The Menopause – an overview

What is the Menopause?

Women giving the menopause the thumbs upThe term ‘menopause’ is used to describe the final cessation of periods which signal an end to a woman’s fertility. Ovulation and the levels of oestrogen in a woman’s body decline as the ovaries cease egg production.
This can happen naturally when a woman is in her forties or fifties, prematurely (before the age of forty) or as a result of illness, medical or surgical treatment affecting the ovaries.

When does the menopause begin?

Menopausal symptoms can be experienced from the onset of the perimenopausal or pre-menopausal period when a woman’s periods start to become irregular and slowly decline. During the perimenopause, a woman’s periods may become lighter or heavier than normal and harder to predict due to the change in frequency.

Not all women experience all the symptoms typical of the menopause, 20% of women do not experience any. Some may experience very few issues while others are faced with a plethora of symptoms in all their glory.


  • Hot flushes including night sweats
  • Insomnia leading to daytime fatigue and irritability
  • Mood changes, particularly low mood
  • Forgetfulness
  • Low sex drive
  • Tenderness of the breasts
  • Vaginal itching, dryness or soreness
  • General aches and pains, leg cramp and stiff joints
  • Reduced muscle mass and increased risk of osteoporosis
  • Urinary tract infections which may be recurrent

Hormone Replacement

Although the menopause is a natural process, the changes it brings can be distressing for many women to the extent that they need hormone replacement therapy or HRT.

Hormone therapy works by replacing the oestrogen in a woman’s body. Another hormone, progesterone, is given alongside oestrogen to reduce the risk of cancer of the womb. Women who have undergone a hysterectomy can be treated with oestrogen alone.

HRT can be taken orally in tablet form; via implants or topically as patches or gel.

Although HRT relieves a number of the unpleasant symptoms of the menopause, side effects include headache, bleeding from the vagina and tenderness of the breasts. In some women on HRT the risk of blood clots and breast cancer can increase.

Dealing with Symptoms

Vaginal discomfort can be relieved by direct oestrogen treatment in the form of pessaries, cream or a vaginal ring. All are safe to use if you are taking HRT and in conjunction with vaginal lubricants or moisturisers available over the counter.