Menopause: Symptoms, Support, and When to See Your GP

ByFamily Doctor Editorial

Menopause is a natural part of ageing — but for many women, the transition comes with symptoms that significantly affect daily life. Awareness, accurate information, and options have all improved in recent years. This guide covers what’s happening, what helps, and when to involve your GP.

The Three Stages

Perimenopause

The transition phase — often years long — when hormone levels fluctuate and symptoms begin. Starts for most women in their mid-40s but can begin earlier. Periods become irregular; hot flushes, sleep disturbance, and mood changes commonly emerge.

Menopause

Formally defined as 12 consecutive months without a period. The average age of menopause in Australia is 51, though the normal range is 45-55. Menopause before 40 is called premature ovarian insufficiency and needs specific medical attention.

Post-menopause

The years after your final period. Hormone levels stabilise at low levels. Some symptoms ease; others (such as vaginal dryness and bone thinning) can continue or worsen if untreated.

Common Symptoms

  • Hot flushes and night sweats — affect most women; can last years.
  • Sleep disturbance — often driven by night sweats but also independent.
  • Mood changes — anxiety, low mood, irritability, loss of confidence.
  • Brain fog — memory and concentration difficulties, often temporary.
  • Joint aches — commonly missed as a menopause symptom but frequent.
  • Vaginal dryness and urinary symptoms — burning, itching, painful sex, increased UTIs.
  • Lower libido
  • Weight changes — particularly increased central fat.
  • Thinning hair and skin changes
  • Headaches and migraines — can increase in frequency around menopause.

Hormone Replacement Therapy (HRT / MHT)

Menopausal Hormone Therapy (increasingly called MHT rather than HRT) remains the most effective treatment for moderate to severe symptoms. The decision to use it is individual — your GP will discuss benefits and risks based on your history.

Benefits of MHT include:

  • Significant reduction in hot flushes and night sweats
  • Improved sleep and mood
  • Relief of vaginal and urinary symptoms
  • Reduced risk of osteoporosis and fractures
  • Possible reduction in colon cancer risk

Risks depend on the type of MHT, age at starting, and individual health factors. Modern body-identical hormones (estradiol, progesterone) have a better safety profile than older synthetic forms. For most women starting within 10 years of menopause, benefits clearly outweigh risks.

MHT is usually not recommended if you have:

  • Current or recent breast cancer
  • Active thromboembolic disease
  • Severe liver disease
  • Unexplained vaginal bleeding until investigated

Vaginal Estrogen

For vaginal dryness, painful sex, and recurrent UTIs, local vaginal estrogen (creams, pessaries, or tablets) is highly effective and very safe — even for women who cannot take systemic MHT. The dose is tiny and acts locally.

Non-Hormonal Options

  • SSRIs and SNRIs — some antidepressants are effective for hot flushes even in women who aren’t depressed.
  • Gabapentin — can help hot flushes and sleep.
  • Cognitive Behavioural Therapy (CBT) — evidence-based for hot flushes, sleep, and mood changes.
  • Mindfulness and relaxation — reduce symptom severity.
  • Cooling fans, layered clothing, bedroom temperature — practical measures help.
  • Lifestyle — regular exercise, avoiding triggers (caffeine, alcohol, spicy foods), weight management.

Long-Term Health After Menopause

  • Cardiovascular health — heart disease risk rises significantly after menopause. Blood pressure, cholesterol, and lifestyle matter more than ever.
  • Bone health — bone loss accelerates. Calcium, vitamin D, weight-bearing exercise, and screening (DEXA scans) help.
  • Mental health — depression risk rises; early recognition and treatment important.
  • Sexual health — remains important throughout life; don’t assume it shouldn’t be discussed with your GP.
  • Cancer screening — continue cervical (to 74), breast (to 74), and bowel (to 74) screening.

Frequently Asked Questions

Do I need a blood test to confirm menopause?

For most women over 45, the diagnosis is clinical — based on symptoms and period history. Blood tests (FSH, estradiol) can help in younger women, complicated cases, or if using certain contraceptives.

Can I start MHT years after menopause?

Generally MHT is safer when started within 10 years of menopause or before age 60. Starting later is possible but the risk-benefit discussion is more nuanced.

Does MHT cause breast cancer?

A small increased risk with combined MHT (estrogen plus progesterone) after several years of use. Absolute risk remains low; needs to be weighed against benefits. Estrogen-only MHT (in women who’ve had a hysterectomy) may not increase breast cancer risk.

Are herbal remedies effective?

Black cohosh, red clover, and soy have modest evidence for some symptoms — variable results across trials. Discuss with your GP; some herbals interact with medications.

When should I see my GP about menopause?

If symptoms are affecting your sleep, mood, relationships, work, or quality of life — see your GP. Symptoms are treatable; you don’t have to just endure them.

Book a Menopause Consultation

Book a long appointment with your GP to properly discuss symptoms and options. Find your nearest Family Doctor clinic.

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