Menopause: more than the end of your period.
Menopause is a turning point, not the end. Much of what is taken for inevitable in these years is treatable, once you know what to look for.
A single point in time, and the phase after it.
Menopause is confirmed in hindsight, once the last period was twelve months ago. The time after that is postmenopause. In Switzerland, women are 51 on average at their last period.
An early menopause before 45 and premature ovarian insufficiency before 40 always warrant a medical assessment and are usually treated, because the hormone deficit acts over many years here. What most women experience as the menopause transition already happens in perimenopause, the phase before it.
Menopause in numbers
Studies show values for groups. Your personal situation may differ.
What becomes noticeable in menopause and after.
Menopause symptoms touch many organ systems, because oestrogen acts throughout the body.
Vaginal dryness and sexual problems by menopausal status
In a worldwide analysis, 44.8% of midlife women reported vaginal dryness after menopause, compared with 21.2% before the transition. Sexual problems were reported by 54.0% after menopause and 35.2% before the transition. Reporting a problem does not mean being distressed by it.6
| Symptom and menopausal status | Share of women |
|---|---|
| Vaginal dryness, Before the transition | 21.2% |
| Vaginal dryness, Perimenopause | 36.1% |
| Vaginal dryness, After menopause | 44.8% |
| Sexual problems, Before the transition | 35.2% |
| Sexual problems, Perimenopause | 48.8% |
| Sexual problems, After menopause | 54.0% |
Midlife women worldwide, grouped by menopausal status (WHO definition). A selection of two of the five symptoms for which the analysis reports figures by menopausal status. Studies ask about sexual problems in different ways, and reporting a problem does not mean being distressed by it. The studies differ widely, so the figures show an order of magnitude.
Five areas that deserve attention after menopause.
After the last period, hormone levels stay low for good. Because oestrogen acts throughout the body, more than the cycle changes over time.
Oestrogen protects the bones. Bone density is lost fastest in the first years after menopause. Hormone therapy slows that loss for as long as the therapy runs.
Oestrogen protects the blood vessels against arteriosclerosis, the main cause of heart attack and stroke. Started early because of symptoms, hormone therapy can maintain that protection for the heart. It does not protect against stroke. Depending on the form, it can slightly increase the risk of stroke and thrombosis. It is not prescribed to prevent cardiovascular disease alone, it is not licensed for that.
With the loss of oestrogen, glucose metabolism changes and the risk of type 2 diabetes rises. Hormone therapy has a protective effect, new-onset diabetes is less common under therapy. It is prescribed because of symptoms, not for prevention.
Vaginal dryness and recurring urinary tract infections are common. Unlike hot flushes, they do not pass on their own. A local therapy relieves the symptoms effectively.
Oestrogen supports neuroplasticity, the brain's ability to form new connections and adapt. Concentration and word-finding problems relate to the hormone swings. Started early, hormone therapy can contribute to protection against dementia.
Important: these developments are not an unavoidable fate. How much they affect you depends on your personal risk profile, and much of it can be influenced: through strength training, nutrition, vitamin D, not smoking and, where medically sensible, hormone therapy.
What helps during and after menopause?
That depends on which symptoms are bothering you, how long ago your last period was and what your medical history shows. There are approaches with and without hormones, on their own or combined.
Exercise, bones and heart
Regular exercise, especially strength training, along with brisk walking or taking the stairs, helps you maintain muscle and bone. After menopause the risk of cardiovascular disease and type 2 diabetes rises, and exercise helps to counter that too. For your bones, also make sure you get enough calcium from your diet. If you smoke, you lose bone faster and have hot flushes more often, so stopping is always worth it.
Vagina and bladder
Dryness, burning, pain during sex and recurring bladder infections do not go away on their own after menopause. Vaginal moisturisers and lubricants help many women. If that is not enough, a treatment applied directly in the vagina may be an option, including one with hormones, if medically suitable. Do mention it, even if it feels embarrassing. More on vaginal dryness and urinary tract infections (in German).
Without hormones
Cognitive behavioural therapy adapted for menopause can help with sleep problems and low mood, and can make hot flushes less of a burden. If hormones are not an option for you, or you would rather not take them, there are non-hormonal prescription medicines for hot flushes. These have side effects too. For herbal remedies the evidence is mixed and products vary widely, so talk to your physician before you take them, especially if you take any medication. More on hot flushes and sleep problems (in German).
