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Menopause

Menopause is when you have your final period. All people born with ovaries will go through menopause.
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What is menopause?

Menopause is when you have your final menstrual period. Your periods stop because your ovaries stop producing certain hormones and stop producing eggs.

Read more about hormones and menopause.

In Australia, most women (around 3 in 4) reach natural menopause between the ages of 45 and 55 years, but it can happen earlier or later. The average age of natural menopause is 51.

Some women (around 1 in 5) experience premature or early menopause, which is when menopause occurs before the age of 45 years.

  • Premature menopause occurs when menopause happens before the age of 40 years.
  • Early menopause occurs when menopause happens between 41 and 45 years of age.

Some women experience medically induced menopause, which is when menopause is caused by medical treatment, such as surgery, chemotherapy, radiotherapy or some medicines.

Some people use the words ‘menopause’ or ‘the menopause transition’ to describe the whole transition from perimenopause (before the final menstrual period) to postmenopause (after the final menstrual period).

Watch this video to get an overview of menopause

Duration: 2 minutes 5 seconds

What is perimenopause?

Perimenopause refers to the time from when your menstrual periods start changing, or you start having menopausal symptoms, to one year after your final menstrual period (menopause).

Some people use the word ‘menopause’ to cover the whole transition from perimenopause to postmenopause.

During perimenopause, the hormones produced in your ovaries change. This causes your menstrual periods to change and, for some women, menopausal symptoms to start.

In Australia, perimenopause usually starts at around the age of 47. On average, it lasts 4 to 6 years, but for some women it could be shorter or longer.

During perimenopause, you might still ovulate (produce an egg) some months. This is why it is important to consider fertility and contraception during perimenopause.

When to see your doctor

Talk to your doctor if you:

  • feel very tired or fatigued (to rule out loss of iron from heavy periods)
  • have symptoms that are interfering with your daily activities, including exercise and work, your relationships or your quality of life
  • have increased premenstrual syndrome (PMS) symptoms during perimenopause
  • you have concerns about your emotional or mental health.

What is postmenopause?

Postmenopause starts one year after your final menstrual period (when perimenopause ends). You are in postmenopause (or, you are ‘postmenopausal’) for the rest of your life.

As your body adjusts to lower hormone levels you might have fewer or less troubling menopausal symptoms. For some women, though, menopausal symptoms extend into postmenopause.

It’s important to look after your health after menopause. Menopause, ageing or a combination of both increases your risk of developing certain health conditions.

When to see your doctor

Talk to your doctor if:

  • a menstrual period or bleeding from the vagina after menopause (more than 12 months after your last menstrual period)
  • symptoms that are interfering with your daily activities, including exercise and work, your relationships or your quality of life
  • you have concerns about your emotional or mental health.

How do you know if you’ve reached menopause?

You have reached menopause if you haven’t had a menstrual period for 12 months.

It’s a good idea to start tracking your menstrual periods when they start changing, so you know when 12 months have passed since you last had a menstrual period.

After you reach menopause, you are in postmenopause (or you are ‘postmenopausal’) for the rest of your life.

It is more difficult to know if you have reached menopause if you do not have menstrual periods. For example, you might not have menstrual periods because you use an IUD (intrauterine device) for contraception or you have had a hysterectomy (an operation to remove your uterus). You can:

  • keep a detailed journal (a record) of any menopausal symptoms (when they occurred, how they affected you) for at least 3 months
  • take that journal to your doctor, who can use this information to consider further tests.

Remember that something affecting your health at midlife (45-55 years) might not be due to menopause. Midlife is the perfect time to get a thorough check-up from your doctor to check your general health, even if you are not experiencing any symptoms.

Use the Perimenopause and menopause symptom checklist as a tool to help identify your symptoms.

When to see your doctor

Talk to your doctor if:

  • You are younger than 45 and your periods are irregular or have stopped
  • You have symptoms that are interfering with your daily activities, including exercise and work
  • You have symptoms that are affecting your mental health or your relationships
  • You have not had a menstrual period for 12 months, and you then have a period or bleeding from the vagina.

Tests to diagnose menopause

It is not usual for doctors to measure hormone levels for a diagnosis if you are in the expected age range for menopause (45 to 55 years). Your doctor will assess your symptoms and whether and how your periods have changed.

