Medical Encyclopaedia › Menopause (short definition)
In brief: The menopausal transition (climacteric) is the phase in which the ovaries gradually stop producing hormones. The menopause is the time of the last menstrual period and in Germany occurs on average around the age of 51.
What happens in the body?
In the perimenopause, hormones fluctuate considerably and the cycle becomes irregular. After that, oestrogen and progesterone fall permanently. The menopause is determined retrospectively when there has been no bleeding for twelve months.
Typical symptoms
Many women experience hot flushes, night sweats, sleep problems, mood swings, difficulty concentrating, joint complaints, vaginal dryness and urinary symptoms. Severity and duration vary greatly; hot flushes can continue for several years. In the long term, the risk of osteoporosis and cardiovascular disease increases.
Hormone therapy
For pronounced hot flushes, hormone replacement therapy with oestrogen is the most effective; women with a uterus also receive a progestogen to protect the uterine lining. If started before the age of 60 or within ten years of the menopause, the benefit usually outweighs the risks for symptoms that need treatment. Possible risks include thromboses, a slightly increased risk of breast cancer depending on the preparation and duration, and strokes. Patches or gel applied to the skin are considered more favourable with regard to the risk of thrombosis. The decision should be made individually and reviewed regularly.
Other options
For vaginal dryness, low-dose locally applied oestrogen as well as lubricants and moisturising gels help. For hot flushes, there are also non-hormonal medicines, such as certain antidepressants or newer active substances that act on temperature regulation in the brain. Cognitive behavioural therapy, exercise, weight loss and not smoking can relieve symptoms. For many herbal preparations, the evidence of effectiveness is weak.
When to see a doctor?
Distressing symptoms, bleeding after the menopause or very heavy, irregular bleeding during the transition should be assessed by a gynaecologist. Bleeding after more than twelve months without bleeding must always be investigated.
Related terms in the encyclopaedia
Perimenopause, Hot flushes, Oestrogen, Progesterone, Hormone replacement therapy, Vaginal dryness, Osteoporosis, Uterine cancer
Sources
- Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG): S3-Leitlinie Peri- und Postmenopause – Diagnostik und Interventionen, AWMF-Register 015-062
- North American Menopause Society: The 2022 Hormone Therapy Position Statement
- IQWiG: gesundheitsinformation.de – Gesundheitsinformationen des Instituts für Qualität und Wirtschaftlichkeit im Gesundheitswesen
Note: This article is for general information and does not replace advice, diagnosis or treatment from a doctor or pharmacist. Last updated: October 2026.