Menopause
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Menopause is the natural time in life when a woman's periods stop permanently. It happens because the ovaries produce less of the hormones estrogen and progesterone. This is a normal part of ageing, not a disease.
Key facts
- Menopause usually happens between the ages of 45 and 55, with the average age being 51.
- You are considered to have reached menopause when you have not had a period for 12 consecutive months.
- Some women experience menopause earlier due to surgery (removal of ovaries) or medical treatments like chemotherapy.
Yes, menopause is a normal stage that every woman who lives long enough will experience. It affects about half the world's population at some point.
Menopause affects anyone who has ovaries, including women, trans men, and non-binary people assigned female at birth. It typically starts between ages 45 and 55, but can happen earlier or later.
Symptoms
- Very heavy menstrual bleeding where you soak through a pad or tampon every hour for several hours
- Bleeding that is severe enough to make you feel faint, dizzy, or short of breath
- Large clots (bigger than a 50p coin) with heavy bleeding
- ⚠Bleeding after you have completely stopped periods for 12 months (postmenopausal bleeding) – this needs same-day assessment
- ⚠Any sudden change in your period pattern that concerns you
- ⚠Symptoms that seriously affect your daily life or mental health
Common symptoms
- Hot flushes (sudden feelings of heat in the face, neck, and chest)
- Night sweats (hot flushes that happen during sleep, often causing dampness)
- Vaginal dryness and discomfort during sex
- Sleep problems (trouble falling or staying asleep)
- Mood changes (feeling more irritable, anxious, or low)
- Joint and muscle aches
- Loss of interest in sex (low libido)
Symptoms in children
- Menopause does not occur in children. If a child or young person lacks periods or has early menopause due to medical reasons, a specialist should be consulted.
Symptoms in older adults
- In women over 65, symptoms like vaginal dryness and bone thinning (osteoporosis) may become more noticeable. Hot flushes often become less frequent or stop. Regular health checks for bone health are important.
Causes
Main causes
- Natural decline in the hormones estrogen and progesterone as the ovaries age
- Surgical removal of both ovaries (bilateral oophorectomy)
- Certain cancer treatments like chemotherapy, radiotherapy to the pelvis, or hormone-blocking drugs
- Primary ovarian insufficiency (when the ovaries stop working before age 40)
Risk factors
- Smoking (can bring on menopause 1–2 years earlier)
- Family history of early menopause (if your mother or sisters had early menopause)
- Never having been pregnant
- Certain medical conditions like autoimmune disorders or Turner syndrome
When to see a doctor
See a doctor urgently if:
- Any bleeding after you have already gone 12 months without a period (postmenopausal bleeding)
- Heavy bleeding that soaks through a pad or tampon every hour for more than 2 hours
- Bleeding with large clots or signs of anemia (pale skin, fatigue, shortness of breath)
Book a routine appointment if:
- If your menopause symptoms (like hot flushes, mood changes, or sleep problems) are bothering you and affecting your quality of life
- If you want to discuss treatment options or lifestyle changes to manage symptoms
- If you have not had a period for 12 months and are under 45 – to check for early menopause
Diagnosis
Menopause is usually diagnosed based on your age and symptoms. Your doctor will ask about your periods and how you are feeling. In most cases, tests are not needed. For women under 45, a blood test to measure follicle-stimulating hormone (FSH) may help confirm the diagnosis.
Tests that may be done
- FSH blood test (if under 45 or when the diagnosis is unclear)
- A review of your menstrual history (how often you have periods and when they stopped)
What to expect at your appointment
Your doctor will talk with you in a calm, private setting. They will ask about your periods, any symptoms, your medical history, and your family history. They may also check your blood pressure and weight. There is no single test that 'proves' menopause for everyone over 45 – it is usually clear from the pattern.
Treatment
Treatment for menopause is about managing symptoms and supporting long-term health. Options range from lifestyle changes to medical treatments. The right choice depends on your symptoms, health history, and personal preference. Always discuss with a healthcare provider before starting any treatment.
Self-care at home
- Dress in layers so you can remove clothes when a hot flush starts
- Keep a fan at your desk or bedside and sip cool water
- Avoid triggers like spicy food, caffeine, alcohol, and hot drinks
- Practice relaxation techniques such as deep breathing or yoga to reduce stress
- Use water-based vaginal lubricants or moisturisers for dryness
- Exercise regularly to improve mood, sleep, and bone health
Medical treatments
Medical treatments for menopause include hormone replacement therapy (HRT), which replaces some of the hormones your body no longer makes. HRT can be given as tablets, skin patches, gels, or implants. For women who cannot or choose not to take hormones, non-hormonal options such as certain antidepressants or gabapentin-like drugs may be offered at low doses. Vaginal estrogen (cream, ring, or tablet) can treat vaginal dryness without affecting the rest of the body. Always discuss benefits and risks with your doctor.
When is surgery considered?
Surgery is not a treatment for natural menopause. However, if menopause is caused by removal of the ovaries (oophorectomy), hormone replacement therapy may be recommended unless there is a medical reason not to.
Living with this condition
Living with menopause means adapting to changes in your body. Keep a diary of symptoms to see what triggers them. Plan ahead – for example, keep a fan handy at work. Talk to your partner or family about what you are experiencing so they can understand and support you.
Lifestyle tips
- Get regular physical activity like brisk walking, swimming, or yoga
- Manage stress with mindfulness, meditation, or talking to a friend
- Pelvic floor exercises can help with bladder control issues
- Ensure good sleep hygiene – keep a cool bedroom and avoid screens before bed
- Limit alcohol and caffeine, especially in the evening
Diet and exercise
Eat a balanced diet rich in calcium (from milk, yogurt, or fortified foods) and vitamin D (from sunlight or supplements as advised) to maintain bone health. Include plenty of fruits, vegetables, whole grains, and protein. Weight-bearing exercises like walking, jogging, or dancing help keep bones strong. Aim for 150 minutes of moderate exercise per week.
Mental health and emotional wellbeing
The hormonal changes of menopause can affect mood, causing anxiety, irritability, or low mood. Sleep disturbances can make this worse. It is important to talk to a healthcare professional if you feel overwhelmed. Cognitive behavioural therapy (CBT) and support groups can help. Remember – you are not alone, and help is available.
Prevention
No, menopause cannot be prevented – it is a natural stage of life. However, you can reduce the impact of some symptoms and lower your risk of complications like osteoporosis by staying active, eating well, and not smoking.
Vaccines
Vaccines are not relevant to preventing menopause. However, staying up to date with recommended vaccines (like flu and shingles) supports overall health.
Screening programmes
There is no screening test for menopause itself. But your doctor may recommend a bone density scan (DXA scan) if you have risk factors for osteoporosis. Women over 65 should have a routine bone health assessment. Mammograms and cervical screening remain important during and after menopause.
Complications
If left untreated
- Increased risk of osteoporosis – bones become weaker and more likely to break from a minor fall
- Higher chance of cardiovascular disease, including heart attack and stroke, due to lower estrogen levels
- Persistent vaginal dryness that can lead to discomfort and urinary tract infections
- Long-term sleep problems that affect mood and quality of life
Long-term outlook
Menopause is a normal life transition, not an illness. Most women find that symptoms improve over time, often within a few years. With the right support and lifestyle adjustments, you can stay healthy and active through menopause and beyond. Many women feel relieved to no longer have periods or worry about pregnancy. Talk to your doctor if you need help managing symptoms – there are many effective options.
Find support
International organisations
Local organisations
- NHS UK – Menopause ↗ · United Kingdom
- Menopause Matters ↗ · United Kingdom
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.