Your doctor might do blood tests to check your general health or to rule out any other causes of symptoms.

If you are younger than 45 years and your periods are irregular or have stopped, your doctor will probably measure your hormone levels to understand what’s causing the change.

Some companies sell blood or saliva tests to do at home to diagnose menopause or predict when menopause will happen. These tests are not recommended.

Watch videos about menopause in your language

Find out what happens to your body during menopause and how to manage menopausal symptoms. You can watch the video in Mandarin or Vietnamese.

How do you know if you are in perimenopause?

The most reliable sign you are in perimenopause (or you are ‘perimenopausal’) is if your menstrual periods have become:

  • Irregular
  • Shorter or longer than usual
  • Lighter or heavier than usual
  • Absent for a few months.

Some women might start to experience menopausal symptoms in perimenopause, with hot flushes and night sweats the most common.

It is more difficult to know if you have reached menopause if you do not have menstrual periods. For example, you might not have menstrual periods because you use an IUD (intrauterine device) for contraception or you have had a hysterectomy (an operation to remove your uterus). You can:

  • keep a detailed journal (a record) of any menopausal symptoms (when they occurred, how they affected you) for at least 3 months
  • take that journal to your doctor, who can use this information to consider further tests

Remember that some health issues and concerns at midlife (45 to 55 years) might not be due to menopause. Midlife is the perfect time to get a thorough check-up from your doctor to protect your future health and wellbeing, even if you are not experiencing any challenging symptoms.

Use the Perimenopause and menopause symptom checklist as a tool to help identify your symptoms and talk to your doctor if something doesn’t feel right.

When to see your doctor

Talk to your doctor if:

  • You are younger than 45 and your periods are irregular or have stopped
  • You have symptoms that are interfering with your daily activities, including exercise and work
  • You have symptoms that are affecting your mental health or your relationships.

Tests to diagnose perimenopause

It is not usual for doctors to measure hormone levels to check if you are in perimenopause if you are in the expected age range for menopause (45 to 55 years). Your doctor will assess your symptoms and whether and how your periods have changed.

Your doctor might do blood tests to check your general health or to rule out any other causes of symptoms.

If you are younger than 45 years and your periods are irregular or have stopped, your doctor will probably measure your hormone levels to understand what’s causing the change.

Some companies sell blood or saliva tests to do at home to diagnose perimenopause or predict when menopause will happen. These tests are not recommended.

Perimenopause and menopause checklist

Use this handy checklist to track your menopausal symptoms. Tick the boxes to show which symptoms are bothering you. Take the checklist with you to your next medical appointment.

Menopausal symptoms

Menopause can affect a woman’s physical (body), mental (psychological) and emotional health. Every woman will experience menopause differently.

Around 1 in 4 women will have no menopausal symptoms. Around 1 in 4 women will have severe menopausal symptoms, which interrupt daily activities and quality of life. The rest (2 in 4 women) will have menopausal symptoms that range from mild and annoying through to symptoms that are difficult to manage.

Menopausal symptoms can be influenced by many things, including:

  • Your general health and wellbeing
  • Your diet and physical activity
  • Whether you smoke or not
  • Other stresses in your life, such as work, financial and relationship pressures
  • Your own thoughts and feelings about menopause
  • How your partner, family, friends or community think and feel about menopause.

If you have menopausal symptoms, they will usually start during perimenopause. For some women, symptoms might continue into postmenopause.

Not all of the health issues and concerns experienced by women in midlife (45 to 55 years of age) are due directly to menopause. Some might be due to ageing, or to other health conditions or to life pressures that affect our wellbeing.

Treatments that help your menopausal symptoms might not help with all the health issues you experience around the time of menopause. To understand and manage your own menopause, you might need to be ready to try different things to improve your health and wellbeing.

All midlife health issues and concerns are important, whether they are caused by menopause or not. Speak with your doctor about any health issue or concern that is affecting your quality of life.

Learn more about managing common symptoms

The most common health issues that improve with treatments for menopausal symptoms are covered below. Information on other common health issues – which might or might not be due directly to hormones – are covered in ‘Other health issues and concerns’.

Watch this video about common menopausal symptoms

Professor Rodney Baber, Professor of Obstetrics and Gynaecology, University of Sydney, describes the most common symptoms that women in Australia experience around the time of menopause.

