Menopause is the stage of life when menstrual periods permanently stop due to natural decline in ovarian hormone production.
It is diagnosed when a woman has gone 12 consecutive months without a menstrual period.
The transition leading up to menopause is known as perimenopause, during which hormone levels fluctuate and symptoms may begin to appear.
Menopause most commonly occurs between 45 and 55 years of age.
Symptoms
Symptoms vary widely and may include:
- Hot flushes
- Night sweats
- Sleep disturbance
- Mood changes
- Vaginal dryness
- Reduced libido
- Brain fog or difficulty concentrating
Some women experience only mild symptoms, while others may have more significant effects on daily life.
Causes
Menopause occurs when the ovaries gradually stop producing the hormones oestrogen and progesterone, which regulate the menstrual cycle and ovulation. As hormone levels decline, ovulation stops and menstrual periods eventually cease.
Menopause is a natural biological process, most commonly occurring between 45 and 55 years of age, with the average age around 51.
Several different processes can lead to menopause.
Diagnosis
Dr Dunn can identify your transition to menopause with your signs and symptoms. To confirm the diagnosis, Dr Dunn may order blood tests to check your levels of follicle-stimulating hormone (FSH) and oestrogen (oestradiol), as a decrease in the level of these hormones can project menopause.
Lifestyle Remedies
Some of these lifestyle remedies can also help you reduce or prevent the symptoms of menopause.
- Cool off hot flushes by drinking cold water or staying in a cool room. Identify factors that trigger your hot flushes, like hot beverages, alcohol, caffeine, and spicy foods, and try to avoid them.
- Use vaginal lubricants to help you with vaginal dryness and discomfort. Coconut Oil and “Olive & Bee” are natural, low irritant lubricants.
- Reduce stress, get adequate sleep, eat healthy, stay active and don’t smoke.
- Exercise regularly. Pelvic floor exercises can help you strengthen your pelvic floor muscles, improve vaginal blood flow and reduce vaginal symptoms of the menopause.
Treatment
Treatment for menopause focuses on relieving symptoms and supporting long-term health during the transition that occurs as ovarian hormone production declines. Management is highly individualised and depends on a woman’s symptoms, medical history, and personal preferences.
Many women experience only mild symptoms and may not require medical treatment. For others, symptoms such as hot flushes, sleep disturbance, or vaginal dryness can significantly affect quality of life and may benefit from treatment.
Menopausal Hormone Therapy:
Menopausal hormone therapy (MHT) — sometimes referred to as hormone replacement therapy (HRT) — is one of the most effective treatments for moderate to severe menopausal symptoms.
MHT replaces the hormones that decline during menopause, primarily oestrogen, and in some cases progesterone.
Potential benefits of MHT may include:
- Reduction in hot flushes and night sweats
- Improved sleep and mood
- Relief of vaginal dryness and discomfort
- Protection against bone loss and osteoporosis
Women who still have a uterus usually require both oestrogen and progesterone, as progesterone protects the uterine lining from excessive stimulation by oestrogen.
MHT is typically considered for women with significant symptoms within the early years of menopause, following a careful medical assessment.
Vaginal Oestrogen:
Some women primarily experience genitourinary symptoms of menopause, including:
- Vaginal dryness
- Discomfort during intercourse
- Urinary urgency or recurrent urinary infections
In these cases, local vaginal oestrogen therapy can be highly effective. This treatment delivers low doses of oestrogen directly to vaginal tissues, helping restore vaginal moisture, elasticity and tissue health.
Because the hormone is applied locally, systemic absorption is minimal.
Antidepressants/ Pain medications: Low-dose antidepressants and gabapentin can help you manage hot flushes when menopausal hormone therapy is not advisable for you, and will also help improve your mood.
Vaginal Laser: Some doctors and patients report an improvement in vaginal menopausal symtoms with vaginal laser treatment. At this stage, there is not enough good quality evidence for RANZCOG (the Royal Australian and New Zealand College of Obstetricians and Gynaecologists) to recommend this treatment or verify its safety.
