Menopause

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Dr. Felix Lucian Happich

Written by

Dr. Felix Lucian Happich

MD, MHBA ·

In short

Menopause is 12 months without a period with no other cause, at a median age of 51.4 years. Women over 45 are diagnosed from their periods and symptoms, without a blood test. Hot flushes affect up to 80 percent of women, 8 in 10, and vaginal and bladder symptoms about half.

Condition Overview


What is menopause?

Menopause is the permanent end of menstrual periods, confirmed after 12 months without a period and without another cause such as pregnancy or a medicine. The ovaries have run out of egg follicles, so oestradiol falls and follicle-stimulating hormone (FSH), the pituitary signal to the ovaries, rises. The years of changing cycles before it are perimenopause.

At what age does menopause happen?

Menopause happens at a median age of 51.4 years. Genetics, smoking and reproductive history shift the timing. Two earlier forms have their own names and risks.

Menopause by age
Age at the last period Name
Under 40 Primary ovarian insufficiency
40 to 45 Early menopause
Around 51 Menopause at the usual age

Early menopause and primary ovarian insufficiency carry a higher risk of heart disease, bone loss and memory problems, so hormone replacement is usually recommended until about 51: early menopause treatment.

What are the symptoms of menopause?

The typical symptoms of menopause are hot flushes, night sweats, broken sleep, mood changes and vaginal dryness. Hot flushes occur in up to 80 percent of women, but only 20 to 30 percent seek treatment, about 1 in 4. The table lists the main symptoms.

Common symptoms around menopause
Symptom How common
Hot flushes and night sweats Up to 80 percent, 8 in 10
Difficulty sleeping 38 to 46 percent in the late transition
Vaginal dryness and bladder symptoms About 50 percent
Joint aches 50 to 60 percent of women in midlife
New depression 2.5 times more likely during the transition

Each symptom in detail: hot flushes, hormonal sleep disturbance, hormonal mood changes and brain fog in menopause.

What is genitourinary syndrome of menopause?

Genitourinary syndrome of menopause (GSM) is dryness, burning, pain during sex and urinary symptoms from low oestrogen in the vulva, vagina and bladder. GSM affects about 50 percent of women after menopause, 1 in 2. GSM usually starts later than hot flushes and does not settle on its own. Low desire in the same years: low libido in women.

What does menopause change in bone and heart?

Menopause speeds up bone loss and raises cardiovascular risk. Bone density falls fastest from 1 year before to 2 years after the last period. LDL cholesterol rose by about 6 percent across the transition in the SWAN study of over 2,500 women, from 116 to 123 mg/dL on average. Blood pressure, lipids, blood sugar and bone risk are therefore checked in the menopause years.

How is menopause diagnosed?

Menopause in women over 45 is diagnosed from 12 months without a period, without a blood test. FSH is not needed and a normal FSH does not rule out the transition, because the level swings from week to week, according to clinical guidance and the NICE guideline (NICE NG23). Tests are used in 4 situations:

  • Age 40 to 45: pregnancy test, prolactin and thyroid-stimulating hormone (TSH) to exclude other causes
  • Under 40: a full work-up for primary ovarian insufficiency
  • After hysterectomy or on the pill: FSH, because periods no longer show the stage
  • Signs of another disease: prolactin or thyroid tests when the history points to them

A first check at home: the menopause self-check, based on the Menopause Rating Scale.

Which conditions look like menopause?

An overactive thyroid is the most important look-alike, because it causes irregular periods, sweating and mood changes. Pregnancy, raised prolactin, an underactive thyroid, medicines and, rarely, tumours that cause flushing are also considered when the pattern is unusual.

Menopause in Dubai and the UAE

How well informed are women in the UAE about menopause?

In a Dubai study of 591 women, 82 percent had fair or poor knowledge of menopause and its treatment, about 8 in 10 (Menopause, 2021). A review of 15 studies from Arab countries found that fewer than 1 in 5 women used hormone therapy in 11 of the studies (Frontiers in Global Women’s Health, 2026).

