menopause risks and benefits for patients

Overview

Menopause is the point in life when a person's periods stop permanently, usually because the body makes less oestrogen. It is a natural life stage, not an illness. The months or years before periods stop are called perimenopause, when symptoms often begin.

Yes. Every person who has periods and lives long enough will experience menopause. It is a normal part of ageing, and many people notice at least a few symptoms.

Menopause affects people who were born with ovaries, usually between the ages of 45 and 55. It can happen earlier after surgery, cancer treatment, or premature ovarian insufficiency. Trans men and non-binary people may also experience menopause and should receive respectful, supportive care.

Symptoms

Common symptoms

• Hot flushes and night sweats
• Irregular periods that may become heavier or lighter
• Difficulty sleeping and fatigue
• Vaginal dryness and discomfort during sex
• Mood changes, anxiety, or low mood
• Brain fog, poor concentration, and memory slips
• Joint aches and muscle pain
• Reduced interest in sex

Symptoms in children

• Menopause does not occur in children.
• A child who has missed periods, hot flushes, or severe headaches should see a doctor, as these symptoms have other causes.

Symptoms in older adults

• After the menopause transition, hot flushes often become milder or stop.
• Vaginal dryness and bladder changes can continue in older age.
• Older adults should focus on bone health, heart health, and regular health screens.

Causes

Main causes

• The natural decline in oestrogen as the ovaries stop releasing eggs
• Surgery to remove both ovaries
• Chemotherapy or pelvic radiation therapy for cancer
• Premature ovarian insufficiency, when the ovaries stop working before age 40

Risk factors

• Family history of early menopause
• Smoking, which may bring menopause on earlier
• Cancer treatments that affect the ovaries
• Having a hysterectomy that includes removal of both ovaries

When to see a doctor

See a doctor urgently if:

• Heavy bleeding that is getting worse or lasts for many days
• Bleeding after menopause (after a full year without periods)
• Severe pelvic pain or signs of infection, such as fever and smelly discharge
• Dizziness or fainting caused by heavy bleeding

Book a routine appointment if:

• Symptoms such as hot flushes, night sweats, sleep problems, or mood changes affect your daily life
• You want to talk about treatment options and their benefits and risks
• Your periods become irregular before age 40
• You have questions about what changes to expect

Diagnosis

Menopause is usually diagnosed based on your age, symptoms, and period pattern. In many cases, no test is needed. If periods stop before age 45, or if the diagnosis is unclear, a doctor may suggest blood tests.

Tests that may be done

• A blood test to check hormone levels, such as oestrogen and FSH
• A thyroid function test if symptoms suggest a thyroid problem
• A full blood count if heavy bleeding has led to tiredness
• A bone density scan if there is a high risk of osteoporosis

What to expect at your appointment

Your doctor will ask about your cycle, symptoms, family history, and general health. They may check your blood pressure, height, and weight. Then you can discuss lifestyle changes, treatment options, and long-term health checks together.

Treatment

Treatment does not cure menopause because menopause is not an illness. The aim is to reduce troubling symptoms and protect long-term health. Your choices will depend on your age, symptoms, health history, and personal preferences. Some people need no treatment at all; others feel much better with support.

Self-care at home

• Dress in light, layered clothing so you can cool down quickly during a hot flush
• Keep a fan or a cold drink of water nearby
• Practice slow breathing or relaxation techniques
• Keep your bedroom cool at night to improve sleep
• Avoid heavy meals, caffeine, and alcohol if they seem to trigger flushes
• Do regular physical activity to improve energy, mood, sleep, and bone strength

Medical treatments

Several medical approaches can help. Menopause hormone therapy, often called HRT, is very effective for hot flushes, night sweats, and vaginal symptoms, and it helps protect bones. However, HRT may not be safe or suitable for everyone, and it carries small risks of blood clots and breast cancer for some people. There are also non-hormonal prescription options, talking therapies, vaginal moisturisers, lubricants, and low-dose local hormonal treatments for vaginal dryness. Your doctor will explain the benefits and risks of each approach so you can make an informed choice. No single treatment is right for everyone.

When is surgery considered?

Surgery is not needed to treat menopause itself. However, surgery may be used to treat conditions that cause heavy bleeding, such as fibroids, endometriosis, or gynaecological cancer. If surgery includes removing both ovaries before natural menopause, it causes immediate menopause. Your doctor should discuss how to manage symptoms and long-term health before and after surgery.

Living with this condition

Keep a simple diary of your symptoms and what triggers them. This can help you spot patterns and prepare. Plan ahead for hot flushes by wearing layers and carrying a small fan. Tell your partner, family, or employer if you need support at work, such as a cooler room or flexible breaks. Menopause is a transition, not the end of good health.

Lifestyle tips

• Try mindfulness, deep breathing, or meditation to reduce stress
• Stay socially connected and accept support from others
• Use lubricants or vaginal moisturisers for dryness
• Practise pelvic floor exercises to support bladder health
• Limit alcohol and stop smoking to reduce symptoms and long-term risks
• Stay active in ways you enjoy so exercise feels like a treat, not a chore

Diet and exercise

Eat a varied diet with enough calcium and vitamin D from food such as dairy products, leafy greens, beans, nuts, and fortified foods. Include weight-bearing exercise like walking, jogging, dancing, or strength training a few times a week to keep bones and heart healthy. Stay hydrated and try to limit alcohol, caffeine, and very spicy foods if they trigger hot flushes.

Mental health and emotional wellbeing

Changing hormones can affect mood, sleep, and how you cope with stress. You may feel anxious, irritable, or lower than usual. These feelings are common and are not your fault. Speak to your doctor if they last or interfere with daily life. Talking therapies can be helpful. If you ever feel you might hurt yourself, call your local emergency number right away.

Prevention

Menopause cannot be prevented because it is a natural part of ageing. But many long-term risks linked to lower oestrogen, such as bone thinning and heart disease, can be reduced with healthy habits and regular check-ups. If menopause happens early due to surgery or cancer treatment, ask your care team about ways to protect your health and manage symptoms.

Vaccines

No vaccine prevents menopause. Keeping up with routine vaccinations recommended by your health service, such as flu and other standard vaccines, is a simple way to protect your health during and after menopause.

Screening programmes

As you enter menopause, your doctor may check your blood pressure, cholesterol, and blood sugar. Ask about cervical screening and breast screening when appropriate. Bone density testing may be recommended if you have risk factors for osteoporosis. These checks help catch problems early and keep you well.

Complications

If left untreated

• Troubling symptoms like night sweats and poor sleep may continue and affect your energy and quality of life.
• Vaginal dryness and bladder discomfort may worsen if they are not addressed.
• Lower oestrogen levels increase the risk of bone thinning, which can lead to fractures in later life.
• The risk of heart disease and stroke rises after menopause, although a healthy lifestyle can reduce this risk.

Long-term outlook

For most people, menopause is a time of change, not a crisis. Symptoms often ease within a few years, and many people feel better and more confident once they find the right support. There can also be benefits: no more periods, no period pain, and no concern about pregnancy. With good habits and regular health checks, you can stay active, strong, and well for many years to come.

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