Menopause is when you have your final period. Menopause is a normal part of ageing.
In Australia, the average age of menopause is 51. It’s normal to reach menopause between the ages of 45 and 55 years, but some women reach menopause earlier or later than this.
Perimenopause is the time leading up to menopause, and postmenopause is the time after your final period.
How do you know if you’ve reached menopause?
What causes menopause?
Hormones and menopause
Perimenopause, menopause and postmenopause
Diagnosing perimenopause and menopause
When to see your doctor
It can be hard to know if you’ve reached menopause, because your periods might be irregular during this time. It’s likely you’ve reached menopause if you haven’t had a period for 12 months.
Menopause is caused by a drop in certain hormones such as oestrogen. From about 35 to 40 years of age, you have fewer eggs left in your ovaries and don’t ovulate (release an egg from your ovary) as often. Menopause means your ovulation and periods stop.
You might reach menopause at the expected age, or you might have premature or early menopause.
Hormones are chemicals made in your body that relay messages through your bloodstream. For example, your hormones tell your body to eat and sleep.
The three main hormones that change as you approach menopause are:
The change in hormone levels can lead to different menopausal symptoms.
Oestrogen is produced from the cells around the eggs in your ovaries. It is one of the main female sex hormones. Oestrogen plays an important role in the female body. For example, it’s needed for the menstrual cycle, fertility, pregnancy and bone strength. It also helps with brain function and bladder control and protects you from heart disease.
Your oestrogen production changes in the lead-up to menopause. As you approach your final period, your number of eggs decreases, and oestrogen levels drop by up to 90%.
Progesterone is responsible for things like mucus levels in your cervix, acidity levels in your vagina and milk cells in your breasts. It can also impact your mood.
Progesterone is produced when an egg is released. It prepares your uterus for a fertilised egg and pregnancy. As you approach your final period, your progesterone levels decrease.
Testosterone is produced by your ovaries and other parts of your body.
You might think testosterone is a male hormone, but it also plays an important role in women’s sexual desire, emotional wellbeing and bone and muscle strength.
Testosterone decreases gradually with age. In some women, levels fall by half between the ages of 20 and 40.
This video explains what happens to your body at menopause and how to manage menopausal symptoms.
Menopause is when you have your final period. Most women reach menopause between the ages of 45 and 55 years. In Australia, the average age for women to reach menopause is 51 to 52. Some women reach menopause as late as 60.
Perimenopause is the time leading up to menopause, when your body reaches the end of its reproductive years. And postmenopause is the time after your final period.
Perimenopause usually happens sometime in your 40s. On average, it lasts 4 to 6 years, but it can last from one to 10 years.
During this time, your ovaries begin to run out of eggs. This causes hormone levels, particularly oestrogen, to change, causing different symptoms, like hot flushes and mood changes.
Changing hormones can also affect your menstrual cycle. For example, your periods may be irregular, shorter (or longer), lighter (or heavier), or they may not come for a few months.
Some months you may ovulate and other months you may not. You may even ovulate twice in a cycle.
Even though fertility is lower in your 40s and 50s, it is possible to become pregnant. This is because you still ovulate during perimenopause.
The chance of pregnancy in women aged 45 to 49 years is about 2% to 3% per year. After the age of 50, it’s less than 1%. But it’s important to remember that every woman’s fertility is different.
If you don’t want to become pregnant, you should continue to use contraception until you’ve had:
Menopausal hormone therapy (MHT) is not a contraceptive. You shouldn’t rely on MHT to prevent pregnancy.
As your body adjusts to lower hormone levels:
It’s important to look after your health after menopause, as changes due to ageing and lower levels of oestrogen can increase your risk of developing certain health conditions.
Before menopause, women have a lower risk of heart disease than men. But, as women age and their oestrogen levels fall, their risk of heart disease increases. Heart disease is one of the leading causes of death for women in Australia. Heart disease also claims 3 times as many lives as breast cancer.
After menopause, you may be more likely to develop risk factors for heart disease, including:
You can reduce the risk of heart disease by having a healthy lifestyle.
You can also see your doctor for a heart check. They will take your blood pressure and test your blood to determine your risk factors. If you have a high risk of heart disease, your doctor may prescribe medicine for high blood pressure and cholesterol.
Read our articles about:
After menopause, lower levels of oestrogen affect women’s bone health, which puts them at greater risk of developing osteoporosis.
Osteoporosis is a condition where bones weaken. This can cause bones to break (fracture) easily. About half of all women over 60 are impacted by osteoporosis.
On average, women lose up to 10% of their bone mass in the first 5 years after menopause. After this, the rate of bone loss slows.
It’s important to have regular bone health checks. Your doctor might ask about your medical history, check risk factors for osteoporosis and do a bone density test. Note that Medicare rebates for bone density tests are only available for women with certain risk factors or those over 70 years of age.
Learn how to reduce your risk of osteoporosis with a healthy diet and exercise.
After menopause, you may notice extra body fat around your belly. This can increase your risk of health conditions such as type 2 diabetes, heart disease, dementia and some cancers.
It’s important to maintain a healthy weight at this stage of life.
Learn more about how to achieve and maintain a healthy weight.
Read our article about weight gain at menopause.
Lower levels of oestrogen after menopause can affect your bladder health. For example, it may cause:
These factors can lead to incontinence, for example, wee leakage. You don’t have to put up with incontinence. You can ask your doctor for a referral to a continence nurse or pelvic floor physiotherapist to help strengthen your pelvic floor muscles.
Sometimes vaginal and vulval symptoms continue after menopause. For example, vaginal dryness, thinning of the vaginal walls and painful sex. If these symptoms bother you, ask your doctor about treatment options.
After menopause, you still need regular cervical screening tests (similar to Pap smears) until you’re 75. You will need to get tested every 5 years if your results are normal. If your results are abnormal, you will need to do tests more often.
Bleeding from your vagina after menopause is not normal. If you have any bleeding, spotting or staining after menopause, talk to your doctor.
If you don’t want to get pregnant and you’re younger than 50 years of age, you should use contraception for at least 2 years after your final period.
If you don’t want to get pregnant and you’re 50 or older, you should use contraception for at least one year after your final period.
It’s important to know that MHT is not a contraceptive.
There are many types of contraception available. Speak to your doctor to learn more about the different options.
The risk of breast cancer increases as you get older. About 79% of all new cases of breast cancer happen in women over the age of 50.
It’s important to know the normal look and feel of your breasts and talk to your doctor if you notice any changes.
If you are 50 years or older and have no breast changes, you should have a breast screen, or mammogram, every 2 years. Regular mammograms are the best way to find breast cancer early. Ask your doctor for more information.
Learn more about breast self-checks and cancer screening.
Ask your doctor to check if you are perimenopausal or have reached menopause. If you are at the expected age, have experienced some symptoms and have irregular periods, it’s likely you are perimenopausal. If you haven’t had a period for 12 months, you have probably reached menopause.
The best way to predict menopause is to keep track of your symptoms. If your periods are irregular and your symptoms are getting worse, it’s likely you are approaching menopause.
Blood tests cannot accurately predict when menopause will happen. It’s not standard practice for doctors to measure hormone levels in the diagnosis of perimenopause or menopause.
If you’re younger than 45 years and your periods are irregular or have stopped, your doctor might measure your hormone levels to understand what might be causing this change.
Saliva tests are not an accurate way of predicting menopause, as changing hormone levels can affect the results.
Talk to your doctor if you are worried about:
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This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
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