What is menopause?

Menopause is a natural part of every woman’s life. It is the last menstrual period, marking the end of a woman’s reproductive years. Most women reach menopause between the ages of 45 and 55.

Menopause symptoms can begin gradually over the two to six years before the last menstrual period. Perimenopause, or menopause transition, is the time when periods fluctuate until they stop.

Not all women suffer from signs of menopause; in fact 20 per cent have no symptoms. Some 60 per cent have mild symptoms, while only 20 per cent suffer severe symptoms.

What is early and premature menopause?

Menopause before the age of 40 is called early or premature menopause. It may occur:

• Naturally when hormone levels decrease
• Surgically when a woman has her ovaries removed
• Chemically from chemotherapy / radiotherapy for cancer.

Women who experience early menopause are at greater risk of osteoporosis and heart disease because of the long-term effects of low oestrogen levels, so if you think you’re experiencing early menopause it is important to talk to your health practitioner.

(See  Early Menopause (103.15 KB) for more information)

What happens to your body at menopause?

We are born with about a million eggs in each ovary but by the time we reach menopause there are no functioning eggs left.

We release about 400-500 eggs in our reproductive life, from the time periods start till they end at menopause.

From about 35-40 years, the remaining eggs in our ovaries rapidly diminish and we ovulate (when an egg is released from the ovary) less or irregularly until our periods stop. Oestrogens are produced from the cells around the eggs. Progesterone is also produced but only if an egg has been released. The production of oestrogen diminishes when the number of eggs left is small and close to the final period.

In the few years prior to the final period (menopause) the hormone levels can fluctuate widely, being both high and low.

As the production of oestrogen by the ovaries slows down, hormone levels change and fluctuate and you may notice the following changes in your menstrual cycle:

• Longer, shorter or irregular periods
• Lighter bleeding
• Unpredictable and heavy bleeding (see your health practitioner)

Eventually hormone levels will decrease so that menstruation stops altogether and menopause is reached. Where appropriate, birth control is still needed until you have had one year without a natural period.

Symptoms

• Hot flushes and night sweats
• Aches and pains
• Headaches
• Vaginal dryness
• Reduced sex drive (libido)
• Urinary frequency
• Tiredness
• Irritability
• Depression
• Sleeping difficulty
• Forgetfulness
• Low self-esteem
• Crawling or itching sensations under the skin

How can you help yourself?

Healthy eating

• Have plenty of fresh vegetables, fruits, cereals and whole grains
• Drink six to eight glasses of water daily
• Decrease caffeine intake (coffee, tea, cola, chocolate)
• Limit alcohol to one to two standard glasses, or less, per day
• Eat high-calcium, low-fat dairy foods
• Include lean meat, fish or chicken in your diet
• Phytoestrogens (plant oestrogens) replace some natural oestrogens lost during menopause, and may reduce symptoms, cholesterol and blood pressure (good sources include soy and linseed bread, soy beans, tofu, whole grains and legumes)

(See our  Healthy Eating (102.59 KB) for more information) 

Regular physical activity

Aim for 30 minutes of moderate physical activity on most days of the week to maintain general health, control weight and help keep bones healthy.

(See our  Physical Activity (93.97 KB) factsheet for more information)

Avoid smoking

Need help quitting smoking? Call the Quitline on 131 848 or visit www.quit.org.au  

Look after your emotional health

You may experience mood changes such as mild depression and irritability, often related to physical changes like hot flushes, night sweats and interrupted sleep. Talk to a health practitioner about controlling the physical symptoms to help improve your general wellbeing.

(See our  Emotional Health at Midlife and Menopause (155.76 KB) factsheet for more information)

Have regular Pap tests and breast checks

See your health practitioner for a Pap test every two years and regularly check your breasts. Mammograms are free if you’re over 40 years of age – phone BreastScreen on 132 050.

What therapies can help you manage symptoms?

Hormone replacement therapy (HRT) (also known as hormone therapy – HT)

Hormone replacement therapy can help relieve the symptoms of menopause, but no treatment is without side effects. Any decision about HRT is an individual one, so talk to your health practitioner about risks, benefits, concerns and other alternatives.

It is important that all women using HRT be reviewed once a year by their health practitioner.

(See  Hormone Therapy (161.29 KB) for more information)

Natural therapies

Women often use natural therapies to manage menopause symptoms. See a qualified naturopath for long-term guidance, as some natural herb and plant medications can have side effects. For women who choose complementary therapies. It is important to remember that ‘natural’ herb and plant medications should be treated as medicines; therefore if considering complementary therapy for long-term guidance and balance throughout the menopausal years, it is important to see a qualified naturopath with an interest in women’s health.

Complementary therapies can often be taken in conjunction with HRT, for example; a woman might take HRT to address some symptoms and complementary therapies for others. It is essential to let both your doctor and naturopath know exactly what each has prescribed.

In women with a history of breast cancer or hormone-dependent cancers, the safety of some herbal therapies is not known. It is advisable to seek the advice of a naturopath to discuss safe options, and you should always consult your cancer specialists before taking any ‘natural’ remedies.

Non-hormonal therapies

In women who have developed menopause following chemotherapy for cancer or following surgery for a hormone dependent cancer, such as uterine cancer, HRT is not usually recommended. There are a number of different non-hormonal medicines which are suitable. It is important to discuss these with your doctor.

Where can I get more information?

www.jeanhailes.org.au

www.managingmenopause.org.au

www.healthinsite.gov.au

www.betterhealth.vic.gov.au

Further Resources

Menopause (75.22 KB)

Content updated October 2009