Journal | Menopause

The Essential Guide to Menopause

A thoughtful-looking woman with blonde hair wearing a light blue shirt, surrounded by dotted lines pointing to words like 'Hot Flushes,' 'Night Sweats,' 'Sleep Quality,' and 'Mood,' indicating symptoms related to menopause.

Everything you need to know to navigate menopause, advocate for yourself, and find the right treatment options.

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Written by Written by Team Biolae

Medically reviewed by Dr. Madison Davies, MPH (PHC), FRACGP

Featuring Dr. Charlotte Middleton, Biolae Chief Medical Officer

Menopause is inevitable.

Navigating it blind is not.

This guide is here to help you cut through the noise. It’s your resource for trustworthy, fact-based support as your body transitions through the stages of menopause.

Bookmark it, share it, come back when you need clarity.

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01

The stages of menopause

Menopause isn’t just one moment in time. It’s a biological transition that unfolds over years. Yet, we tend to oversimplify it. Menopause is defined by a single day—the 12-month anniversary of your final menstrual period. But around it, perimenopause and postmenopause change everything, sometimes before you even realise it’s happening.

Perimenopause: the beginning of the shift

Perimenopause is the prelude to menopause, a period of fluctuating hormones that often begins without warning. Most women are caught off-guard—symptoms emerge early, long before menopause is on their radar. It’s the phase where irregular periods, hot flushes, and unexplained weight gain become common, but often, stress or fatigue are blamed.

Quick facts about perimenopause:

Definition

The stage leading up to menopause, where hormonal shifts trigger physical and emotional changes.

Identifying mark

Irregular or missed periods.

Average age

Most women enter perimenopause in their early 40s, but it can start as early as the 30s.

Average duration

Symptoms can appear 4-10 years before menopause.

It's important to note that although your cycles are sporadic during perimenopause, it’s still possible to get pregnant until you reach menopause, defined as 12 consecutive months without a cycle.

Symptoms can vary greatly from person to person. Women may experience up to 50 recognised symptoms.

  • The most frequent include: Irregular periods, worsening PMS, brain fog, mood swings, unpredictable hot flushes, and weight gain.
  • Less common symptoms, like hair thinning, bloating, skin itching, nausea, and changes in libido, are often overlooked or misdiagnosed.

Understanding what to expect—and when perimenopause might begin for you—can make a real difference in your ability to treat your symptoms early. New data reveals 70% of women underestimate how early perimenopause can start.

Learn more about perimenopause to prepare yourself for this new chapter.

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Menopause: a single day, a major milestone

The word menopause is often used as a catch-all for years of hormonal change. But menopause itself is just one day. It’s the point when you’ve gone 12 months without a period.

By the time you hit menopause, your estrogen levels have plummeted, triggering some of the most notorious symptoms—vaginal dryness, hot flushes, and disrupted sleep. These symptoms can persist for years, but understanding the changes can help you manage them proactively.

Quick facts about menopause:

Definition

The official end of menstruation, marked by 12 consecutive months without a period.

Identifying mark

A significant drop in estrogen occurs about six months before menopause, causing most symptoms to worse.

Average age

Menopause typically occurs at age 51, though it can vary widely.

Average duration

Symptoms often start years before menopause and can linger for 4-10 years after.

Menopause is more than just the end of periods. It signals the final transition in your reproductive life. Knowing when it happens and what to expect can empower you to seek solutions and support.

Learn more about the menopause transition

Postmenopause: the next chapter

After passing the menopause milestone, you enter postmenopause—a phase that lasts for the rest of your life. Hormone levels now remain consistently low. The good news: some perimenopause symptoms should fade as your body adapts to these lower, stable hormone levels. The less good news: new health risks emerge during this phase, requiring diligent monitoring.

Postmenopausal women face an increased risk of conditions like cardiovascular disease, osteoporosis, and urogenital symptoms such as vaginal dryness, vaginal itching, bladder issues, changes in vaginal discharge and odour, bacterial vaginosis infections, and urinary tract infections (UTIs). Understanding these risks allows you to take steps to protect your long-term health.

Quick facts about postmenopause:

Definition

The life stage following 12 consecutive months without a period.

Identifying mark

Low levels of estrogen and other reproductive hormones.

Average age

Increased risk of heart disease, osteoporosis, and urogenital symptoms.

Average duration

Symptoms can last 3-8 years after menopause, but for some women, they may persist longer.

Embrace this new stage with confidence. It’s a chance to prioritise your well-being and take steps that support your body for the years ahead.

Early and premature menopause

For some women, menopause arrives early. Up to 12% of women experience their last period before age 45, either naturally or due to medical reasons. If menopause occurs before 40, it’s classified as premature1.

