Menopause is defined as the absence of periods for 12 months and typically occurs around age 51 in Australia. Most women start experiencing symptoms of perimenopause up to 10 years before their periods stop.

The list of symptoms is endless but the most commonly reported are:

• Hot flushes and night sweats.
• Irritability, mood changes including depression and anxiety.
• Brain fog, difficulty concentrating and remembering things.
• Dry vulva and vagina like you have a urinary tract infection all the time.
• Decreased libido and sexual desire.
• Sleep disturbances including insomnia or broken sleep cycles.
• Joint aches and pains.
• Changes in hair, skin and nails including dry hair and skin, sensation of something crawling under your skin.

The important thing to note is that even though your periods may have stopped, these symptoms may still carry on for a further few years, and some women report symptoms up to 20 years after their last period.

What if I don’t have a womb to tell me my periods have stopped?

Doctors are able to do a blood test looking for your FSH (follicle stimulating hormone) levels. Two elevated FSH levels at least 6 weeks apart is diagnostic of menopause in a woman who has had a hysterectomy. 

Do I still need contraception?

If you are over the age of 50 and have not had a period for 12 months, you do not need further contraception. If you are under the age of 50, you will still need contraception for 24 months after your last period. Although the chances of you falling pregnant as you get older is low, it is not impossible. 

Do I need hormone replacement therapy/menopause hormonal treatment (MHT)?

This would be based on individual circumstances and needs. There are benefits to your health for example, preventing osteoporosis, delaying heart disease, improving your mental health but this needs to be balanced with your individual circumstances. Women who have a past history of breast cancer, DVT (clots in their legs) for example, would not be encouraged to have hormone replacement therapy. However, they may still benefit from menopause treatment that is not hormonally based.

Will menopause hormonal treatment fix everything?

Not necessarily. It is likely though that MHT will alleviate most of your symptoms.

What should I prepare before seeing a doctor about this?

If you think you are going through menopause or perimenopause, make a long appointment (20-30 mins) to discuss this. You may need a few appointments to get through all the health checks that need to be done (cervical screening tests, blood tests, cardiovascular checks, mammograms) before you can get started on menopause hormonal treatment.  It might be helpful to bring in a “symptom checker”, any blood tests or scans you may have had in the last 6-12 months and a list of what you have tried previously for your first appointment.

Your usual doctor may not be familiar with menopause treatments so you may find it useful to get recommendations from friends or family, or on the Australian Menopause Society website for a GP or gynaecologist with a special interest in menopause. Please note you will need a referral from GP to access Medicare rebates for a gynaecologist appointment.

You may find it helpful to read up on menopause and perimenopause. Jean Hailes and Australian Menopause Society are two websites that have a lot of information about this.

I am a patient of Dr Sue Man, and she has helped me navigate every step of my experience in a straight to the point, honest and very supportive way and I am incredibly grateful to have Dr Man’s support to collaborate with me on this important topic, and to raise awareness about the Meno change. You can see the professionals I have engaged with on my journey at the Meno reference page here.