may feel like they are racing, or you may feel faint or dizzy from time to time or get ringing in your ears.
  • Mood changes – you may feel tired, irritable, depressed, tearful or angry; this can be from hormonal changes, because you are not sleeping well or because you are adjusting to change.
  • Skin – your skin may look more tired and be less firm, and the hair on your head, armpits and legs may get thinner.
  • Bones – you won't feel it, but your bones may start getting thinner (osteoporosis). Much later you may break them more easily or start to get shorter (loose some of your height) or find it hard to straighten up.

Note: if you have very heavy periods or bleeding between your periods you must contact your doctor.

Looking after yourself during menopause

Menopause is a normal part of life. Allow yourself time to adjust to what you are experiencing and try to get support from others, especially from your partner and family. If they understand what you are going through it will help them know how they can best support you.

Don't forget about contraception!

  • If aged less than 50 years, the general advice is you still need contraception for two years after your final menstrual period (FMP).
  • If you are aged 50 years or more when you reach menopause, you need to continue to use contraception for at least one year after your final period.

Read more about self-care for menopause

Seeking medical advice for menopause

If you have ongoing symptoms which are not relieved by self-care measures, see your doctor for advice. 

You may be offered hormone replacement therapy (HRT), now called menopause hormonal therapy (MHT) to reduce the menopausal symptoms. While this has been less popular over the last ten years, it is still one of the best treatments for menopausal symptoms and is considered safe for most women less than 60 years old.

For vaginal dryness, you can be offered a topical oestrogen cream which works well and comes as pessaries or cream. If you are at risk of thinning bones (osteoporosis) you may be given calcium supplements or other treatments.

Menopause is a good time to have a general health examination, including checks for your blood pressure, having a cervical smear, breast examinationmammogram and possibly a bone density scan. You should also discuss ways to look after your health over the coming years with your doctor.

Read more about menopause treatment and management Jean Hailes Women's Health.

Learn more

Menopause section Jean Hailes Women's Health, Australia
Menopause NHS Choices UK, 2014
Menopause: signs, symptoms, treatment, diagnosis Southern Cross Healthcare Group NZ, 2012
The Australasian Menopause Society provides a range of educational material and resources on midlife and menopause for the benefit of women.
Loss of libido during menopause Healthline (USA)

Credits: Health Navigator Editorial Team.