A family history of early menopause can increase your likelihood of facing it. Other factors include surgeries like hysterectomies, cancer treatments, or chronic conditions. Regardless of the cause, early menopause brings with it the same challenges as typical menopause but often with additional emotional and medical considerations.

Experiencing menopause earlier than expected can feel isolating, but you’re not alone.

Learn more about early and premature menopause

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02

Menopause symptoms – what to expect

Menopause is more than just hot flushes. While many women associate menopause with a handful of well-known symptoms, the reality is far more complex. Our State of Menopause Survey revealed that 67% of Australian and New Zealand women felt completely unprepared for the breadth and intensity of their menopause symptoms.

Knowing what to expect, and when, can make all the difference in managing your experience.

Common menopause symptoms

You’ve heard about hot flushes and night sweats, but menopause symptoms extend well beyond the familiar. There are over 50 recognised symptoms, many of which are surprising and often misunderstood.

Here are some of the changes you might experience:

These symptoms can disrupt daily life, but they don’t have to control it. Knowing what to expect helps you take steps toward effective treatment.

When do menopause symptoms start and end?

The onset of menopause symptoms typically begins during perimenopause, often in your early 40s. Symptoms may intensify as you approach menopause, when hormone levels fluctuate more dramatically. While the average duration of symptoms is around seven years, they can last for up to a decade, with some lingering into postmenopause.

For example, vaginal dryness and urinary symptoms may persist well after menopause, while hot flushes typically ease over time but can last for years. One study found that hot flushes can persist for up to 14 years after menopause2.

Signs you’re in menopause

There is no definitive way to know exactly when menopause will begin. However, irregular periods and changes in how you feel day-to-day can signal the start of perimenopause. If you’re under 45 and noticing symptoms that align with the 50+ recognised menopause symptoms, it may be time to consult a healthcare provider.

Remember, your menopause experience is unique, and while family history can offer clues, your symptoms and their intensity will vary.

Treatment options

Regardless of the symptoms you are experiencing, you don’t need to suffer through them. Advocate for yourself and discuss your symptoms, family and medical history, and preferences with a healthcare provider. Whether you want to treat your symptoms through natural solutions, lifestyle changes, or menopausal hormone therapy (aka hormone replacement therapy), you have options.

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03

Emotional and mental health

Menopause isn’t just a physical shift—it can take a toll on your emotional and mental well-being. It often hits when life feels the busiest—juggling a career, managing a family, and trying to carve out time for yourself. The mental fog, mood swings, and anxiety that accompany menopause can feel overwhelming, especially when they come out of nowhere.

For many women, these emotional shifts can feel like an unseen burden. But it’s not “just mood swings.” It’s real, and it’s important to acknowledge the deep emotional impact menopause can have. Anxiety, irritability, and even depression are common as hormonal changes disrupt your mental equilibrium.

In fact, recent research shows that women in perimenopause are 40% more likely to experience depression than those who are premenopausal3. Worsening anxiety is also a frequent companion during this phase. Seeking help is not only important—it’s essential.

There’s no one way to experience menopause. Every journey is unique, and prioritising your mental health during this time is key. Reach out, seek support, and know that you’re not alone. Managing your mental health isn’t just an option—it’s part of navigating this transition with strength and care.

If you are in Australia and need help now, call:

  • Lifeline – 13 11 14
  • Beyond Blue – 1300 224 636

For other regions, seek support from your local hotline.

Learn more about the link between menopause and mental health

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04

Vaginal and sexual health

Menopause isn’t just about hot flushes and mood swings—it brings real changes to your vaginal and sexual health. Yet, these changes often get swept under the rug.

Genitourinary Syndrome of Menopause (GSM) is the name given to this set of symptoms. GSM symptoms include vaginal dryness, itching, recurring infections, odour and abnormal discharge, and painful sex. These symptoms can disrupt your daily life and put strain on intimacy, but they are completely treatable.

Yet, millions of women are still suffering in silence. Up to 80% of postmenopausal women have symptoms of GSM, yet only 7% receive treatment3. You don’t have to suffer in silence, and you definitely don’t have to go through this alone. Let’s talk about what’s really going on—and how to get the care you deserve.

Vulvo-vaginal and urinary changes

Vaginal dryness isn’t just a minor inconvenience. Without enough estrogen, your vaginal tissues become thinner, less elastic, and dry. This can make intimacy painful and everyday activities uncomfortable. Left untreated, vaginal dryness only gets worse, but early treatment can make a big difference. Solutions like localised estrogen, or hormone-free vaginal moisturisers and lubricants can restore your comfort.

Vaginal itching can also be a telltale sign of GSM. Don’t dismiss it. Persistent itching, especially when combined with changes in vaginal discharge, could indicate an infection. Menopause also impacts urinary health, leading to frequent infections, urgency, or even incontinence.

