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Menopause is a natural phenomena in all women's lives. Menopause means the end of menstruation (periods). Average age of menopause is 52, but it can happen earlier or later. Menopause actually means "last period" and the term perimenopause refers to the time period before and after menstruation stops. Perimenopause can last for years, and symptoms commonly occur between 45-55 yrs. Menopause occurs because the ovaries no longer produce eggs or hormones, as at that time in a woman's life, she no longer wants or needs to get pregnant! Many women think they cannot fall pregnant in the perimenopause, but they can. Late unplanned pregnancy can be a shock and distressing to deal with, so there is a special approach for women who are in their later reproductive years, who still need contraception.

The natural, gradual reduction in hormone levels can sometimes produce symptoms, such as hot flushes, insomnia, vaginal dryness, reduced libido and mood changes. Most women don't need or want to take any medication to relieve symptoms, but if symptoms of oestrogen withdrawal are bothersome, there are many options. We will discuss the pros and cons of the options available to you, and what will suit you, as an individual.

Options for treatment of menopausal symptoms include hormone replacement therapy (HRT), topical hormone treatments eg vaginal pessaries, natural remedies and SSRI medication, or testosterone treatment. Individual treatments plans can be decided using a shared decision making approach, after discussion, between you and one of our doctors. The best (and right) option for you depends on your past medical history and your own ideas, concerns and expectations. Any of our doctors will happily talk with you, helping you choose the best approach to perimenopause, and menopause, as well as covering other important factors that need to be considered at this important time, such as bone health (prevention of osteoporosis), cardiovascular health (we can undertake a risk assessment for this) and your sexual function (desire and capability!). Pap tests are recommended up to the age of 70 yrs.

Specifically, we will encourage you to undergo breast cancer screening, cardiovascular risk assessment as well as advising you on managing your own experience of perimenopause and menopause. If you have poor pelvic floor tone or urinary incontinence (urge or stress or mixed) we can help improve your quality of life with individualised management.

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