Menopause

Menopause

Menopause is when a woman’s periods stop for 12 months in a row and do not come back. It is a natural stage of life.

When does it happen?

1. Most women reach menopause around 50 years old.
2. About 1 in 10 women reach it before 46.
3. Family history matters – if your mother or sisters had an early menopause, you are more likely to as well.
4. Smoking can bring menopause 1–2 years earlier.
5. The age of menopause is not affected by using the pill or by the number of pregnancies.

The transition (perimenopause)

1. The time before and after your final period (usually a few years).
2. Periods may become irregular, heavier or lighter.
3. Fertility declines until it stops.

Common symptoms

1. Hot flushes and night sweats.
2. Trouble sleeping.
3. Mood changes, irritability, anxiety.
4. Vaginal dryness or discomfort with sex.
5. Symptoms may last 1–2 years; in some women they last longer.

Other causes of period changes

Sometimes missed or irregular periods are due to:

1. Pregnancy, thyroid problems, polycystic ovary syndrome (PCOS).
2. Rarely, premature ovarian failure (menopause before age 40).

Tests

Often no tests are needed if you are over 45 and your periods have stopped.

Tests may be used if:

1. You are under 45.
2. Symptoms are unclear.
3. Other conditions (e.g. thyroid problems) need to be excluded.

Tests may include:

1. Hormone tests (FSH, LH, oestrogen).
2. Thyroid function test.
3. Pregnancy test if younger.
4. Bone scan (DEXA) if at risk of osteoporosis.

Treatment Plan

1. Lifestyle advice
2. Regular exercise, healthy diet, limit alcohol, stop smoking.
3. Sleep hygiene, stress reduction strategies.
4. Non-hormonal options
5. Vaginal lubricants/moisturisers for dryness.
6. SSRIs/SNRIs, gabapentin, clonidine for vasomotor symptoms if HRT unsuitable.
7. Hormone Replacement Therapy (HRT)
8. Oestrogen-only therapy (if hysterectomy).
9. Combined oestrogen + progesterone (if intact uterus).
10. Transdermal oestrogen preferred if ↑ risk of VTE.
11. Review risks/benefits: breast cancer, VTE, stroke, cardiovascular risk.
12. Bone health
13. Calcium, vitamin D supplementation if deficient.
14. Weight-bearing exercise.
15. Consider bisphosphonates if osteoporosis confirmed.
16. Monitoring & Follow-up
17. Review at 3 months, then annually.
18. Assess symptom control, side effects, blood pressure, weight, breast exams.
19. Ongoing screening: mammogram, cervical screening, DEXA as indicated.

Regular check-ups are important to make sure treatment is safe and effective. To discuss your symptoms with one of our GPs, book a consultation today on https://aussiescripts.com.au/telehealth-consultations