The AMS website is often the first port of call for patients. With this in mind we have decided to create a set of fact sheets for patients, as companion sheets to the popular videos, and the other more detailed AMS Information Sheets.
Menopause what are the symptoms?
Menopause at a glance
- Every woman is affected by menopause in some way – either they experience symptoms orother physical changes.
- The average age of menopause is 51 years but you can enter menopause earlier.
- Hormonal changes cause menopausal symptoms.
- Most women will have some symptoms.
- Most women have symptoms for 5 to 10 years.
Menopause occurs when you have not had a menstrual period for 12 months. Menopause is a natural part of life occurring at around age 51 years but can also happen for other reasons.
Non-hormonal treatment options for menopausal symptoms
- Your doctor can suggest prescription medication options for your menopausal symptoms if you are unable to or do not want to use menopausal hormone therapy (MHT).
- Prescription medication options can help with hot flushes, sweatsand changes in mood and sleep patterns.
- Specific antidepressants and epilepsy medications can help with menopausal symptoms in many women.
- A blood pressure drug (clonidine) can give relief for some women with milder symptomsDownload
What is Menopausal Hormone Therapy (MHT) and is it safe?
- MHT (also known as Hormone Replacement Therapy or HRT) covers a range of hormonal treatments that can reduce menopausal symptoms.
- MHT is the most effective way to control menopausal symptoms while also giving other health benefits.
- MHT is safe to use for most women in their 50s or for the first 10 years after the onset of menopause.
- The risk for blood clots, stroke and breast cancer while taking MHT are very small.
- Different types of MHT are associated with different risks. Your doctor can work with you to reduce your risk by using different hormonal treatment options.
Will menopause affect my sex life?
- If your sex life is good before menopause, it is likely to remain good after menopause.
- Sexual wellbeing is complex and many other personal factors in your life could be involved.
- Vaginal dryness can be treated with creams and lubricant.
- Hormonal treatments include oestrogen or testosterone therapy but only use testosterone designed for women.
- Your doctor, a pelvic health physiotherapist or a counsellor may need to work with you to look at the many factors that might be affecting your sexual wellbeing.
Complementary medicine options for menopausal symptoms
- Complementary medicine is used to describe a wide range of health care medicines, therapies (forms of treatment that do not involve medicines) and other products that are not generally considered as part of conventional medicine
- Some complementary medicines may help with mild symptoms, but there is little evidence that many popular complementary medicines help with symptoms or are safe.
- Speak with your doctor before using complementary medicine because they might affect other medications.
- Avoid buying online products – their safety cannot be guaranteed.
- You should not use soy/ phytoestrogen products if you can’t take prescribed hormone therapy for safety reasons such as breast cancer.
- Bio-identical compounded hormone therapy cannot be recommended because their safety is unknown.
- No complementary medicine is as effective as oestrogen therapy for menopausal symptoms
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Bioidentical Hormone Therapy
- The Australasian Menopause Societydoes not recommend the use of compounded bioidentical hormonetherapy in any form.
- Many pharmaceutical-grade, approvedmenopause hormone therapies (MHTs)prescribed by your doctorare ‘bodyidentical’– i.e.they contain hormonesidentical to those produced in thehuman body.
- Compounded bioidentical hormones(BHTs) are not more ‘natural’ – evenwhen made from plants, they must bechemically synthesised in a laboratory.
- Compounded BHTs are not tested forquality, safety and negative side effectsand they have been associated withcases of endometrial cancer.
- There is no evidence that compoundedBHTs are effective and safe to use.
Lifestyle and behaviour changes for menopausal symptoms
- Many women wonder if lifestyle and behaviour changes can help with menopausal symptoms.
- Studies have shown mixed results for lifestyle changes, so speak with your doctor if you have any questions.
- Maintaining healthy weight might be helpful as there is evidence that weight gain can increase the severity of menopausal symptoms.
- Some evidence suggests yoga can help menopausal symptoms. Other activities such as exercising, breathing and relaxation practices or controlling environmental temperature might not necessarily help your symptoms, but they can help with your overall sense of wellbeing.
