Menopause: What it is and How to take care of yourself
- theprocesshk
- Dec 22, 2024
- 13 min read
Updated: Mar 14
What is menopause?
Menopause is your final period. As you approach menopause, your reproductive hormones (e.g. oestrogen) drop. Most women reach menopause between the ages of 45 and 55.
Menopausal symptoms: What it is and How to take care of yourself
Menopause is different for everyone. Some women have no symptoms at all, while others have symptoms that interfere with their daily life.
Symptoms of menopause may include:
hot flushes
night sweats
aches and pains
low mood
difficulty concentrating.
You may also experience:
vaginal dryness
painful sex.
Managing menopausal symptoms
There are many ways to manage menopausal symptoms. It may take time to find the right approach.
Menopausal hormone therapy (MHT)
Menopausal symptoms are caused by a drop in hormone levels, mainly oestrogen. MHT replaces these hormones and it's an effective and safe way to reduce symptoms. MHT may also reduce the risk of developing conditions, such as osteoporosis and heart disease, in the future.
If you’re thinking about taking MHT, talk to your doctor. Note that MHT is not suitable for everyone, for example if you are older than 60 or have hormone-dependent cancer.
Non-hormonal medicines
Some women cannot use MHT. Others don't want to use MHT and prefer to try non-hormonal prescription medicines for symptoms like hot flushes and sweating. Non-hormonal medicines include:
certain antidepressants
gabapentin (epilepsy medication)
clonidine (used to treat migraine and blood pressure).
Your doctor can give you more information.
Menopause and natural therapies
Natural therapies are part of a broad range of complementary medicine and therapies (CMT).
Sometimes herbs are used to manage symptoms of menopause. There is some research supporting the use of black cohosh and red clover extract. Other herbs commonly used for insomnia, anxiety and fatigue include lemon balm, valerian and passionflower.
While these herbs may be commonly used, more research is needed to understand how effective and safe they are for managing menopausal symptoms.
Some studies suggest that cognitive behavior therapy (CBT) can help reduce menopausal symptoms.
Make sure you get advice from a qualified health practitioner before using natural and complementary therapies. It’s also important to tell your doctor if you use herbal remedies as they can affect other prescribed medicines.
Healthy lifestyle
Healthy lifestyle choices can help you manage symptoms of menopause and reduce the risk of developing health conditions.
Try to:
eat a healthy diet
achieve and maintain a healthy weight
do regular physical activity
develop good sleep habits
reduce or stop drinking alcohol
quit smoking and other drugs.
It’s also important to look after your emotional health. For example:
take time to do things you enjoy
be kind to yourself
talk to your partner, close friends or family about how you feel
practise relaxation techniques
work with a therapist.
When to see your doctor
See your doctor if your menopausal symptoms are affecting your quality of life. It's important to seek accurate and reliable information before you start any treatment.
Looking after yourself during menopause
During menopause, it’s important to look after yourself. Healthy lifestyle choices will help to improve physical and emotional symptoms at every stage of menopause.
Healthy weight
Many women think weight gain is part of menopause, but it’s more likely due to ageing and associated lifestyle changes.
Women tend to gain weight as they age, whether they are experiencing menopause or not. On average, women between the ages of 45 and 55 years gain about half a kilo per year.
Ageing causes a decrease in muscle mass, which slows down your metabolism. So, if your diet stays the same, you are likely to gain weight.
Weight gain and increased abdominal (belly) fat is common among women at midlife.
Studies show that reduced levels of oestrogen around menopause cause fat to be stored on the waist, rather than the thighs and hips. In fact, belly fat in postmenopausal women accounts for between 15% and 20% of their total body fat. This compares with 5% to 8% in premenopausal women.
It’s not healthy to carry too much weight, but weight around your stomach has significant health risks. Fat stored in this part of your body is also known as 'visceral fat'.
Unlike the other type of fat (that you can pinch with your fingers), visceral fat lies deeper in your body. It can wrap around your vital organs such as your liver, gut and pancreas.
Excess visceral fat is linked to:
an increased risk of heart disease (one of the leading causes of death for women in Australia)
type 2 diabetes
breast cancer
dementia.
Increased belly fat also increases menopausal symptoms such as hot flushes.
