This article was last reviewed on
This article waslast modified on 15 September 2023.
What is it?

Menopause is the time in a woman's life when her normal menstrual periods stop and a woman's ovaries, the organs that produce eggs, stop producing female hormones. Menopause occurs at an average age of about 50, but the is usually 40–51 years of age, however it can occur earlier <40 years of age or be delayed (55 years or greater).

Two important hormones, oestradiol and progesterone, are made by the ovaries (the organs that produce eggs) in a cyclical fashion and help to maintain a normal menstrual cycle. When a woman reaches menopause, cyclical hormone production from the ovaries stops, leading to a cessation in monthly menstrual periods and of egg production.

The menopausal change is slow and usually takes two to five years to complete. During this so-called peri-menopausal phase (also sometimes referred to as ‘the climacteric’ or ‘the change’), hormone levels can fluctuate from high to low and from one month to the next. Some months a woman may have a period but then go for several months without a period. It is important to note that during this time, a woman may still be able to get pregnant. Menopause is said to have taken place when a woman has not had a period for 12 months. Menopause happens naturally as a woman ages. However, menopause can also occur for other reasons, including the removal of the ovaries for cancer or other medical reasons like endometriosis.

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About Menopose
  • Symptoms

    A woman’s body goes through several changes during menopause. Some of the more common symptoms of menopause occur when oestrogen levels start to drop. Women may experience:

    Common mental health symptoms of menopause and perimenopause include:

    • changes to your mood, like low mood, anxiety, mood swings and low self-esteem
    • problems with memory or concentration (brain fog)

    Common physical symptoms of menopause and perimenopause include:

    • hot flushes, when you have sudden feelings of hot or cold in your face, neck and chest which can make you dizzy
    • difficulty sleeping, which may be a result of night sweats and make you feel tired and irritable during the day
    • palpitations, when your heartbeats suddenly become more noticeable
    • headaches and migraines that are worse than usual
    • muscle aches and joint pains
    • changed body shape and weight gain
    • skin changes including dry and itchy skin
    • reduced sex drive
    • vaginal dryness and pain, itching or discomfort during sex
    • recurrent urinary tract infections (UTIs) (taken from NHS website)

    In addition, bone loss, which occurs naturally with age, is accelerated after menopause due to the lack of oestrogens. Excessive bone loss can lead to osteoporosis and a higher incidence of fractures of the hip and spinal column. A higher risk for heart disease is also seen after menopause because the levels of LDL "bad" cholesterol in the blood may rise.


  • Tests

    The diagnosis of menopause is usually made on clinical grounds, i.e. symptoms and history. The following biochemical investigations may be performed on blood when menopause is suspected but the diagnosis is not clear:

    • Follicle-stimulating hormone (FSH), to learn whether she is approaching or has gone through menopause
    • Oestradiol, to measure ovarian production of oestrogen and to further assist in determining menopausal state
    • Anti-Mullerian hormone measurements to assess ovarian reserve.
    • Thyroid function testing (T4 and TSH tests) to assess the function of the thyroid gland
    • Assessment of liver and kidney function

    NICE guidelines recommend that diagnosis is made without laboratory tests in otherwise healthy women aged over 45 years showing menopausal symptoms.


  • Treatment

    Some menopausal symptoms can be managed without drug treatments, such as with diet and exercise or by quitting smoking and cutting back on alcohol consumption. Some women, however, may choose to start taking hormone replacement therapy to help prevent or reduce hot flushes, mood swings, and bone loss. Hormone replacement therapy (HRT) also known as Menopausal Hormone Treatment (MRT) is the most common therapy prescribed to relieve the various symptoms of menopause.

    HRT is a safe and effective treatment for most going through menopause and perimenopause. The GP will discuss any possible risks before prescribing.

    HRT involves using oestrogen to replace your body's own levels around the time of the menopause. There are different types and doses of HRT. Using the right dose and type usually means symptoms improve.

    The treatment can come as:

    • skin patches
    • a gel or spray to put on the skin
    • implants
    • tablets