Menopause is when you have your final menstrual period. Your periods stop because your ovaries stop producing certain hormones and stop producing eggs.

Read more about hormones and menopause.

In Australia, most women (around 3 in 4) reach natural menopause between the ages of 45 and 55 years, but it can happen earlier or later. The average age of natural menopause is 51.

Some women (around 1 in 5) experience premature or early menopause, which is when menopause occurs before the age of 45 years.

• Premature menopause occurs when menopause happens before the age of 40 years.
• Early menopause occurs when menopause happens between 40 and 45 years of age.

Some women experience medically induced menopause, which is when menopause is caused by medical treatment, such as surgery, chemotherapy, radiotherapy or some medicines.

Some people use the words menopause or the menopause transition to describe the whole transition from perimenopause (before the final menstrual period) to postmenopause (after the final menstrual period).

Perimenopause refers to the time from when your periods start changing, or you start having menopausal symptoms, to one year after your final menstrual period (menopause).

Some people use the word menopause to cover the whole transition from perimenopause to postmenopause.

During perimenopause, the hormones produced in your ovaries change. This causes your periods to change and, for some women, menopausal symptoms to start.

In Australia, perimenopause usually starts at around the age of 47. On average, it lasts 4 to 6 years, but for some women it could be shorter or longer.

During perimenopause, you might still ovulate (produce an egg) some months. This is why it is important to consider fertility and contraception during perimenopause.

When to see your doctor

Talk to your doctor if:

• you feel very tired or fatigued (to rule out low iron levels from heavy periods)
• you have symptoms that are interfering with your daily activities (including exercise, work, your relationships or your quality of life)
• you have increased premenstrual syndrome (PMS) symptoms during perimenopause
• you are worried about your emotional or mental health.

Postmenopause starts one year after your final period.

You are in postmenopause (that is, you are postmenopausal) for the rest of your life.

As your body adjusts to lower hormone levels you might have fewer or less troubling menopausal symptoms. For some women, menopausal symptoms continue into postmenopause.

It’s important to look after your health after menopause. Menopause, ageing or a combination of both increases your risk of developing certain health conditions.

When to see your doctor

Talk to your doctor if you:

• have a period or bleeding from the vagina after menopause (more than 12 months after your last period)
• have symptoms that are interfering with your daily activities (including exercise, work, your relationships or your quality of life)
• are worried about your emotional or mental health.

The most reliable sign you are in perimenopause (that is, you are perimenopausal) is if your menstrual periods have become:

• irregular
• shorter or longer than usual
• lighter or heavier than usual
• absent for a few months.

Some women might start to experience menopausal symptoms in perimenopause. Hot flushes and night sweats are the most common symptoms.

It is more difficult to know if you have reached menopause if you do not have menstrual periods. For example, you might not have periods because you use an IUD (intrauterine device) for contraception, or you have had an operation to remove your uterus (hysterectomy). You can:

• keep a detailed journal (a record) of any menopausal symptoms, such as when they occurred, how they affected you) for at least 3 months
• take the journal to your doctor, who can use this information to consider further tests.

It’s important to remember that symptoms and health issues at midlife (from age 45 to 55) are not always due to perimenopause or menopause. However, midlife is a good time to see your doctor to protect your future health and wellbeing, even if you are not experiencing any symptoms.

Use the Perimenopause and menopause symptom checklist as a tool to help identify your symptoms.

When to see your doctor

Talk to your doctor if you:

• are younger than 45 and your periods are irregular or have stopped
• have symptoms that are interfering with your daily activities (including exercise, work, your relationships or your quality of life)
• are worried about your emotional or mental health.

Tests to diagnose perimenopause

If you are in the expected age range for menopause (45 to 55 years), it is not usual for a doctor to measure your hormone levels to diagnose perimenopause. Your doctor will assess your symptoms and any changes to your periods.

Your doctor might do blood tests to check your overall health or to rule out any other causes of your symptoms.

If you are younger than 45 years and your periods are irregular or have stopped, your doctor will probably measure your hormone levels to understand what’s causing the change.

Some companies sell blood or saliva tests to do at home to diagnose perimenopause or predict when menopause will happen. These tests are not recommended.

You have reached menopause if you haven’t had a period for 12 months.

It’s a good idea to start tracking your periods when they start changing, so you know when 12 months have passed since you last had a period.

After you reach menopause, you are in postmenopause (that is, you are postmenopausal) for the rest of your life.

It is more difficult to know if you have reached menopause if you do not have periods. For example, you might not have periods because you use an IUD (intrauterine device) for contraception, or you have had an operation to remove your uterus (hysterectomy). You can:

• keep a detailed journal (a record) of any menopausal symptoms, such as when they occurred, how they affected you) for at least 3 months
• take the journal to your doctor, who can use this information to consider further tests.

