What is menopause?

It is also known as the 'change of life' and it is the end of menstruation. This means a woman's ovaries stop producing an egg every four weeks. She will no longer have a monthly period or be able to have children.

In the UK, the average age for a woman to reach the menopause is 52, although women can experience the menopause in their 30s or 40s.

If a woman experiences the menopause when she is under 45 years of age, it is known as a premature menopause. Monthly periods can sometimes stop suddenly when you reach the menopause. However, it is more likely that your periods will become less frequent, with longer intervals in between each one before they stop altogether.

Causes

The menopause is caused by a change in the balance of the body's sex hormones.

In the lead up to the menopause (perimenopause) oestrogen levels decrease, which causes the ovaries to stop producing an egg each month (ovulation). Oestrogen is the female sex hormone that regulates a woman's periods.

The fall in oestrogen also causes both physical and emotional symptoms including:

• hot flushes
• night sweats
• mood swings
• vaginal dryness

If you experience the menopause suddenly rather than gradually, your symptoms may be worse. The symptoms will usually last for two-five years before disappearing, although in some cases they can last longer. Vaginal symptoms, such as dryness, can sometimes persist and get worse as you get older.

Hot flushes and night sweats

A hot flush is a sudden feeling of heat in your upper body, which can start in your face, neck or chest, before spreading upwards and downwards. The skin on your face, neck and chest may become red and patchy and you may start to sweat. You may also feel a change in your heart rate. It may become very rapid, or it may be irregular and stronger than usual (palpitations).

Hot flushes that occur at night are called night sweats. Most hot flushes only last a few minutes and they are most common in the first year after your final period. Many menopausal women have trouble sleeping due to night sweats, but sleep disturbances may also occur as a result of anxiety.

Vaginal symptoms

During the time leading up to the menopause, you may experience vaginal dryness, itching or discomfort. This can make sex difficult or painful (dyspareunia). These symptoms combined are known as vaginal atrophy. About a third of women experience the symptoms of vaginal atrophy shortly after the menopause, with slightly more women having them later on. In some cases, this can persist for more than 10 years after your final period.If you have vaginal symptoms, it is likely that they will continue or get worse over time unless they are treated.

Urinary symptoms

During the menopause, you are more likely to experience recurrent lower urinary tract infections, such as cystitis. You may also feel an urgent and frequent need to pass urine.