Friday, March 1, 2024

Menopause guide

The menopause is a normal part of every woman’s aging process which takes place during the 40s and 50s.

Menopause indicates that a woman’s menstrual cycles have ended and that she’s no longer able to conceive naturally. The process generally takes a number of years, but menopause is officially diagnosed when periods have stopped for 12 consecutive months.

It’s a time of significant change for your health and wellbeing. Fluctuating hormones mean that most women will experience some form of menopause symptoms, from hot flushes and nights sweats to mood changes and weight gain.

In this guide

What is menopause?

Menopause is a natural process that generally occurs between the ages of 45 to 55. In the UK, the average age for women to reach menopause is 51.

What are the first signs of menopause?

As women age, oestrogen and progesterone levels begin to decline. As these are the hormones that regulate menstruation, you may begin to notice changes in your periods. They may become lighter, heavier, less frequent, or be longer or shorter than normal. This usually occurs in your 40s and is the first sign of the menopause.

How long does menopause last?

The menopause generally takes place over a number of years, but for some women it can happen very suddenly. It’s common for women to start experiencing symptoms around four years before their periods stop altogether, and these may continue for a few years afterwards too. But, it’s different for everyone and many hidden factors – including genetics and ovarian health – can influence how menopause affects you.

When to see your doctor about the menopause

Many women go through the menopause with no need for any medical support. For others, symptoms can become problematic and affect day-to-day life. If you’re struggling to cope, talk to your GP about the options available to help you manage them. Rarely, menopause is misdiagnosed by practitioners – in these cases, you could consider making a claim and seeking a second opinion elsewhere.

Menopause remedies

Menopause facts and figures

  • Menopause is a natural part of aging that generally occurs between the ages of 45 to 55.
  • It is possible to become pregnant during and after menopause. Use contraception for 12 months after your last period if aged over 50, and 24 months if aged below 50.
  • Common symptoms include menstruation changes, hot flushes, mood changes, sleeping problems, weight gain and vaginal dryness.
  • Treatments include hormone replacement therapy (HRT), natural supplements and complementary therapies. Lifestyle changes, such as improved diet and sleep and exercising, can also be effective.

Menopause symptoms

While the signs of menopause vary from woman to woman, there are some symptoms that often happen as a result of your fluctuating hormone levels. Read through the following common symptoms to get a better idea of what happens during menopause.

  • Hot flushes – suddenly feeling hot and/or sweaty, often around the face, neck and chest. These often occur during the night, known as ‘night sweats’.
  • Mood changes – many women feel more anxious than normal, feel their moods dropping or have difficulty concentrating. In some cases, this can lead to depression, which should always be discussed with your GP.
  • Sleeping problems – symptoms like night sweats and increased anxiety can lead to disturbed sleep and insomnia.
  • Menopause joint pain – joints can become stiffer, causing aches and pains.
  • Weight gain – when the metabolism starts to slow down it can lead to weight gain during menopause.
  • Changes to hair – you may notice your hair thinning during the menopause. Some women grow body hair on the face, check or upper back.
  • Complications with sex – menopause can lead to vaginal dryness, which can make sex uncomfortable. Loss of libido is also a common symptom.

Menopause in numbers

  • In the UK, the average age for women to reach menopause is 51.
  • Around 70% of women will experience some menopause symptoms.
  • Around one in 100 women in the UK go through premature menopause, when periods stop before the age of 40.

What are the stages of menopause?

The menopause takes place over three stages:

Perimenopause – before our periods stop completely, our hormones begin to change in preparation. This is known as the perimenopause or ‘menopause transition’. Some women barely notice it, others experience a range of menopausal symptoms for up to 10 years before the menopause.

Menopause – menopause is reached when a woman doesn’t menstruate for 12 consecutive months. This means the ovaries have stopped releasing eggs and producing most of their oestrogen, marking the end of the reproductive years.

Postmenopause – this is the period following the menopause. It’s common to continue experiencing menopausal symptoms to some degree. This can last up to 10 years, but for many women the symptoms decrease sooner.

What causes menopause?


In most cases, women go through the menopause as a natural part of the aging process when their reproductive hormones start declining during their 40s.

