Menopause
What happens in the body during this time, which symptoms belong to it, what helps against them – and what is worth considering regardless of symptoms.
The menopause is not an event but a phase: it usually begins around the age of 45 with irregular cycles, reaches its midpoint with the last period and only fades out years later. What happens in the body during this time is well understood – and better treatable than the reputation of hormone therapy suggests. This overview sorts what the individual pages explain in detail.
The symptoms go well beyond hot flushes: disturbed sleep, palpitations, joint pain, vaginal dryness, more frequent bladder infections, loss of libido. Not every woman has all of them; one in three has hardly any. The menopause score (Menopause Rating Scale II) measures in two minutes how severe the symptoms actually are – a number to start the consultation with.
Treatment depends on what troubles you. For hot flushes and sleep disturbance, hormone therapy is the most effective option; for healthy women under 60 or within ten years of the last period, the benefit outweighs the risk according to current evidence. For vaginal dryness and bladder symptoms, local oestrogen treatment is often enough and barely enters the bloodstream. Anyone who does not want hormones or cannot take them has alternatives – with honestly stated limits. What applies today and what is out of date is set out in the overview of the menopause.
Two things that are often overlooked. First: contraception is still needed, until one year after the last period if it came after your 50th birthday – otherwise two years. The Mirena hormonal coil answers three questions at once in this phase: it prevents pregnancy, reduces the often heavier bleeding and can later serve as the progestogen component of hormone therapy. Second: low mood in these years rarely has a single cause. Hormones play a part, but so do sleep, strain and life circumstances. Where psychotherapeutic assessment and support would help, we refer you on rather than dismiss the question.
Screening continues. The cervical smear, breast examination and mammography carry on regardless of hormone status; the screening planner shows what is due when. And any bleeding that occurs more than twelve months after the last period needs to be assessed – even if it turns out to be harmless.
The practice is a private (Wahlarzt) practice in Vienna-Leopoldstadt. The consultation takes the time the subject needs; you submit the invoice to your insurer. Make an appointment.
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Frequently asked questions
How do I know the menopause has begun?
Usually from the cycles: they become shorter or longer, the bleeding heavier or lighter, individual periods are missed. Hot flushes and sleep disturbance often come later. A hormone level in the blood can confirm it, but fluctuates in this phase and is therefore only meaningful together with the symptoms.
Is hormone therapy dangerous?
For healthy women who start it within ten years of the last period or before their 60th birthday, current evidence says the benefit outweighs the risk. The breast cancer risk rises slightly under combined therapy and only after several years; oestrogen through the skin does not increase the risk of thrombosis. Whether it is an option for you depends on your history – that is what the consultation is for.
Do I still need contraception during the menopause?
Yes. Irregular cycles do not mean that ovulation has stopped. The rule of thumb: until one year after the last period if it came after your 50th birthday, otherwise until two years after.
Which examinations matter in this phase?
The annual check-up with smear and ultrasound, the breast examination and, from 45, the mammography under the Austrian screening programme. Plus any bleeding that returns after a gap of more than twelve months – that needs to be assessed.
What does the consultation cost?
The practice is a private (Wahlarzt) practice; the amounts are listed under Fees. You submit the invoice to your Austrian health insurer, which refunds 80 per cent of the corresponding public tariff.