The menopause occurs in all women. It can occur when the ovaries spontaneously fail to produce the hormones oestrogen and progesterone; when the ovaries fail due to specific treatment such as chemotherapy or radiotherapy; or when the ovaries are removed, often at the time of a hysterectomy.
What is the menopause?
Ovaries naturally fail to produce oestrogen and progesterone when they have few remaining egg cells. At that stage, the ovaries become less able to respond to the pituitary hormones and less oestrogen is produced. The resulting low and changing levels of ovarian hormones, particularly oestrogen, are thought to be the cause of menopausal symptoms in many women.
Menopause means the last menstrual period. Periods stop because the low levels of oestrogen and progesterone do not stimulate the lining of the womb in the normal cycle. Hormone levels can fluctuate for several years before eventually becoming so low that the lining of the womb stays thin and does not bleed.
At what age does the menopause happen?
The average age of the natural menopause is 51 years old, but it can occur much earlier or later.
Menopause occurring before the age of 45 is known as early or premature menopause. This affects 1% of women. Daisy Network Premature Menopause Support Group is a registered charity for women who have experienced a premature menopause.
Early or premature menopause may follow surgery such as a hysterectomy, when the ovaries may be removed along with the womb, or may occur early even if the ovaries are left in place at the time of hysterectomy. Other causes of early or premature menopause include chromosomal disorders, such as Turner’s syndrome and Down’s syndrome; and chemotherapy or radiotherapy.
Women with early or premature menopause have an increased risk of osteoporosis, so they are generally advised to take hormone replacement therapy (HRT) until they reach the average age of the menopause, for both symptom control and bone protective effect.
Late menopause can also occur, but by the age of 54 years old 80% of women will have stopped having periods.
Signs and Symptoms
Symptoms of the menopause can last for a few months or for many years. Some of them are as follows:
- Hot flushes
- Night sweats
- Joints aching
- Mood swings and irritability
- Difficulty concentrating
- Difficulty coping
- Discomfort during sexual intercourse (see our section on Sex in later life for more information)
- Bladder problems, such as passing urine more often, discomfort in passing urine, urine infection and leakage.
Hormone Replacement Therapy (HRT)
In the UK, Hormone Replacement Therapy (HRT) – either oestrogen-only or a combination of progesterone and oestrogen – is used to reduce menopausal symptoms.
There has been some recent concern about the side-effects of HRT. The current advice from the Department of Health is that taking HRT on a short-term basis is a suitable treatment for women to relieve menopausal symptoms, as the benefits outweigh the risks. However, for women taking HRT on a long-term basis, for example to prevent osteoporosis, it should only be prescribed if other treatments are inappropriate or have proven unsuccessful.
For women who have experienced a premature menopause, HRT may be used until they reach the average age of the menopause, when treatment should then be reviewed.
If you have been prescribed HRT and are worried about possible side-effects, make an appointment to see your GP.
There are several complementary medicines and therapies which are said to be helpful in the treatment of menopausal symptoms, including:
- Relaxation techniques
Other Useful Information
Other Useful Organisations
- The Patient Information Centre offers a range of health related information including;
- medical conditions
- procedures and treatments
- details about self help and support groups
- information about complaints procedures
- copies of leaflets
- NHS 111 is the new telephone service which has replaced NHS Direct. You can call 111 when you need medical help fast but it’s not a 999 emergency. NHS 111 is a fast and easy way to get the right help, whatever the time.
- NHS.UK is a website providing health and medical advice, an online symptom checker and a facility for searching for services near you.
Please note – The content on this website is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. If you are feeling unwell, make an appointment to see your GP or contact NHS 111. In an emergency, dial 999.
Last updated: December 10, 2018