Learn more about vaginal discomfort—the silent symptom of menopause.

Changes in libido

Lower estrogen levels can also affect your sex drive. If intimacy feels uncomfortable, treating any vaginal dryness or pain is the first step. Once your body is ready, rekindling desire becomes easier. Open conversations with your partner are key—menopause is a shared experience, and communication can help maintain intimacy.

Communication is essential. Menopause isn’t something to go through alone—it’s a shared experience, and open, honest conversations with your partner can make a world of difference. Discussing what you’re going through, both physically and emotionally, can help close the gap and bring you closer during this transition.

Read the partner guide to menopause to help you navigate this period together and strengthen your relationship along the way.

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05

How to talk to your healthcare provider # about menopause

Decide when to speak to your healthcare provider

If menopause symptoms are negatively impacting your daily activities, mood, or overall well-being, it’s a good idea to see a healthcare provider. Menopause symptoms can last for years and may intensify, so you shouldn’t wait for them to get better on their own.

When you do decide to see a healthcare provider, it helps to be prepared. Research potential healthcare providers like GPs, gynaecologists, or endocrinologists. Reflect on your symptoms, their severity, frequency, and impact on your life. Consider your family medical history and preferred treatment options, such as lifestyle changes or hormone therapy.

To help you prepare, Biolae’s Chief Medical Officer, Dr. Charlotte Middleton shares five proactive steps you can take to make the most of your appointment and increase your chances of leaving with a treatment plan that works for you.

Keep and open mind and consider all solutions

Practitioners agree there is no one-size-fits all solution for menopause symptoms, so it’s important to speak to your doctor about the symptoms you are experiencing and any preferences you may have for treating them. The North American Menopause Society, Australasian Menopause Society, Jean Hailes for Women’s Health, and National Institute on aging collectively suggest

  • Lifestyle changes – regular exercise; a balanced diet rich in vegetables, fruits, lean protein and reduced sodium and sugar; reduced caffeine and alcohol consumption; no smoking; eight hours of sleep; and reduced stress.
  • Hormone therapy – artificial estrogen and progesterone, available in multiple forms such as a pill, skin patch, implant, topical gel and vaginal suppository.
  • Natural remedies – vitamins, minerals and phytoestrogens like Biolae’s Meno Essential +
  • Other complementary therapies – hypnotherapy, mindfulness therapy, and acupuncture may be effective at alleviating menopause symptoms.

Raising the standard for natural menopause care.

Meno Essential + is a practitioner-formulated blend of clinically tested, natural ingredients that treat menopause symptoms at the source.

Shop now
06

Natural remedies for menopause

Why consider natural remedies?

Not every woman wants or needs to take Menopausal Hormone Therapy (MHT). In fact, nearly half (49%) of women prefer not to5. Whether it’s due to personal preference, medical history, or a desire for a natural approach, many women turn to complementary medicines, vitamins, and lifestyle changes to manage their symptoms. According to research, 44% of women prioritise supplements, while others focus on nutrition, exercise, and fitness5.

For women who do chose MHT, many also find that complementary medicines offer a helpful natural boost in addition to their hormone therapy.

Avoiding “snake oil” in the supplement industry

It’s no secret that the supplement industry is woefully underregulated. It can be hard to sort the ethical companies committed to research and science from the opportunistic.

Biolae’s Chief Medical Officer, Dr. Charlotte Middleton, breaks down what to look for and what to avoid, when considering natural menopause options.

Here’s what to look for:

  • Patented, clinically tested active ingredients
  • Ingredients at clinically tested doses
  • Holistic, medically-reviewed resources
  • Practitioner developed and supported

And what to watch out for:

  • Anti-Hormone therapy marketing
  • Multi-Level marketing schemes
  • Unsubstantiated claims

Menopause symptoms are real, and you don’t have time for pseudoscience.

Learn more about our rigorous approach to clinical testing and science-backed formulations.

Phytoestrogens – nature’s ‘root cause’ therapy

The decline in estrogen during menopause causes symptoms like hot flushes, night sweats, fatigue, anxiety, vaginal dryness, and poor sleep. Phytoestrogens, found in foods like tofu and dried fruits or as supplements, may mimic the effects of estrogen to relieve symptoms. Some examples include:

  • Red clover
  • Hops
  • Lingans (flax seeds, Norway spruce)
  • Shatavari
  • Agnus Castus (Vitex) or Chasteberry
  • Soy

These plants have compounds similar to estrogen that bind to estrogen receptors, mimicking its benefits. For instance, Hops extract 8-PN in Lifenol, in Meno Essential +, resembles human estrogen.

