For a long time, menopause was something women were expected to endure quietly. Hot flushes were joked about, mood changes were dismissed and many women spent years struggling with symptoms that affected their sleep, work and relationships without ever discussing them with a doctor. That silence is finally lifting.
Today, there is far greater awareness of the impact menopause can have and the range of options available to manage it. For many women, treatments such as menopausal hormone therapy can significantly improve quality of life, while others prefer lifestyle changes or non-hormonal options. Understanding the choices is the first step towards finding the right support.
What menopause actually is
Menopause marks the end of menstrual periods and reproductive years. It is officially confirmed when a woman has gone twelve months without a period. In Australia, most women reach menopause in their late forties or early fifties, although it can happen earlier.
The years leading up to menopause are known as perimenopause. During this time, hormone levels fluctuate, and many women begin to notice symptoms. Perimenopause can last several years.
Some women experience menopause earlier due to surgery, cancer treatment or other medical reasons.
Common symptoms
Menopause affects women differently. Some experience few symptoms, while others find them severe and disruptive.
Common symptoms include hot flushes and night sweats, sleep disturbances, mood changes such as irritability, anxiety or low mood, brain fog and difficulty concentrating, vaginal dryness and discomfort, reduced libido, joint aches and changes in menstrual patterns during perimenopause.
Many women do not realise that some of these symptoms are linked to menopause, particularly psychological changes and joint pain.
Long-term health considerations
Falling oestrogen levels after menopause can affect long-term health. Bone density declines more quickly, increasing the risk of osteoporosis. Cardiovascular risk also rises.
Regular check-ups with a GP, including discussions about bone health, heart health and screening tests, become increasingly important.
Menopausal hormone therapy
Menopausal hormone therapy, sometimes called MHT or HRT, replaces hormones the body produces less of during menopause. It is considered the most effective treatment for hot flushes and night sweats and can help with other symptoms such as sleep disturbance and vaginal dryness.
MHT comes in various forms, including tablets, patches, gels and vaginal preparations. The right type depends on individual circumstances, such as whether a woman still has her uterus and her overall health.
Concerns about MHT were widespread for many years following early research findings. Since then, further research has given a more nuanced understanding of benefits and risks. For many healthy women experiencing troublesome symptoms around the time of menopause, the benefits may outweigh the risks. However, MHT is not suitable for everyone, and decisions should be made with a doctor who can consider personal and family medical history.
Non-hormonal options
For women who cannot or prefer not to use hormone therapy, other options exist. Certain prescription medications can help reduce hot flushes. Vaginal moisturisers and lubricants can relieve dryness. Cognitive behavioural therapy has been shown to help some women manage symptoms such as hot flushes and sleep problems.
Lifestyle approaches
Healthy habits can support wellbeing during menopause. Regular physical activity, including weight-bearing exercise, supports bone health, mood and sleep. A balanced diet rich in calcium and vitamin D helps protect bones.
Reducing alcohol, caffeine and spicy foods may help some women with hot flushes. Good sleep habits, stress management and staying socially connected also make a difference.
Menopause at work
Many women are working through menopause, often at the peak of their careers. Symptoms can affect concentration, confidence and comfort at work. Increasingly, employers are recognising the importance of menopause-friendly workplaces, with flexible arrangements, temperature control and supportive policies.
Preparing for your appointment
Getting the most out of a medical appointment about menopause often comes down to preparation. Before you go, write down your symptoms, how often they occur and how they affect your sleep, work and relationships. Note any changes in your periods, as well as medications and supplements you take. Think about your family history, including breast cancer, heart disease, blood clots and osteoporosis, as these can influence treatment options. Bring a list of questions, and do not be afraid to ask for a longer appointment or a referral to a doctor with a particular interest in menopause.
Seeking support
If symptoms are affecting your life, talk to a GP or women’s health specialist. Keeping a diary of symptoms can help guide the conversation.
Remember that support is available. Menopause is a natural life stage, but suffering through it in silence does not have to be part of the experience.
