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What happens during the menopause?
The climacteric, or menopausal transition, is the time when the ovaries gradually work less and periods eventually stop. The menopause itself is the last period: we say it has happened when there has been no bleeding for 12 months in a row, with no other cause. For most women, this happens between the ages of 45 and 55.
Symptoms often start years earlier, while periods are still happening but changing (perimenopause). Some women have hardly any symptoms; for others, they make daily life harder for several years. If the menopause happens before the age of 40, it is considered early; in that case, a medical assessment is especially important.
What symptoms can we help with?
- Hot flushes and night sweats: if they disrupt your days or wake you at night.
- Changes in bleeding: periods that are less or more frequent, heavier or lighter.
- Sleep problems and tiredness: difficulty falling asleep, waking often, exhaustion during the day.
- Mood changes: irritability, anxiety, low mood, forgetfulness or difficulty concentrating.
- Vaginal and urinary symptoms: dryness, burning, painful sex, needing to pass urine more often, leaking urine.
- Physical changes: weight gain, joint and muscle pain, thinning hair, dry skin, reduced sex drive.
The menopause also affects health in the longer term: bone density can fall, raising the risk of osteoporosis and fractures, and the risk of heart and circulatory disease also rises. So the visit is about prevention, too.
When should you not wait to be seen?
- if you notice any bleeding after the menopause, that is, after at least 12 months without bleeding, even a single light spotting;
- if your periods become much heavier than before;
- if you still have irregular or heavy bleeding after six months on hormone replacement therapy;
- if you have palpitations;
- if symptoms suggesting the menopause appear before the age of 45.
These do not necessarily mean a serious illness, but they do need a medical assessment.
What happens during the examination?
- A detailed conversation. We talk through your symptoms, changes in your cycle, your medical history, family risks, the medicines you take, and what bothers you most in daily life.
- Examination. Depending on your symptoms, this may include a gynaecological examination, an ultrasound or screening tests.
- Blood tests, if needed. Over the age of 45, the menopause can usually be recognised from the symptoms, because hormone levels fluctuate strongly at this time and a single measurement tells us little. In younger women, or to rule out other causes, a laboratory test can be useful.
- A shared plan. Based on the results, we discuss the options, and also when it makes sense to come back for a check-up.
What treatment options are there?
There is no single solution that suits everyone. The choice depends on your symptoms, your age, your medical history and your own preferences.
- Lifestyle: regular exercise, sleep habits and a balanced diet can help a lot. Our dietitian can support you with this too.
- Hormone replacement therapy: a treatment that can ease hot flushes and other menopausal symptoms. We always weigh the benefits and risks for you personally, and this includes choosing the product and how it is taken.
- Non-hormonal treatment: there are options for those who do not want, or cannot have, hormone replacement therapy.
- Local treatment: vaginal dryness and related symptoms can also be treated directly.
- Emotional support: if mood symptoms come to the fore, our psychologist colleagues can also help.
How should you prepare for the examination?
- Note the dates of your last periods and what the bleeding was like.
- Write down your symptoms: when they started, how often they happen, and what makes them better or worse.
- Bring your previous test results (for example gynaecological screening, mammography, bone density scan, laboratory results).
- Make a list of the medicines, vitamins and dietary supplements you take.
- Think about whether anyone in your family has had thrombosis, breast cancer, osteoporosis or early heart disease.
Let’s take the first step together
When booking, just let us know briefly that you would like to come to the Menopause Centre. Our team will help you choose a suitable time and tell you the price of the consultation.
Clinical background
Sources for this general information:
