What is the menopause and what are the signs?

Every woman goes through the menopause and symptoms normally start in the mid-40s.

Here’s our guide to what happens in the run-up to periods stopping.

What is the menopause?

The menopause is when women’s periods stop, which normally happens around the age of 51.

This signals the end of the reproductive years and the start of a new phase of life.

The lead-up to this happening, when periods become irregular, is known as the peri-menopause. It starts, on average, at 46.

This is when many women notice their periods becoming unpredictable or heavy, and have feelings or physical problems they haven’t experienced before.

When periods haven’t happened for 12 months, you can look back and say you’ve been through the menopause (the last period).

For some, it can happen earlier - either naturally, or after treatment for another condition.

What causes it?

Hormone levels are changing - specifically oestrogen, which controls the menstrual cycle.

As women age, the ovaries produce fewer eggs, oestrogen levels fluctuate and then gradually reduce, and this leads to menopausal symptoms.

This doesn’t happen overnight though.

It can take several years for this crucial hormone to fall to low levels - and then it stays that way - causing changes to the body along the way.

When the ovaries stop producing eggs altogether, pregnancy is no longer possible and the menopause happens.

What are the symptoms?

The menopause - and the years leading up to it - affect women in different ways.

The brain, periods, skin, muscles and emotions are all affected by falling levels of oestrogen.

There are lots of possible symptoms and you can have some of them, all of them, or none - and for varied lengths of time.

The most common symptoms are:

• heavy or irregular bleeding

• hot flushes

• night sweats

• low mood

• vaginal dryness

• bladder problems

Poor memory and concentration, usually called brain fog, is also often mentioned, as are painful joints and dry skin.

Not all women get symptoms - but most do, around 75%.

And a quarter of women going through the menopause describe severe symptoms.

They can last for an average of seven years, with one in three women experiencing them for even longer.

If you’re taking a contraceptive pill, it may be more difficult to know when you’ve reached the menopause because they can affect your periods in different ways.

What causes hot flushes?

A lack of oestrogen. It is involved in the workings of the body’s thermostat in the brain.

Normally, the body copes well with temperature changes, but when oestrogen is lacking, the thermostat goes wonky and the brain thinks the body is overheating when it’s not.

Oestrogen can affect mood too. The hormone interacts with chemicals in brain receptors which control mood, and at low levels it can cause anxiety and low mood.

Are other hormones involved?

Yes, progesterone and testosterone - but they don’t have the same impact as low levels of oestrogen.

Progesterone helps to prepare the body for pregnancy every month, and it declines when ovulation ceases and periods stop.

Testosterone, which women produce in high levels, has been linked to sex drive and energy levels.