Menopause is the last menstrual (monthly) period in a woman's life. It is a natural occurrence which marks the end of the reproductive years, just as the first menstrual period, during puberty, marked the start.

Australian women are now living one third of their lives after menopause. Most women reach menopause somewhere between the ages of 48 and 55, the average being around 51 to 52 years. Early menopause before the age of 40 is called 'premature' menopause.

Nowadays, the word 'menopause' tends to have broadened to include what is medically termed 'the climacteric'. This is the transition phase during which the body is undergoing changes. For most women these changes occur gradually over two to six years around the last menstrual period. It is in these years that symptoms of menopause can occur.

• 20 per cent of women have no symptoms 
• 60 per cent have mild symptoms 
• 20 per cent of women seek help for severe symptoms

Early menopause

Early menopause, before the age of 40, is termed 'premature' menopause. It may occur spontaneously as a result of early failure of the ovaries; be caused surgically when a woman has her ovaries removed; or be caused chemically by chemotherapy for cancer.

Symptoms of early menopause are basically the same as for natural menopause.

Due to the long-term effects of oestrogen deficiency, the risk of developing osteoporosis or heart disease for women experiencing early menopause are considerably higher than for women reaching menopause at the expected age. For this reason, it is of extreme importance that advice is sought from your doctor. Treatment is usually long-term hormone replacement therapy, but the risks, particularly of breast cancer, do not increase until after 50.

For more see Early Menopause www.earlymenopause.org.au

What happens around menopause?

As we approach menopause, the production of hormones (i.e. oestrogen) by the ovaries starts to slow down. As this process accelerates, hormone levels fluctuate more and often a woman notices changes in her menstrual cycle.

• Cycles may become longer, shorter or totally irregular
• Bleeding may become lighter
• Bleeding may become unpredictable and heavy (seek advice from your doctor)

Eventually the hormone levels will fall to a level where menstruation (periods) will cease altogether and menopause is reached. Contraception is needed until you have had one year without a natural period.

Other signs and symptoms

The most common symptom is the hot flush; however women may sometimes experience several of the symptoms listed below:

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

Content updated  June 19, 2008