Menopause is the time in a woman’s life when her periods stop naturally. It usually occurs between the ages of 45 and 55. This is the time when the ovarian production of the female hormones (Estrogens and Progesterone) falls to its minimum level.

Stages of Natural Menopause:

Menopause is a normal part of life, just like puberty. It is the time of your last menstrual period.

You may notice changes in your body before and after menopause. This transition usually has three parts:

  • Perimenopause
  • Menopause
  • Postmenopause

Changes in your body normally start with perimenopause. This can begin several years before your last menstrual period. Changing levels of estrogen and progesterone, which are two female hormones made in your ovaries, might lead to specific symptoms. Menopause comes next, which is the end of your menstrual periods. After a full year without a period, you can say you have been “through menopause,” and perimenopause is over.

Postmenopause follows menopause and lasts the rest of your life.

Other Factors Affecting the Ovaries and Leading to Early Menopause

You can have menopause at a very young age (before the age of 45) for the some of the following reasons:

  • Smoking
  • Surgical removal of both your ovaries. This could be at the time of hysterectomy or ovarian surgery
  • Radiotherapy to the pelvis
  • Some chemotherapy medications
  • Premature Ovarian Insufficiency
Signs and Symptoms

Estrogen is used by many parts of your body. As your ovarian production of estrogens falls, you start experiencing various symptoms. Here are the most common changes you might notice in your midlife.

Change in your period

This might be what you notice first. These are all normal changes, but to make sure there isn’t a problem, see your Gynaecologist if:

  • Your periods come very close together
  • You have heavy bleeding
  • You have spotting
  • Your periods last more than a week
  • Your periods return after no bleeding for more than a year

Hot flashes

A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Many women have hot flashes, which can last a few years after menopause. They occur due to changes in estrogen levels.

Night Sweats

Severe hot flashes, strong enough to wake you up from sleep and leading to sudden sweating are called night sweats. These may last between 30 seconds and 10 minutes.

Effect on your Life

Vaginal health and bladder control

You may notice that your vagina may get drier. This could make sexual intercourse uncomfortable. Or, you could have other health problems, such as vaginal or bladder infections. Some women also find it hard to hold their urine long enough to get to the bathroom. This loss of bladder control is called incontinence. You may have a sudden urge to urinate, or urine may leak during exercise, sneezing, or laughing.


Some women start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily, or you wake up too early. Night sweats might wake you up. You might have trouble falling back to sleep if you wake up during the night.


You may find that your feelings about sex are changing. You could be less interested. Or, you could feel freer and sexier after menopause.


After 1 full year without a period, you can no longer become pregnant.

Mood changes

You might find yourself more moody or irritable around the time of menopause. Scientists don’t know why this happens. It’s possible that stress, family changes such as growing children or aging parents, a history of depression, or feeling tired could be causing these mood changes.

Your body may seem different

Your waistline could get larger. You could lose muscle and gain fat. Your skin could get thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. These could also be changes due to age. Your Gynaecologist will be able to tell the difference.

Thinning of Bones called Osteoporosis

Day in and day out, your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss, and losing estrogen around the time of menopause causes women to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis.

Heart disease

After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. But, so is getting older. As you age, you may gain weight and develop other problems, like high blood pressure. These could put you at greater risk for heart disease. Be sure to have ragular check ups of your blood pressure, blood levels of triglycerides, fasting blood glucose, and cholesterol.

Training Skills and Experience

Dr Salma Kayani has undergone special training in management of menopause and its symptoms. She has extensive experience in managing problems occurring with menopause. The management is tailor-made to the deficiencies, requirements and personal risk factors of each woman.