Patient information from BMJ

Menopause: what is it?

Last published:Apr 15, 2025

The menopause is when your periods stop for good. It isn't an illness but will be part of every woman's life at some point. Some people feel well throughout menopause. However sometimes it causes symptoms that can be distressing. You can get symptoms of menopause for several years. But there are some treatments that might help.

What is menopause?

Menopause is when your periods stop as your ovaries stop producing eggs and your hormone levels decline. It marks the end of fertility.

Over time your ovaries produce less of the hormones estrogen and progesterone. This can cause your periods to become irregular. This may be one of the first changes you notice, and may begin up to 10 years before you have your last ever period. Other symptoms may occur due to the changing levels of hormones in your body. If you are having symptoms but still having periods this stage is called perimenopause.

Eventually, the amount of hormones your ovaries produce is so low that your periods stop completely.

When you haven’t had a period for 12 months in a row you have been through menopause

You can’t get pregnant once your periods have stopped for good. But you should still use contraception until you have not had a period for 12 months.

Most women will go through their menopause between the ages of 45 and 55, but some have an early menopause. Doctors say a woman has an early menopause when it happens before she is 40.

Some women still have periods when they're over 55. These women are said to have a late menopause.

What are the symptoms of menopause?

Common symptoms of menopause include:

• Changes to your periods. You might find your periods are lighter than before, or heavier. They might last longer, or just a few days, and they might be more or less frequent. All of these changes are normal. But if you have very heavy periods (needing to change pads or tampons every hour) or if you get bleeding after sex or "spotting" mid-cycle, see your doctor.

• Hot flashes, where you suddenly feel hot and might go red in the face. They might be mild, or bad enough to wake you at night. Some women find that hot flashes can be triggered by caffeine, spicy foods, hot drinks, or alcohol.

• Night sweats, usually caused by hot flashes at night. But night sweats can be caused by other things, like an infection, so see your doctor if you get them.

• Symptoms caused by the lining of your vagina becoming drier and thinner due to hormone changes. This can cause itching and make sex painful.

• Losing interest in sex.

• Problems sleeping. You might find it hard to get to sleep, wake up because of hot flashes, or wake up very early and be unable to get back to sleep.

• Putting on weight and other physical changes, such as a loss of muscle tone and increased fat around your middle. Doctors don’t know if this is because of hormone changes or just part of getting older.

• Feeling low or depressed, or having mood swings. These negative feelings can include being irritable, anxious, panicky, and forgetful.

Some women don’t have any problems when they go through menopause. But most women get at least one symptom. The severity of these symptoms can vary between mild and very distressing.

Your doctor will usually be able to tell from your symptoms and your age whether you are going through menopause. But if you are younger than 40 you might need a blood test to check your hormone levels (called the FSH test) to find out for sure.

What happens next?

Women experience menopause in different ways. You might go through menopause with few problems. Or you might have severe symptoms that affect your quality of life.

Your experience of menopause might depend on what else is going on in your life. You might find it more difficult to cope with if you're under stress for other reasons.

Your feelings about this time in your life will also affect how you experience menopause. Some women see menopause as a positive step in moving on to the next stage of life. Other women feel anxious or depressed about the physical changes.

Some women choose to take hormone replacement therapy (HRT). Many women find this helpful but it can cause side effects. For more information see our patient information Menopausal symptoms: what are the treatment options?

Once you have been through menopause it’s extra important to keep your bones strong and your heart healthy. This is because you are more at risk of bone fractures and heart disease when your estrogen levels have dropped.

You can help look after your bones and heart by:

• eating a balanced diet with plenty of fruits and vegetables and plenty of calcium (found in dairy products)

• limiting alcohol and caffeine to moderate levels

• maintaining a healthy weight

• not smoking

• doing regular exercise, including weight-bearing exercise like walking or jogging.