Why does bone health matter more in the UAE?

Bone health matters more in the UAE because vitamin D deficiency is very common. In Abu Dhabi, 72 percent of 12,346 people tested had levels below 50 nmol/L, more than 7 in 10, with the lowest values in July and August (BMC Research Notes, 2019). Vitamin D and calcium intake are therefore part of the menopause check.

Dr Felix treats within the scope of his Dubai Health Authority licence. When a case needs a specialist view, for example bleeding after menopause, a breast finding or severe depression, the decision is made together with a gynaecologist, breast specialist or psychiatrist.

How menopause symptoms are treated: hormone replacement therapy, HRT patches and oestrogen gel, vaginal oestrogen and non-hormonal menopause treatment. All options: Menopause & HRT Clinic Dubai.

Your first consultation

Sit down with Dr. Felix, say what you want to know and leave with a clear plan. One physician, from the first question to the follow-up.

When to See a Doctor


  • Hot flushes or night sweats disturb your sleep, work or daytime function.
  • Mood, anxiety or concentration changed around your last period.
  • Vaginal dryness, pain during sex or repeated urinary symptoms started after menopause.
  • Your periods stopped before 45.
  • Vaginal bleeding after 12 months without a period: assessment before any treatment.
  • A new breast lump, nipple change or breast skin change: assessment without delay.
  • Thoughts of self-harm or hopelessness: urgent care the same day, not a routine appointment.
Stethoscope, notebook and blood pressure cuff, private medical consultation with Dr Felix Happich in Dubai

How Dr. Felix Assesses This


  • 1

    Symptoms

    Flushes, sleep, mood, memory, libido, vaginal and bladder symptoms, and which one matters most to you.

  • 2

    History

    Periods, contraception, migraine, clots, heart disease, breast and family history, and screening status.

  • 3

    Examination and selective tests

    Blood pressure and weight; tests only where they change the plan, such as thyroid, lipids, HbA1c or bone risk.

  • 4

    Diagnosis and plan

    What causes your symptoms, the options side by side and a written plan with a review date.

Treatment Options


Why Early Treatment Can Matter


Early assessment of menopause symptoms restores sleep and daily function sooner and catches bone and heart risk while it is easy to change. Hormone therapy started under 60 or within 10 years of menopause has a more favourable balance of benefit and risk than therapy started later.

Why Early Treatment Can Matter


Early assessment of menopause symptoms restores sleep and daily function sooner and catches bone and heart risk while it is easy to change. Hormone therapy started under 60 or within 10 years of menopause has a more favourable balance of benefit and risk than therapy started later.

Symptoms settle

Flushes and night sweats respond within weeks of the right treatment.

Bone and heart

Bone loss and rising cholesterol are found during the years they change fastest.

One decision

Symptoms, risks and options discussed in one consultation.

Cost & Consultation Investment


The cost of a menopause assessment covers the consultation with Dr Felix, the examination, any tests that change the plan and the written plan. Dr Felix explains the full cost before anything is done.

Frequently Asked Questions


No, women over 45 are diagnosed from 12 months without a period, and FSH is not needed. Between 40 and 45, pregnancy, prolactin and thyroid causes are excluded first.

Menopause happens at a median age of 51.4 years. Before 45 it is early menopause, and before 40 primary ovarian insufficiency.

Hot flushes last a median of 7.4 years in total. Vaginal and bladder symptoms tend to persist and worsen without treatment.

The cost covers the consultation, examination, any necessary tests and the written plan. Dr Felix explains the full cost before anything is done.

Evidence

Where this information comes from

Every figure on this page is taken from the sources below. All of them are free to read, so you can check them yourself.

Written byDr Felix Lucian Happich

This page is general medical information and does not replace a personal consultation. Trial results are averages across large groups, not a prediction for any one person.

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