What is menopause?
Menopause is a natural and permanent biological process in a woman's life that
marks the end of her reproductive years. The ovaries stop producing eggs and also
produce a lower level of hormones- mainly oestrogen and progesterone. While
menopause is a single point in time, it is part of a broader transition with three
stages:
Peri-menopause is the time leading up to the menopause, when ovarian function
starts to decline, causing instability of the menstrual cycles and also hormone levels.
This results in irregular periods, changed flow and uncomfortable symptoms such as
insomnia, moodiness and hot flushes. Peri-menopause can last for years (average
4-8). You can still have regular periods in the peri-menopause if you have typical
symptoms. Conversely, irregular or heavy bleeding may be due to something other
than peri-menopause and may need investigations.
Women who experience typical symptoms over the age of 45 years of age do
not need a blood test to diagnose peri-menopause. Hormone testing can be
unreliable or difficult to interpret due to daily and inter-cycle fluctuations.
Menopause is the last actual menstrual period in a woman’s life, which can only be
diagnosed in retrospect, once there has not been a period for 12 months (in the
absence of another cause, such as suppression due to breastfeeding). The average
age of menopause in Australian women is 51 years old. Menopause can also be
surgically induced, by removal of the both ovaries, or caused by medical treatments
such as chemotherapy or radiotherapy.
Women who experience menopause between age 40-45 years are said to have
early menopause.
Women who experience menopause prior to age 40 years are said to have
premature menopause, or premature ovarian insufficiency (POI). This affects
roughly 1% of women. These women are at higher risk of adverse health outcomes if
they are not treated with hormonal therapy
Post menopause is the rest of the time after the menopause. While some
symptoms may persist, they often lessen over time. The lower levels of hormones
after menopause increases the risk of certain health conditions, such as
cardiovascular disease, osteoporosis and genitourinary syndrome.
MENO-SSENTIALS by Dr Jessie Huang © 2025 Affirm Medical