Premature menopause

Around one in 100 women in the UK go through an early menopause, or ‘premature menopause’, when periods stop before the age of 40. When this happens naturally it means that the ovaries aren’t making high enough levels of certain hormones to continue menstruating. This is called premature ovarian failure, and it could be down to genetics, or be caused by chromosome abnormalities, an autoimmune disease or by certain infections, such as tuberculosis, malaria and mumps. Premature menopause can also be the result of certain cancer treatments or a hysterectomy, explained below.


When women have a hysterectomy, their womb (uterus) is surgically removed. There are different types of hysterectomy which remove different parts of the reproductive system. No matter what age you are, and what surgery you have, this causes the periods to stop and it will no longer be possible to become pregnant. If the uterus and ovaries are removed, it will also trigger the menopause.

Cancer treatment

Some cancer treatments can affect how the ovaries function, sometimes causing an early or temporary menopause. These include chemotherapy, hormonal treatments for breast cancer, radiotherapy to the pelvis and surgery to remove both ovaries. If you’re offered cancer treatment, your doctor or cancer specialist will always explain any risks like this that may be involved so you can discuss them properly before going ahead.

Menopause advice

Menopause complications

Oestrogen helps maintain bone calcium levels and bone density, so when these levels drop after menopause it increases the risk of osteoporosis. This can cause the bones to become weak and brittle and can increase the risk of fractures.

This drop in oestrogen levels can also increase the risk of cardiovascular disease, so it’s crucial that you take regular exercise and keep track of your cholesterol levels and blood pressure.

Another unwelcome menopausal complication is when the tissues of your vagina and urethra lose elasticity, which can lead to incontinence and urinary tract infections. It’s a great idea to combat this with regular pelvic floor exercises.

Menopause treatments

The good news is that. while the menopause can be a time of dramatic shifts for your emotional and physical wellbeing, there’s lots of help on offer. When it comes to treatment, there’s no one-size-fits-all approach, so consider all your options to see what works best for you.

Home remedies

Simple lifestyle changes can make a huge difference to menopausal symptoms. For some women, this will be enough to enable them cope with the changes that the menopause brings. For others, these can fit in well alongside medical treatment. Either way, it’s a good idea to start with some simple changes to your lifestyle to see how effective they are. When it comes to diet, there are many foods that help with menopause symptoms. Boost your bone health with food rich in magnesium and boron, including apples, pears, legumes and nuts. Phyto or plant oestrogens act in a similar way to oestrogen, helping to keep hormones in balance. Try to eat more soya milk and flour, linseeds, tofu, tempeh and miso. If your sleep is being affected, turn to our articles on foods to help aid sleep and natural home remedies for sleeplessness. Doing more exercise will not only help you stay in shape physically, it will also boost your mental health and help reduce the risks of cancer, osteoporosis and heart disease.

Over-the-counter treatments

Head to your local chemist or health food shop and you may be surprised at how much is available to help you tackle your symptoms, from natural menopause supplements to lubricants to help with vaginal dryness. Popular remedies include black cohost and sage for hot flushes, St John’s Wort for low moods and anxiety and ginseng to improve sleep. Read our guide on supplements to relieve menopause symptoms for more detailed information on what’s available. It’s always a good idea to get medical advice before taking menopause supplements, especially if you’re also taking medication such as HRT.

Medical treatments

Hormone Replacement Therapy (HRT) is the conventional treatment for relieving menopause symptoms, and it’s proven to be very effective. It works by replacing hormones that are decreasing in your body as you approach the menopause. But there are a number of side effects that need to be considered. These include breast tenderness, headaches and vaginal bleeding, as well as more serious risks like increased risk of blood clots and breast cancer in some women. For these reasons, HRT isn’t for everyone. Some women are advised not to take it, and others prefer to avoid the risks. If your menopausal symptoms are affecting your quality of life, HRT could be a lifeline. Start by talking to your doctor and doing your own research so you can make an informed decision.

Alternative and complementary therapies

If you’re still unsure about HRT, non-prescribed treatments including herbal medicines and complementary therapies such as aromatherapy, acupressure or acupuncture are other options. Before trying these, be aware that the effects of these therapies are not well known. And, if you’re taking other medication it’s always advisable to talk to your doctor before trying anything new. For more advice about what’s on offer, read our guide on 6 ways to treat menopause symptoms without taking HRT.

Did you know?

Insomnia and sleeplessness can be a problem for many women during menopause, sometimes caused by symptoms such as hot flushes keeping you awake at night. It’s important to maintain a regular bedtime routine as this can help you get a more restful night’s sleep.