Menopause

Menopause means a woman has had her last menstrual period. Most women reach menopause between the ages of 45 and 60, with the average age for Australian women being 51.

Perimenopause is the transition period leading up to – and one year after – the final period. During this phase, cycles often become irregular and early symptoms can begin to appear.

Premature menopause (Primary Ovarian Insufficiency / POI) occurs before age 40 and can be caused by genetic factors, autoimmune conditions, or certain cancer treatments. Women with POI typically require hormone therapy until at least the average age of natural menopause.

Symptoms vary widely. Many women experience mild discomfort, while others find symptoms significantly affect daily life – sometimes persisting for over a decade.

Hot flushes & night sweats: The most common symptom – a sudden feeling of warmth spreading over the face, neck and chest, often with redness and palpitations. Triggers include caffeine, alcohol and hot environments.

Sleep & mood changes: Disrupted sleep, irritability, difficulty concentrating, and low mood are frequently linked to declining oestrogen levels.

Vaginal & urinary symptoms: Vaginal dryness, discomfort during sex, and increased urinary frequency due to thinning of vaginal tissues.

Muscle & joint pain: Aches and joint pain are a common but often overlooked symptom of oestrogen loss, particularly prevalent in Asian women.

Menopause is typically diagnosed based on the absence of menstrual periods and the presence of menopausal symptoms. Blood tests are not usually required unless premature menopause is suspected, or a previous hysterectomy makes symptom-based diagnosis unclear.

A range of options are available depending on your symptoms, health history, and personal preferences.

Lifestyle changes: Regular exercise, a balanced diet, maintaining a healthy weight, and reducing caffeine and alcohol can meaningfully reduce symptom severity. Dressing in layers and sleeping in a cool room can also help manage hot flushes.

Menopausal hormone therapy (MHT): The most effective treatment for menopausal symptoms. MHT eases hot flushes, night sweats and vaginal symptoms, improves bone density, and for women aged 50–60 may reduce cardiovascular risk. Available as tablets, patches, gels, or vaginal preparations.

Complementary therapies: Phytoestrogens (found in soy and legume products) are used by some women, though scientific evidence for effectiveness is limited. Always discuss complementary therapies with your doctor before starting, as they may interact with other medicines.

Note: The right approach is individual. Dose, duration, and type of MHT should reflect your symptoms, health history, and treatment goals – reviewed annually with your doctor.

Menopause increases the long-term risk of two key conditions worth discussing with your doctor:

Osteoporosis: Bone loss accelerates after menopause, increasing the risk of fractures. Prevention begins with adequate calcium, vitamin D, regular exercise, and maintaining a healthy weight.

Cardiovascular disease: The risk of heart disease increases after menopause. Healthy lifestyle choices are the primary preventive measure. Hormone therapy may also reduce cardiovascular risk in women within 10 years of their last period.

Regular health checks – including blood pressure, cholesterol, mammogram, and bone density assessment – are recommended around the time of menopause.

If you’re experiencing menopausal symptoms and would like personalised guidance, Dr Joseph Sgroi is available for consultations in Melbourne. Contact us to arrange an appointment.

How long do menopausal symptoms last?

Most women experience symptoms for up to five years, but for some they persist beyond ten. The duration varies considerably between individuals.

Is MHT safe?

For most women under 60, the benefits of MHT outweigh the risks. Short-term side effects are usually manageable and dose-related. Long-term risks — such as a small increase in breast cancer risk with combined MHT — are modest and not seen for at least seven years. An annual review with your doctor helps ensure the approach remains right for you.

Do I still need contraception during perimenopause?

Yes. You should use contraception for 12 months after your last period if it occurs after age 50, and for 24 months if before age 50.

What is the difference between perimenopause and menopause?

Perimenopause is the transition phase leading up to – and one year after – your final period. Menopause itself refers to the point at which you have had your last menstrual period.

What causes premature menopause?

Premature menopause (POI) before age 40 can be caused by genetic abnormalities, autoimmune or endocrine disorders, and certain cancer treatments. In many cases no cause is identified. Women with POI should seek specialist advice, as hormone therapy is generally recommended until the natural age of menopause.