Hormone therapy, if medically suitable
For troublesome hot flushes and night sweats, the guidelines recommend offering hormone therapy, unless there is a reason not to. Whether it is an option for you depends on your age, your medical history and your risks. If it is only started after 60, or more than ten years after menopause, it is weighed especially carefully. It is not risk-free: depending on the form and duration, it can, for example, slightly increase the risk of thrombosis, stroke or breast cancer. After breast cancer or a thrombosis, and with some other pre-existing conditions, it is either ruled out or only an option after careful consideration. If you still have your uterus, you need additional protection for its lining. More in our HRT overview (in German).
When to see a doctor
Have new, severe or persistent symptoms checked by a doctor. If you have sudden chest pain, shortness of breath, fainting, paralysis or difficulty speaking, call the emergency number 144 immediately. Have any bleeding after menopause, even a single episode of spotting, examined in person by your gynaecologist first. Your physician will clarify whether lab tests would help. More on hormone levels and blood tests (in German).
What is medically possible in menopause, step by step.
It always starts with a medical consultation. What follows depends on your symptoms and your findings.
Medical history questionnaire beforehand, then a 1:1 video consultation. Your physician works out which symptoms belong to menopause and which have another cause.
After menopause hormone levels stay low, a single hormone value rarely adds anything. Lab values are used where they change the plan, for example before a therapy or to check tolerability.
A dedicated video consultation: what is treatable, what is watched and which long-term topics matter for you.
Closely guided during the setup phase, then on a quarterly rhythm. Dosage, tolerability and long-term topics stay in view.
Treatment decisions are made by your physician, not an algorithm.
To treatmentYour medical consultation
Your consultation brings clarity about your next medical step. Where medically indicated, targeted diagnostics complete the assessment. During treatment you are supported by a physician throughout.
Preparation in your patient area, a review by your physician before the appointment, 30 minutes by video with her, then your report with treatment plan in writing.
Follow-up with your physician every month, for phases in which effect, tolerability or dosage need to be guided closely. You can stop at any time, and the current monthly period runs to its end.
Follow-up with your physician every three months, once your treatment is well established. You pay for three months in advance. You can cancel at any time, and the quarterly period you have already paid for runs to its end.
Where medically indicated: targeted diagnostics. Your physician discusses the scope and cost with you beforehand.
Your medical consultation
A fixed price for your consultation. Then you decide whether ongoing care makes sense.
Included in both
When your body changes, your next step should be clear.
In your medical consultation, your physician already knows your medical history and any existing results before you speak. You use the 30-minute video call to look ahead, and afterwards you receive your report with treatment plan in writing.
- Between 38 and 65 years old
- Typical perimenopausal or menopausal symptoms
- Also with hormone therapy already underway
When your body changes, your next step should be clear.
In your medical consultation, your physician already knows your medical history and any existing results before you speak. You use the 30-minute video call to look ahead, and afterwards you receive your report with treatment plan in writing.
Common questions about menopause.
The most common questions about menopause and postmenopause. Anything further you clarify directly with your physician.
All questions and answersWhat is menopause?
Menopause is the point at which your periods stop for good, because the ovaries have largely stopped making hormones. It is confirmed in hindsight, once the last period was twelve months ago. In everyday speech, many people use the word for this whole stage of life, known medically as the climacteric. The years before it are called perimenopause, and the time after it postmenopause.
At what age does menopause happen?
In Switzerland, women reach menopause at 51 on average, most of them between 45 and 55. Before 45 it is called an early menopause, before 40 premature ovarian insufficiency (POI), and both should be checked by a doctor. Whether you have reached it only becomes clear in hindsight, after twelve months without a period. After a hysterectomy, on hormonal contraception or on hormone therapy, you cannot tell this from your bleeding.34
What is postmenopause?
Postmenopause is the time after menopause, and it lasts for the rest of your life. Hormone levels stay low for good. Hot flushes usually ease over time, whereas vaginal dryness does not go away on its own, and your bones, heart and metabolism deserve more attention. Have any bleeding after menopause, even a single episode of spotting, examined in person by your gynaecologist first.