A review published by the Mayo Clinic shows women can prevent weight gain at midlife. They can do this by adopting a healthy lifestyle and addressing menopausal symptoms.
Achieving and maintaining a healthy weight during perimenopause is very important. Looking after your health during the perimenopause years can prevent weight gain during menopause. This will also help you reduce the risk of chronic disease.
Menopausal hormone therapy (MHT) may also help to reduce belly fat after menopause , but MHT should not be prescribed specifically for weight management.
Healthy diet
What you eat matters. Diet can be especially important to help prevent weight gain during midlife. Making healthy food choices is one of the best ways to achieve and maintain a healthy weight.
A healthy diet will improve your energy levels, keep your blood glucose stable and help you manage your weight.
You can try:
filling half a plate with vegetables and have a palmful of lean protein at each meal
eating different coloured fruits and vegetables so you get lots of vitamins and minerals
including legumes and pulses such as beans, lentils and peas in your meals
eating more whole grains like brown rice
including calcium-rich foods like yoghurt, canned sardines and parmesan cheese
including healthy fats from fish, olive oil, seeds and nuts, such as linseeds and macadamias
eating breakfast every day
reducing alcohol, sugary snacks and caffeine
eating mindfully and enjoying what you eat
eating smaller meals more often to maintain your metabolic rate.
If you are overweight or gaining weight, you can talk to your doctor, dietitian or a nutritionist about the best way to lose weight. They may suggest a low-calorie or low-carb diet, together with physical activity.
In this podcast Jean Hailes naturopath Sandra Villella talks about menopause and nutrition.
Physical activity
Menopausal symptoms can make it harder to do physical activity, which may contribute to weight gain. If you don’t feel like your normal self during this time, it may be hard to stick to regular exercise and healthy eating.
Physical activity is a vital part of being healthy, especially as we age. It can reduce the risk of chronic disease, falls and osteoporosis. It can also help you manage your weight and your menopausal symptoms. If you want to lose weight, you will need to combine regular physical activity with reduced calorie intake.
It’s recommended that adults aged 18 to 64 years be active on most (preferably all) days of the week. This activity should include:
2.5–5 hours of moderate-intensity activity each week
1.25–2.5 hours of vigorous-intensity activity each week.
It’s also recommended you do muscle-strengthening activities at least 2 days per week.
You don’t have to do this in one go. You can accumulate shorter bursts of activity during the day. On days when you feel a bit tired, try a gentle walk.
Other tips to keep active include:
moving more and sitting less
walking or cycling part of the way to work
taking the stairs instead of the escalator or lift.
Signing up for a team sport or taking dance classes is also a great way to get active and have fun. Research shows that exercising with others makes it more likely you’ll stick with it. You’re also more likely to spend more time exercising. Exercising in a group can also improve your mental wellbeing and help you manage the emotional aspects of menopause.
Before starting an exercise program, you can talk to your doctor or an exercise physiologist. They can recommend a program to suit your current situation and health goals.
Healthy bones
After menopause, lower levels of oestrogen affect women’s bone health, which puts them at greater risk of developing osteoporosis. Women who experience premature or early menopause can start to lose bone density at an earlier age than women who experience menopause in their 50s. This puts them at a greater risk of developing osteoporosis earlier in life.
You can reduce your risk of osteoporosis by eating the right amount of calcium per day. Women over 50, or women who have reached menopause before 50, should eat 1300mg of calcium per day, which is equal to 3 to 4 serves of dairy per day.
Other good sources of calcium include:
canned fish with bones (e.g. sardines)
almonds
tofu
leafy green vegetables
legumes (e.g. chickpeas or kidney beans).
You can also:
get the right amount of vitamin D through sunlight or supplements
do regular weight-bearing and resistance exercise
not drink coffee
not smoke.
It’s important to have regular bone health checks which includes checking your medical history and risk factors for osteoporosis. Bone density tests are recommended for women with particular risk factors or those over 70 years of age.
Sleep
Sleep is important for everyone, but it’s very important during menopause. Lack of sleep can contribute to menopausal symptoms and make them worse. This in turn can make it hard for you to exercise regularly.
Research also shows that poor sleep (one of the symptoms of menopause) is associated with a greater intake of food and poorer food choices.