Not all phytoestrogens are well researched and proven effective, so do your research before making a purchase.

Phytoestrogens are considered safe and healthy for most women, but as they can influence the body’s estrogen levels it is recommended that women with a history of hormone related cancer, such as some breast cancers, steer clear.

Learn more about how phytoestrogens treat menopause symptoms at the source

Non-phytoestrogen remedies

Non-phytoestrogen remedies can treat menopause symptoms without affecting estrogen levels. While they may take time to kick in, over time they can ease a variety of menopausal symptoms such as low mood, sleep, vaginal dryness and other vaginal changes. These vitamins and minerals can be part of a holistic routine and paired with phytoestrogens or MHT for healthy aging.

A few of our favourites:

Hyaluronic Acid

Naturally produced in the body, hyaluronic acid keeps eyes, joints, and skin hydrated. However, its production decreases with age. When used internally in the vagina, hyaluronic acid clings to the vaginal cells, maintaining hydration and protection. It's well-researched and proven to be as effective as topical estrogen in treating vaginal dryness, offering a great hormone-free options6.

Probiotics

Hormone fluctuations during menopause can directly affect your gut and vaginal microbiome, causing troublesome symptoms like bloating, IBS, vaginal odour, abnormal discharge, recurring bacterial vaginosis and UTIs. Research suggests that up to 90% of women have unstable vaginal microbial makeups that are susceptible to imbalances and infection7. Healing the microbiome and restoring communication on the gut-vagina axis can alleviate these symptoms and restore whole-body balance.

Vitamin D

Vitamin D is increasingly beneficial with age, and women are likely to become deficient as they enter menopause. Vitamin D supports bone health, particularly when taken with calcium, and boosts mood, easing depression during menopause8. It may also prevent heart disease, stroke, and Type 2 diabetes9.

Consult your HCP before adding supplements to your routine.

Learn more about how vitamins and minerals support whole body health during menopause.

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07

Menopausal Hormone Therapy

Menopausal Hormone Therapy (MHT), also known as Hormone Replacement Therapy (HRT), is a treatment used to relieve symptoms of menopause by supplementing the body with estrogen, or a combination of estrogen and progesterone. MHT helps alleviate common menopausal symptoms such as hot flushes, night sweats, vaginal dryness, and mood swings. MHT can also help prevent bone loss and reduce the risk of osteoporosis in postmenopausal women.

However, it is not without risks, and the decision to use MHT should be based on an individual's health profile, symptom severity, and a thorough discussion with a healthcare provider.

The Australasian Menopause Society and Jean Hailes offer high quality resources on the various forms and benefits of MHT.

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08

Nutrition and exercise # during menopause

Nutrition and exercise are powerful tools in your holistic menopausal health toolkit. Certain foods and exercises have been proven to reduce menopause symptoms and contribute to long-term health.

Eating to ease menopause

Prioritise Calcium and Vitamin D for bone health

As estrogen levels drop, the risk of osteoporosis rises. Ensure adequate intake of calcium (1,200 mg daily) and vitamin D (600-800 IU) through dairy, leafy greens, and fortified foods.

Eat a balanced diet rich in whole foods

A diet rich in fruits, vegetables, whole grains, and lean proteins supports overall health. Phytoestrogens in soy and flaxseeds may help balance hormones, while omega-3 fatty acids from fish reduce inflammation and improve mood.

Limit processed foods

Reducing processed foods and added sugars can help manage weight and minimise menopausal symptoms like hot flashes.

What you eat can be a powerful ally in managing menopause symptoms.

Learn more about the nutrients that can help ease the transition.

Exercises for a stronger, better menopause

Resistance training

Resistance training is crucial during menopause for overall health, mobility, and long-term quality of life. For effective strength-building exercises that boost muscle, protect bones, and enhance strength during menopause, check out these these 6 recommended workouts.

Cardiovascular exercise

Cardio activities like walking or swimming support heart health and help manage weight, crucial as cardiovascular risk increases after menopause.

Flexibility and balance training

Practices like yoga enhance flexibility, balance, and reduce stress, aiding overall well-being during menopause.

Consistency

Aim for 150 minutes of moderate aerobic activity weekly, combined with regular strength training, to optimise health outcomes.

By focusing on balanced nutrition and a consistent exercise routine, women can navigate menopause with better physical and mental health, improving overall quality of life.

References:

Read The Journal – because knowledge shared is power multiplied.

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Guide

The Essential Guide to Menopause

Everything you need to know to navigate menopause, advocate for yourself and find the right treatment.

State of Menopause 2024

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State of Menopause 2024

State of Menopause 2024

How women in Australia and New Zealand navigate menopause today—and where traditional support falls short.

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