Duration: 1 minutes 30 seconds

Other health issues and concerns

Lack of research on menopause means we have gaps in our knowledge when it comes to all menopausal symptoms and how to treat them.

Some health issues and concerns can be experienced by women around menopause but might not be due directly to hormone changes.

Treatments for menopausal symptoms might help some women with these health issues.

Remember that all midlife health issues and concerns are important, whether they are caused by menopause or not. Speak with your doctor about any health issue or concern that is affecting your quality of life.

Hormones and menopause

Hormones are chemicals, made in your body, that relay messages inside your body. They control essential functions, like regulating sleep or hunger.

The main hormones that change as you approach menopause are oestrogen and progesterone. During perimenopause, the amounts of oestrogen and progesterone made by the ovaries swing up and down, causing menopausal symptoms. After menopause, very little oestrogen or progesterone is produced by the ovaries.

Another hormone produced in the ovaries is testosterone. Testosterone does not change because of menopause but starts decreasing in women in their 20s.

Oestrogen

Oestrogen is produced in your ovaries. It is one of the main female sex hormones and plays an important role in the female body.

Oestrogen is needed for:

It also helps with brain function and bladder control, and protects you from heart disease.

During perimenopause, the amount of oestrogen produced by your ovaries swings up and down, causing menopausal symptoms. After menopause, the amount of oestrogen produced by the ovaries drops almost to nothing.

Progesterone

Progesterone is also produced in your ovaries. This female sex hormone plays a role in:

  • protecting against vaginal problems, like vaginal dryness
  • keeping your moods calm
  • promoting sleep.

During perimenopause, the amount of progesterone produced by your ovaries swings up and down. After menopause, the amount of progesterone produced by the ovaries drops almost to nothing.

Testosterone

Testosterone is produced by your ovaries but does not change in menopause. This hormone decreases gradually with age starting in your 40s, and increases again at about 58-59 years of age.

Testosterone is not one of the main female hormones but it does have a role in women’s:

  • sex drive (libido)
  • emotional wellbeing
  • bone and muscle strength.

Your doctor might suggest testosterone to help with loss of sex drive.

Fertility and contraception around menopause

You can become pregnant during perimenopause because you might continue to ovulate (produce eggs), even if your periods are irregular.

Fertility naturally declines with age. For women aged 45 to 49 years, the chance of pregnancy is about 2% to 3% per year. After the age of 50, it’s less than 1%.

If you don’t want to become pregnant around the time of menopause, you still need to use contraception.

How long should you use contraception?

If you’re under 50, use contraception until you’ve had 2 years without a period.

If you’re over 50, continue to use contraception until you’ve had one year without a period.

It’s important to know that menopausal hormone therapy (MHT) is not a contraceptive.

There are many types of contraceptive options available. Ask your doctor for more information.

Health after menopause

Postmenopause is the time after your final menstrual period and lasts the rest of your life. The loss of hormones and ageing (or a combination of both) in postmenopause can increase your risk of developing certain health conditions.

Learn how to stay healthy after menopause in other languages

Watch this short video in Mandarin or Vietnamese.

When to see your doctor

Perimenopause

Talk to your doctor if:

  • you feel very tired or fatigued
  • you have symptoms that are interfering with your daily activities, including exercise and work, your relationships or your quality of life
  • your premenstrual syndrome (PMS) gets worse
  • you have concerns about your emotional or mental health.

Postmenopause

Talk to your doctor if you have:

  • a period or bleeding from the vagina after menopause
  • symptoms that are interfering with your daily activities, including exercise and work, your relationships or your quality of life
  • concerns about your emotional or mental health.

 

Premature and early menopause

Learn about the premature and early menopause, including the causes and how to manage symptoms.  

Medically induced menopause

Learn more about medically induced menopause, including what you can do to ease symptoms and reduce health risks.

Menopausal symptom treatments

Learn more about treatments for specific menopausal symptoms.

Managing menopausal symptoms

Learn more about different ways to manage your symptoms, from medical treatments to lifestyle changes.  

Looking after yourself around the time of menopause

Learn how to look after your physical and mental health around the time of menopause.

Menopause for partners

Learn how to support your partner during perimenopause and menopause.