If you develop good sleep habits and seek help for any sleep problems, you might find it easier to manage your weight and menopausal symptoms.
Alcohol
Drinking too much alcohol can impact menopause by:
contributing to unwanted weight gain
interfering with sleep
causing changes in your mood which may affect your relationships
triggering hot flushes and night sweats.
In the long term, heavy drinking can also lead to an increased risk for developing some cancers, depression, cardiovascular disease, diabetes and poor bone health.
Australian Alcohol Guidelines recommend that you:
drink no more than 10 standard drinks a week
drink no more than 4 standard drinks on any one day
avoid alcohol if you’re pregnant, planning to become pregnant or breastfeeding.
If you have a problem with alcohol, talk to your doctor.
Smoking and other drugs
There is no safe level of smoking or drug use. Smoking is one of the worst things you can do for your health. It can reduce your life expectancy and quality of life. It can also increase your risk of developing other health conditions and dying early.
Women who smoke generally reach menopause earlier than non-smokers. They are also more likely to experience early menopause.
Women who smoke also have more severe and frequent hot flushes and night sweats, and difficulty sleeping.
If you smoke or use illicit drugs, speak to your doctor about ways you can stop.
Emotional wellbeing
There are many practical things you can do look after your emotional wellbeing.
For example:
talk to someone you trust about your feelings (e.g. your friend, family member, doctor or therapist)
keep a diary of your symptoms
take time for yourself and do things you love doing
get quality rest when you can
do regular physical exercise, especially in a group or with friends
practise relaxation techniques
pay attention to your inner voice and practice using positive affirmations.
Talk to your therapist
If you are experiencing strong emotions, anxiety or depression, see your therapist.
Sex and relationships
Sexuality is an important part of our human experience, but hormonal changes at menopause can lead to reduced libido (sexual desire). While this is normal, it can be frustrating and may affect your relationships.
Many factors can influence how you feel about changes to your sexual desire.
For example:
your attitude to sex
your age
how menopause has affected you
whether you’re in a relationship
whether you want to have sex
your physical and mental health.
What can affect your sex life?
Changing hormones
The National Aging Research Institute and the University of Melbourne conducted a large study of women called the 'Women's Healthy Aging Project'. This study found that as women go through menopause, they may have a significant decline in sexual function. The study also found that reduced sexual function is associated with reduced levels of oestradiol (the main oestrogen hormone), but not testosterone.
Sexual problems may be worse for women who have early or premature menopause, due to a sudden change in hormones.
Menopausal symptoms
It’s common for different menopausal symptoms to affect sexual desire. For example, hot flushes, moodiness, sleeplessness and fatigue.
Relationships
If you are in a relationship, it’s important to discuss your thoughts and problems openly with your partner.
Your partner may not know about menopausal symptoms or what you are going through.
You can ask them to read current information about menopause so they can support you through this time.
If you think these conversations may be difficult, you can:
visit your doctor with your partner and discuss your concerns together
visit a therapist who specializes in couple's therapy.
If you are experiencing menopausal symptoms or health issues that affect your daily life (including your sex life), it can have an impact on your relationship. It’s important to ask your partner for their understanding and support during this time.
Stage of life
At this stage of your life, you may have added pressures that affect your sex life. For example, children moving out of home, caring for elderly parents or work pressures.
You may also feel differently about your body at this age and may not want to be intimate with your partner as often as you used to.
Dry vagina and pain during sex
The loss of oestrogen at menopause causes changes in the tissues of your vagina and vulva. This means your vagina becomes drier and less elastic, which can lead to vaginal irritation, vaginal atrophy and pain during sex.
The Study of Women Across the Nation (SWAN) tracked more than 2,400 women over 17 years. It found that more than 50% of women don’t report vaginal dryness and less than 4% use any of the proven therapies to treat this condition.
Managing low libido
If you are concerned about having low libido, it’s important to discuss this with your doctor. They might suggest different options to improve the way you feel about sex. For example, a trial of menopausal hormone therapy (MHT), or vaginal moisturizers, lubricants or oestrogen to improve vaginal dryness.
Testosterone therapy
The area of wellbeing and libido is very complex, and research tells us these are likely to be influenced by psychological factors more than testosterone. But testosterone therapy may be a suitable treatment for postmenopausal women who feel distressed by their loss of sexual desire. This condition is known as hypoactive sexual desire disorder (HSDD).
