The menopause is when a woman stops having periods and is no longer able to get pregnant naturally. Periods usually start to become less frequent over a few months or years before they stop altogether. Sometimes they can stop suddenly.

The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, as a woman's oestrogen levels decline. In the UK, the average age for a woman to reach the menopause is 51.

However, around 1 in 100 women experience the menopause before 40 years of age. This is known as premature menopause or premature ovarian insufficiency. Most women will experience menopausal symptoms. Some of these can be quite severe and have a significant impact on your everyday activities.

Common symptoms include:

• hot flushes
• night sweats
• vaginal dryness and discomfort during sex
• difficulty sleeping
• low mood or anxiety
• reduced sex drive (libido)
• problems with memory and concentration

Menopausal symptoms can begin months or even years before your periods stop and last around 4 years after your last period, although some women experience them for much longer.

When to see your GP

It's worth talking to your GP if you have menopausal symptoms that are troubling you or if you're experiencing symptoms of the menopause before 45 years of age.

Your GP can usually confirm whether you are menopausal based on your symptoms, but a blood test to measure your hormone levels may be carried out if you're under 45.

Treatments for menopausal symptoms

Your GP can offer treatments and suggest lifestyle changes if you have severe menopausal symptoms that interfere with your day-to-day life, including:

• hormone replacement therapy (HRT) – tablets, skin patches, gels and implants that relieve menopausal symptoms by replacing oestrogen
• vaginal oestrogen creams, lubricants or moisturisers for vaginal dryness
• cognitive behavioural therapy (CBT) – a type of talking therapy that can help with low mood and anxiety
• eating a healthy, balanced diet and exercising regularly – maintaining a healthy weight and staying fit and strong can improve some menopausal symptoms

Your GP may refer you to a menopause specialist if your symptoms don't improve after trying treatment or if you're unable to take HRT.

What causes the menopause?

The menopause is caused by a change in the balance of the body's sex hormones, which occurs as you get older. It happens when your ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month.

Premature or early menopause can occur at any age, and in many cases, there's no clear cause. Sometimes it's caused by a treatment such as surgery to remove the ovaries (oophorectomy), some breast cancer treatments, chemotherapy or radiotherapy, or it can be brought on by an underlying medical condition, such as Down's syndrome or Addison's disease.