- Cognitive behaviour therapy (CBT) can improve wellbeing and decrease the impact of menopausal symptoms.
- Hypnosis might give you some benefit, but there is no evidence that acupuncture, magnetic therapy, reflexology or chiropractic interventions help menopausal symptoms.
9 myths and misunderstandings about Menopausal Hormone Therapy (MHT)
- Many of the myths about MHT come from the Women’s Health Initiative (WHI) studies of 2002 and 2004. New information about MHT means doctors better understand the risks and benefits of MHT.
- MHT is the best way to control menopausal symptoms and gives some women health benefits.
- Combined MHT (oestrogen plus progestogen) or oestrogen alone cause no significant increase in breast cancer or heart disease risk in women aged 50 to 59 or in women who start treatment within 10 years of menopause.
Menopause before 40 and spontaneous premature ovarian insufficiency
- Premature ovarian insufficiency (POI) is a loss of function of the ovaries in women who are less than 40 years old.
- Spontaneous POI affects 1% of women less than 40 years and in most cases the cause is not identified.
- Irregular/no menstrual periods or menopausal symptoms may be the only sign of POI and blood tests are needed for diagnosis.
- POI can cause infertility and increase the risk of long-term health problems such as heart disease, osteoporosis and memory problems.
- Hormone replacement therapy is recommended until the natural age of menopause (51 years) to reduce the long-term risks.
- Speak with your doctor about treatments and other options to manage any infertility and health consequences.
Early menopause – chemotherapy and radiation therapy
- Chemotherapy and radiation therapy for cancer and other conditions can cause temporary or permanent loss of your menstrual periods and menopause.
- Before the age of 40, this is known as premature ovarian insufficiency (POI).
- Between the ages of 40 and 45, this is known as early menopause.
- Early menopause and POI can cause infertility and have short- and long-term health consequences such as heart disease, osteoporosis and memory problems.
- Some women who have chemotherapy remain fertile, so it is important to use contraception if you do not want to become pregnant or if your doctor advises you that it is not safe to become pregnant.
- Speak with your doctor about treatments and other options to manage any infertility and long-term health consequences.
Maintaining your weight and health during and after menopause
- Weight gain during and after menopause has more to do with your lifestyle and the changes of ageing than with hormonal changes of menopause.
- The hormonal changes of menopause can cause fat to settle in your abdomen rather than your hips, thighs and buttocks.
- Menopausal Hormone Treatment (MHT) does not cause weight gain and can reduce the abdominal fat caused by menopause.
- Menopause is a great time to visit your doctor,assess your overall health and make changes to improve your lifestyle and health.
- Eating a healthy diet, engaging in physical activity, stopping smoking and drinking less alcohol will help you to maintain a healthy weight beyond menopause.
Vaginal Laser Therapy
- Vaginal laser is a new treatment being offered for some menopausal symptoms
- There is insufficient high quality evidence for its safety and benefits
- Vaginal oestrogen is safe and effective and can be used by most women
- Vaginal laser for menopausal symptoms is not approved by regulatory authorities in Australia and the USA
Decreasing the risk of falls and fractures before, during and after menopause
- Falls and fractures can happen at any age, but the risk increases as women age.
- Falls in older people are more likely to cause more severe injuries.
- Low bone density, low muscle strength and poor balance are more likely as women age and increase the risk of falls.
- Improving your bone health can also help decrease the risk of falls and decrease the severity of any injuries or other consequences if you do fall.
- Appropriate physical activity can help decrease several fall risk factors.
- Speak with your doctor, assess your overall health and make changes to decrease your risk of a fall.
Urinary Incontinence in Women
- Urinary incontinence is common in women
- Women can have stress or urge incontinence or a mixture of both
- Learning how to contract pelvic floor muscles correctly can help treat stress incontinence. Some women may need surgery
- Bladder training and vaginal oestrogen can assist with urge incontinence
Content updated May 2020