It’s important to remember that symptoms and health issues at midlife (from age 45 to 55) are not always due to menopause. However, midlife is a good time to see your doctor and get an overall health check, even if you are not experiencing any symptoms.

Use the Perimenopause and menopause symptom checklist as a tool to help identify your symptoms.

When to see your doctor

Talk to your doctor if you:

• are younger than 45 and your periods are irregular or have stopped
• have symptoms that are interfering with your daily activities (including exercise, work, your relationships or your quality of life)
• are worried about your emotional or mental health
• have not had a period for 12 months, and you then have a period or bleeding from the vagina.

Tests to diagnose menopause

If you are in the expected age range for menopause (45 to 55 years), it is not usual for a doctor to measure your hormone levels to diagnose menopause. Your doctor will assess your symptoms and any changes to your periods.

Your doctor might do blood tests to check your overall health or to rule out any other causes of your symptoms.

If you are younger than 45 years and your periods are irregular or have stopped, your doctor will probably measure your hormone levels to understand what’s causing the change.

Some companies sell blood or saliva tests to do at home to diagnose menopause or predict when menopause will happen. These tests are not recommended.

Use this handy checklist to track your menopausal symptoms. Tick the boxes to show which symptoms are bothering you. Take the checklist with you to your next medical appointment.

Watch this video about common menopausal symptoms

Professor Rodney Baber, Professor of Obstetrics and Gynaecology, University of Sydney, describes the most common symptoms that women in Australia experience around the time of menopause.

Hormones are chemicals, made in your body, that relay messages inside your body. They control essential functions, like regulating sleep or hunger.

The main hormones that change as you approach menopause are estrogen and progesterone. During perimenopause, the amounts of estrogen and progesterone made by the ovaries swing up and down, causing menopausal symptoms. After menopause, very little estrogen or progesterone is produced by the ovaries.

Another hormone produced in the ovaries is testosterone. Testosterone does not change because of menopause but starts decreasing in women from around age 18.

Estrogen

Estrogen is produced in your ovaries. It is one of the main female sex hormones and plays an important role in the female body.

Estrogen is needed for:

• the menstrual cycle
• fertility
• pregnancy
• bone strength.

It also helps with brain function and bladder control, and protects you from heart disease.

During perimenopause, estrogen production from the ovaries swings up and down, leading to menopausal symptoms. After menopause, estrogen production from the ovaries drops to almost nothing.

Progesterone

Progesterone is also produced in your ovaries. This female sex hormone plays a role in:

• the menstrual cycle (preparing the endometrium for pregnancy)
• fertility
• pregnancy
• mood
• promoting sleep.

During perimenopause, the amount of progesterone produced by your ovaries swings up and down. After menopause, the amount of progesterone produced by the ovaries drops almost to nothing.

Testosterone

Testosterone is produced by your ovaries but levels do not change in menopause.

In women, testosterone levels gradually get lower with age. They drop by about a quarter between the ages of 18 and 39 years, and another quarter between the ages of 40 and 59 years.

Then they start to gently rise again from your 60s.

You might have heard that women’s testosterone levels drop significantly when they reach menopause, but this is not true. At menopause, estrogen and progesterone drop significantly.

Testosterone is not one of the main female hormones but it does have a role in women’s:

• sex drive (libido)
• emotional wellbeing
• bone and muscle strength.

Your doctor might suggest testosterone therapy to help with loss of sex drive.

You can become pregnant during perimenopause because you might continue to ovulate (produce eggs), even if your periods are irregular.

Although fertility declines with age, it’s important to use contraception around the time of menopause if you don’t want to become pregnant.

How long should you use contraception?

If you’re under 50, use contraception until you’ve had 2 years without a period.

If you’re over 50, continue to use contraception until you’ve had one year without a period.

It’s important to know that menopausal hormone therapy (MHT) is not a contraceptive.

There are many types of contraceptive options available. Ask your doctor for more information.

Perimenopause

Talk to your doctor if you:

• feel very tired or exhausted
• are younger than 45 and your periods are irregular or have stopped
• have increased premenstrual syndrome (PMS) symptoms
• have symptoms that are interfering with your daily activities (including exercise, work, your relationships or your quality of life)
• are worried about your emotional or mental health.

Postmenopause

Talk to your doctor if you:

• have a period or bleeding from the vagina after menopause (more than 12 months after your last period)
• have symptoms that are interfering with your daily activities (including exercise, work, your relationships or your quality of life)
• are worried about your emotional or mental health.

Learn about the premature and early menopause, including the causes and how to manage symptoms.  

Learn more about medically induced menopause, including what you can do to ease symptoms and reduce health risks.

Learn more about treatments for specific menopausal symptoms.

Learn more about different ways to manage your symptoms, from medical treatments to lifestyle changes.  

Learn how to look after your physical and mental health around the time of menopause.

Learn how to support your partner during perimenopause and menopause.