Testosterone therapy is only recommended for women diagnosed with HSDD. There is no evidence to support using testosterone in premenopausal women for low libido or any other condition such as low mood or depression.
How is testosterone used?
A testosterone 1% cream (specifically for women) is now available and approved for use in Australia.
The cream is applied every night to the lower abdomen or outer thigh. Your doctor will usually test your testosterone level after three weeks to make sure it is not too high, and again after 12 weeks. Your doctor should then see you every six months for a check-up and to monitor blood testosterone levels.
If testosterone therapy is going to improve your libido, you will start to notice this after about four weeks. If there is no improvement after six months, you should stop testosterone treatment.
Side effects of testosterone therapy
You may experience some side effects when you use testosterone therapy, although these are rare if you use the right dose of testosterone.
Side effects from excessive use of testosterone may include:
developing male characteristics, such as acne and excess body hair
fluid retention
adverse effects on blood cholesterol.
If you experience any of the above, see your doctor.
Testosterone therapy is not suitable for:
women with severe acne
women with severe excess body hair
women who are pregnant or breastfeeding
women who have a suspected cancer.
Contraception during menopause
Your fertility will decline as you age, but while you still ovulate it is possible to get pregnant. In the lead-up to menopause, you can ovulate twice during one cycle. And you can still ovulate up to three months before your final period.
The possibility of pregnancy in women aged 45–49 years is estimated to be 2–3% per year. After the age of 50, it’s less than 1%.
When is it safe to stop contraception?
If you’re younger than 50 and you don’t want to fall pregnant, you should use contraception for at least two years after your final period.
If you’re 50 or older and you don’t want to fall pregnant, you should use contraception for at least one year after your final period. Keep in mind, MHT is not a contraceptive.
Talk to your doctor about the best contraception for you.
Menopause and work
Menopause is a normal part of life for most women. Symptoms can affect women at home and at work. The transition into menopause is now recognised as an important workplace issue, but not all workplaces support women going through menopause.
Many employers don’t fully understand the symptoms of menopause. And women may also feel uncomfortable talking about their experience in case they’re seen as ‘too old’ or unable to do their job. It’s estimated that around 10% of women stop working due to severe menopausal symptoms.
The good news is that more employers are developing policies that acknowledge and include menopausal health as an important part of employee wellbeing.
How menopause impacts work
Menopause can impact work in many ways. Physical symptoms like hot flushes, fatigue, poor concentration and poor memory can all impact the quality of your work. They can also reduce your ability to function normally. Symptoms such as loss of self-confidence, low self-esteem, anxiety and depression can make things worse.
Studies show that menopausal symptoms can impact work attendance and performance. Sometimes symptoms are interpreted as poor performance or lack of commitment. Other women may be misjudged as having a mental illness or other health conditions.
Symptoms can also stop women from applying for promotions or cause them to retire early.
What can you do?
Be open and honest
Talk to your employer or manager if you have symptoms that make work difficult. Explain what your symptoms are and how they impact your work. You might also like to share some of the information from our website with your employer.
Be clear about what you need
Ask your employer to make reasonable adjustments if needed. This may be flexible working hours, or the ability to work from home if you need to manage fatigue. It may also include changing the temperature of your office or using a fan to help keep you cool if hot flushes are a problem.
Support others
Women make great advocates for one another in the workplace. If you feel up to it, offer to help develop policies that support menopause at work. Take part in training or induction programs that include information about menopause. Offer formal or informal support for others in your workplace who are going through menopause.
Look after yourself
Looking after your own health can help you manage symptoms and help you cope better at work. You can try:
dressing in layers that you can add or remove
eating regular, healthy meals to help boost energy levels
going for a walk at lunchtime, as this can help to improve your mood
prioritizing sleep and developing a good bedtime routine to help beat fatigue.
Talk to your doctor
If menopausal symptoms are impacting you, talk to your doctor about treatment options. Managing your symptoms can help you cope better at work.
Seek other support
If you feel your manager is not supporting you through menopause, seek other support. You can talk to your organisation’s human resources staff or discuss the issue with advocacy bodies, such as trade unions or professional associations.
Menopause: What it is and How to take care of yourself.
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