Menopause symptoms

For a lay person:

Menopause is when periods stop for good, usually between the mid-forties and mid-fifties, as the ovaries make less oestrogen. In the years around it many women have hot flushes, night sweats, sleep problems, mood changes and vaginal dryness.

For a trained medical person:

Vasomotor, genitourinary, sleep and mood symptoms result from declining ovarian oestrogen during perimenopause and after the final menstrual period; long-term oestrogen deficiency raises the risk of osteoporosis and cardiovascular disease. Diagnosis is usually clinical in women over 45, with FSH testing for younger women or uncertain cases. Management includes lifestyle measures, menopausal hormone therapy for those without contraindications, vaginal oestrogen, and non-hormonal options such as SSRIs, SNRIs or CBT.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Liver and Kidney Yin Deficiency; Heart and Kidney Disharmony; Essence and Blood Deficiency; Kidney Yang Deficiency; Kidney Yin and Yang Deficiency. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: See a doctor for any bleeding after periods have stopped for a year, very heavy or prolonged bleeding, or symptoms affecting daily life. Some herbs used for menopause can affect the liver or interact with medicines, so check if you have liver disease or a history of breast cancer.