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The menopause is a normal process that women experience, and can greatly affect the quality of a woman’s life.  The menopause occurs when the ovaries stop producing eggs, leading to a drop in hormone levels in the body.


There are 3 stages:

  • Perimenopause – this occurs a few years before the menopause when the ovaries gradually make less oestrogen.  The fluctuation of hormone levels lead to the symptoms of menopause.
  • Menopause –  is the point when it has been at least one year since the last menstrual period.  
  • Post menopause – these are the years after the menopause.  As oestrogen drops it can affect different systems in the body, such as skin, bones, heart and vagina.

The average age of menopause in the UK is 51 years.  Symptoms can start earlier at around the age of 45.  Menopause prior to the age of 40 is defined a premature ovarian insufficiency.

Symptoms of menopause vary greatly between women.  Some women may only experience symptoms for a few months, whilst others may suffer for many years.  Around one in four women have no symptoms.  The first sign of menopause is usually a change in the normal pattern of your periods.  They can become lighter or heavier with a change in frequency, until eventually the period stops altogether.  Common symptoms are hot flushes and night sweats.  Other symptoms include vaginal dryness, reduced libido, joint pains, difficulty sleeping, mood changes such as irritability and anxiety.

There are also long-term health problems associated with a lack of oestrogen.  These include osteoporosis which is a weakening of the bones making them fragile and increasing the risk of fractures.  The risk of cardiovascular disease also increases after the menopause.  

Treatment options include hormone replacement therapy (HRT).  HRT can improve can both symptoms and quality of life.  HRT is also recommended for women who have gone through an early menopause and should take it until around the time of natural menopause. HRT can reduce the risk of osteoporosis, however it may also be associated with a small risk of developing breast cancer and women need to be assessed on an individual basis.

HRT is available as tablets, skin patches and gels.  Oestrogen creams can help symptoms of vaginal dryness and discomfort.  There are also over the counter vaginal moisturisers that can be used that do not contain oestrogen.

Wearing lighter clothing, keeping the bedroom cool at night, using a fan, having cool showers or having a cold drink may be simple measures that help the symptoms of hot flushes and night sweats.

Following a healthy lifestyle, reducing alcohol consumption and giving up smoking are beneficial.  Regular weight bearing exercises and safe sun exposure for Vitamin D production helps protect the bones against osteoporosis.

There is limited evidence on ‘natural’ supplements and safety may be uncertain due to lack of data.  Some woman experience benefits from alternative treatments, however you should seek medical advice if you have troublesome symptoms and before starting treatment.