What is Menopause?
Menopause occurs when you have gone 12 consecutive months without a period.
In Australia, natural menopause most commonly occurs between the ages of 45 and 55, with an average age of around 51.
If menopause occurs before 45, it is considered early menopause. Menopause before 40 is called premature ovarian insufficiency (POI) and requires specific assessment and management.
Menopause can also occur earlier because of surgery, chemotherapy, radiotherapy or other medical treatments.
Symptoms
You may experience a few or many of these symptoms, and not every symptom experienced during midlife is necessarily caused by menopause. A consultation with one of our doctors can help explore what may be contributing to the changes you are experiencing, as well as discussing possible treatments for these symptoms.
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hot flushes and night sweats
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changes to your menstrual cycle
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difficulty falling asleep or staying asleep
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fatigue
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mood changes, anxiety or irritability
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brain fog and difficulty concentrating
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vaginal dryness or discomfort during sex
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reduced sexual desire
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headaches
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muscle and joint aches
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urinary or bladder symptoms
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changes in how you feel physically and emotionally
Treatment
There is no single approach to menopause care. Your treatment should be based on your symptoms, health, medical history, personal circumstances and preferences.
Menopausal hormone therapy (MHT)
MHT replaces some of the hormones your body is producing less of during menopause. It is the most effective treatment for hot flushes and night sweats and can also improve symptoms such as vaginal dryness and sleep disturbance.
For women who have a uterus, oestrogen is generally prescribed alongside a progestogen. (Progestogen is needed to protect the lining of the uterus). Women who have had a hysterectomy (removal of the uterus) may be able to use oestrogen alone.
MHT can be given in different forms, including patches, gels and tablets, as well as local vaginal oestrogen for vaginal and urinary symptoms.
MHT is not suitable for everyone, and the benefits and risks need to be considered in the context of your individual health and medical history.
Non-hormonal treatments
If MHT isn't suitable for you, or you prefer not to use hormones, there are non-hormonal treatment options that may help with symptoms such as hot flushes, night sweats, sleep difficulties and mood symptoms.
Treatment for isolated symptoms
Vaginal dryness, irritation, discomfort during sex and urinary symptoms are common around menopause and can have a significant impact on quality of life. Lubricants, vaginal moisturisers and local vaginal oestrogen may be appropriate depending on your circumstances.
Lifestyle and wellbeing
Sleep, nutrition, regular physical activity, maintaining muscle and bone strength, limiting smoking and moderating alcohol can all contribute to your health and wellbeing through midlife and beyond.
Testosterone
Testosterone is occasionally prescribed for postmenopausal women experiencing persistent low sexual desire that causes personal distress, particularly when other contributing factors have been considered.
Testosterone is not a general treatment for menopause and current evidence does not support its use for treating symptoms such as fatigue, brain fog, mood changes or for general wellbeing.
General Health Checks
Menopause is an opportunity to take a proactive approach to your health.
The hormonal changes associated with menopause, together with the natural ageing process, can affect bone health and cardiovascular risk. Your consultation with our doctor will therefore include discussion of your blood pressure, cardiovascular risk factors, bone health, lifestyle, family history and other preventive health needs.
This may consist of tests such as:
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Blood tests (FBC, TFT, UEC, LFT, Iron Studies, glucose, cholesterol)
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Mammogram
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Cervical Screening Test
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Bowel Screening
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Bone Density Scan