What is the difference between peri- and postmenopause?
Perimenopause is the transition phase with periods still present. Menopause is confirmed in hindsight, once the last period was twelve months ago. The time after that is postmenopause.
What is an early menopause, what is POI?
An early menopause is before 45, premature ovarian insufficiency (POI) before 40. Depending on the study, POI affects about 1 to 4 in 100 women, and early menopause is more common. Both warrant a medical assessment, because treatable causes can lie behind them, and are usually treated, because the hormone deficit acts over many years. Ovarian function can return in between, so pregnancy is possible despite POI. Hormone therapy is not a contraceptive.
How long do symptoms last after menopause?
For most women, hot flushes ease over time after menopause, whereas vaginal dryness and bladder symptoms do not go away on their own. Overall, hot flushes last around seven years on average, often beyond menopause. Vaginal and bladder symptoms tend to increase over the years. There are treatments for both, and your physician will work out which one suits you.
Can you still have hot flushes after menopause?
Yes, for many women hot flushes continue beyond menopause. They often start in perimenopause and last around seven years on average overall, for some women beyond the age of 60, and they usually ease over time. If they appear for the first time many years after menopause, or only since you started a new medication, or if fever, unintended weight loss or swollen lymph nodes come with them, have this checked by a doctor, because other causes are then possible too.
What helps during and after menopause?
Depending on your symptoms, options include exercise and strength training for muscles and bones, cognitive behavioural therapy adapted for menopause, treatments for vaginal dryness, non-hormonal medicines and, if medically suitable, hormone therapy. Which approach suits you depends on your age, your medical history, your risks and how long ago your menopause was. Your physician weighs this up with you.
When is hormone therapy an option?
Hormone therapy is an option when menopausal symptoms are bothering you and there is no medical reason against it. Age alone does not decide. According to the guidelines, the benefits outweigh the risks for many women under 60 or within ten years of menopause. It is not risk-free at any age, though: depending on the form and duration, it can, for example, slightly increase the risk of thrombosis, stroke or breast cancer. Started later, the risks of heart attack, stroke and thrombosis are higher, so it is weighed especially carefully. Your physician assesses this with you.
How long can I take hormone therapy?
There is no fixed upper limit. How long hormone therapy makes sense depends on your symptoms and your risks, and your physician reviews this with you at least once a year. Depending on the type of hormone therapy, the risk of breast cancer can rise slightly with duration, which is part of that decision. After stopping, hot flushes come back for many women, at least for a while and usually milder than before.
Will I automatically be prescribed hormones after the medical consultation?
No. Your physician only recommends a therapy when it is medically indicated and suits your medical history. For some women, options without hormones are the better step. For others it is enough at first to understand the symptoms and keep an eye on them. Whether you start a treatment, and which one, you decide together with your physician.
Written by the gynxtra editorial team for general information. It does not replace medical advice.
Sources
- McKinlay 1992: McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Maturitas 1992;14(2):103-115. doi:10.1016/0378-5122(92)90003-M, own illustration europepmc.org ↩︎
- STRAW+10, Harlow 2012: Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop + 10. Menopause 2012;19(4):387-395, own illustration pmc.ncbi.nlm.nih.gov ↩︎
- WHO 2024: World Health Organization (WHO). Menopause. Fact sheet, 16 October 2024 who.int ↩︎
- USZ: University Hospital Zurich, patient information on menopause symptoms («Wechseljahresbeschwerden»), updated 31.07.2026, accessed 07.10.2026 usz.ch ↩︎
- IMS 2025: Panay N, Fenton A, Hamoda H, et al. International Menopause Society (IMS) recommendations and key messages on women's midlife health and menopause. Climacteric 2025. doi:10.1080/13697137.2025.2585487 imsociety.org ↩︎
- Fang 2024: Fang Y, Liu F, Zhang X, et al. Mapping global prevalence of menopausal symptoms among middle-aged women: a systematic review and meta-analysis. BMC Public Health 2024;24:1767. doi:10.1186/s12889-024-19280-5. Licence CC BY 4.0 (creativecommons.org/licenses/by/4.0), own illustration, selection doi.org ↩︎