The main points
- In Australia, the average age of menopause (the last menstrual period) is 51.
- Changes in sex hormones can cause irregular periods before periods stop altogether. People often have other symptoms such as hot flushes, sore joints, low libido and vaginal/internal genital dryness.
- Menopause is a clinical diagnosis based on period changes and menopausal symptoms.
- Menopausal symptoms can be managed by lifestyle changes, psychological support, medication and genital skin care.
- It is recommended that people see a health professional if they have heavy menstrual bleeding during this time, bleeding after sexual intercourse, bleeding after menopause or if they have bothersome menopausal symptoms which negatively impact their quality of life.
What is menopause?
A person is generally considered to have reached menopause 12 months after their final menstrual period. In Australia, the average age of menopause (the last menstrual period) is 51. It most commonly occurs between the ages of 45-55. However, some people experience menopause earlier and later, it varies between individuals.
During menopause, the ovaries start to release fewer eggs and this causes the ovary to make less oestrogen (a female sex hormone). Periods usually become erratic (less regular) before stopping. People often experience symptoms such as hot flushes, sore joints, low libido and vaginal/internal genital dryness.
About 20% of people have no symptoms, while 60% have mild to moderate symptoms. The remaining 20% have severe symptoms that interfere with their daily life.
How is menopause diagnosed?
Menopause is a clinical diagnosis based on period changes and menopausal symptoms. A symptom score sheet can help.
Blood tests to measure hormone levels won't tell you if you are perimenopausal or when you will experience your final period because hormone levels vary widely at this time.
If you are younger than 45 years and your periods are irregular or have stopped, your doctor might measure your hormone levels to understand your situation.
What are some of the symptoms around the time of menopause?
Change in menstrual periods
Irregular periods are an early change in menopause. There can be a change in the length of your cycle. It could mean your period is coming more often or less often. The flow could be heavier or lighter than you’re used to. You also could have some bleeding or spotting between periods. If the bleeding occurs after sexual intercourse or you have bleeding that occurs when you have not had a period for more than 12 months, please see a health professional. These types of changes may need to be further investigated.
Hot flushes and night sweats
Hot flushes and night sweats can range from mild to severe. Some people find these symptoms disturb their sleep – they may even need to change the sheets during the night because of heavy sweating.
Some people have problems sleeping even if they don’t have hot flushes and night sweats.
Changing hormone levels can affect your body clock or make it more difficult for you to fall asleep or stay asleep.
Anxiety or mood changes
Hormonal changes can impact your mood. You might also feel upset, anxious, irritable, sad or angry in situations that would not have bothered you before.
Hormonal changes, vasomotor symptoms and sleep deprivation can contribute to forgetfulness, and trouble concentrating or making decisions.
Some people feel discomfort in their vagina/internal genitals, especially during sexual intercourse. This is a common symptom caused by a decrease in moisture produced by the lining of the vagina/internal genitals.
Overactive bladder or discomfort
People can also find they have bladder changes during menopause. This might make you feel the need to urinate more often, you can’t “hold on”, or your bladder might feel full and uncomfortable.
Pain in your joints and tiredness
Hormonal changes of menopause can cause some people to feel pain in their joints or make them feel more tired than usual.
How can I manage my menopause?
During this time, it is important to take care of your general health by quitting smoking, limiting alcohol intake, maintaining a healthy diet and having an adequate calcium intake (to help prevent loss of bone density). This is a minimum of 1200g per day, preferably from dietary sources. Weight-bearing exercises. Regular health checks, including mammograms, bowel cancer screening and cervical screening tests are also important.
If your symptoms are bothering you, a health professional can help. There are many treatment options available including:
- Lifestyle changes
- Avoid triggers - Try to avoid things that trigger your hot flushes or make them worse. For example, spicy food, hot drinks and caffeine
- Keeping cool
- During the day, try to:
- wear layered clothing so you can take some clothes off if you get hot
- wear lightweight, looser-fitting clothes made of natural fibres
- carry a hand fan or water spray bottle to cool down if needed
- control the air temperature at home through air-conditioning or fans
- drink cold drinks.
- During the day, try to:
- At night, try to:
- wear breathable, light pyjamas
- use cotton sheets on your bed
- use separate bed covers from your partner
- sleep with the window open
- use a fan in your bedroom or adjust your air-conditioning to a cooler temperature
- use a cold pack under your pillow or place one in your bed before going to sleep.
- Psychological support
- Cognitive behavioural therapy (CBT) can help with managing hot flushes and night sweats. While CBT doesn't usually reduce the frequency of hot flushes, it can reduce their impact. CBT can be provided online or with a psychologist.
- Menopausal Hormone Therapy
- Non-hormonal medication options
- Genital skincare
Talk to a health professional if you are worried about:
- heavy bleeding
- bleeding after sexual intercourse
- bleeding after menopause
- menopausal symptoms, such as hot flushes, that interfere with your daily life
Do I need contraception?
During menopause, women and people with a uterus should also consider contraception, because you're not considered infertile until:
- a year after your last period, if you're aged over 50 when you have your last period
- two years after your last period, if you're aged under 50 when you have your last period.
Menopausal Hormone Therapy does not provide contraception.
After the age of 50 the combined hormonal contraceptive pill and ring, and the contraceptive injection are not recommended. Options may include IUDs, the implant, progestogen-only pills and condoms. Speak with your doctor, nurse, or book an appointment at SHV to learn more.
Where to get more information and support
- Sexual Health Victoria
- A doctor or nurse
- A gynaecologist
- An endocrinologist
- Your local community health service
- Australasian Menopause Society
- Jean Hailes
- Multicultural Centre for Women’s Health - for culturally and linguistically diverse women.
- The Women's (The Royal Women’s Hospital)
- Healthy Bones Australia Factsheets including information on calcium
- National Bowel Cancer Screening Program
- National Cervical Cancer Screening Program
If you are using the internet for information, only use reliable and reputable websites, such as the ones provided above.