Welcome to the
Menopause refers to a single episode in a woman's life, her "last" period and the end of female reproduction . Menopause is confirmed when a woman has gone one full year without having a period. The day after that one-year mark, she's now postmenopausal yet people refer to it as menopause. Typically, this occurs around age 52 but the age range runs 40–60, with many who experience it earlier or later.
Although perimenopause is defined as the time before "the change," its starting point isn't so definitive. It's a nebulous concept and you enter into it gradually and come out of it gradually. So, there is no easy, identifying place of how or when it starts. It can last for 8-10 years
Perimenopause is a result of a woman's aging ovaries, specifically when the coordinated patterns of the hormones estrogen and progesterone begin to vary, throwing the delicate system out of balance. It may take a while to detect symptoms, with a period still evident (although possibly shorter in duration, not as regular for instance), and then you may start to notice other small changes or not until you suddenly do...
Perimenopause can start when a woman is in her 30s or 40s, but the 40s are more common. It typically lasts 6–10 years and the experience varies considerably for many.
Perimenopause is marked by a drop in estrogen which is the main female hormone produced by the ovaries. The estrogen levels can also go up and down more sporadically than they do in a typical 28-day cycle. This can cause irregular periods and other symptoms.
During the final stages of perimenopause, your body will produce less and less estrogen. Despite the sharp drop in estrogen, it’s still possible to get pregnant. Perimenopause can last for as little as a few months and as long as 4 years
.
Menopause officially kicks in when the ovaries produce so little estrogen that eggs are no longer released. This also causes your period to stop
.
Your doctor will diagnose menopause once you haven’t had a period for a full year.
You may enter menopause earlier than normal
if you:
have a family history of early menopause
are a smoker
have had a hysterectomy or oophorectomy
have undergone cancer treatments.
Can you tell by a blood test if I am in perimenopause?
Most people can tell by the symptoms that they've started menopause. If you have worries about irregular periods or hot flashes, talk with your healthcare professional.
Tests most often aren't needed to diagnose menopause. But sometimes, your healthcare professional may suggest blood tests to check your levels of:
Follicle-stimulating hormone (FSH) and estrogen (estradiol).
FSHgoes up and estrogen goes down during menopause. Because hormones go up and down during perimenopause, it can be hard to tell from these tests whether you're in menopause.
Thyroid-stimulating hormone (TSH). Overactive thyroid, called hyperthyroidism, can cause symptoms like those of menopause.
You can get home tests to check FSH levels in your urine without a prescription. The tests show whether you have higher FSH levels. This might mean that you're in perimenopause or menopause, But FSH levels rise and fall during your menstrual cycle. So home FSH tests can't really tell you whether you're in menopause.
When hormone levels begin to decline in the lead-up to menopause, every system that has hormone receptors registers the change, including your brain. Ongoing fluctuation in hormone levels during this time can cause a range of symptoms, which may vary greatly between women and even change over time. Symptoms can range from mild to severe, and while some women may not experience many symptoms, others may experience a variety of issues that can significantly impact their quality of life. Even minor symptoms can have a major effect, especially if they persist over time. The long-term effects of menopause include an increased risk of osteoporosis and cardiovascular disease. If you are experiencing symptoms, it is important to discuss them with your GP or gynaecologist to explore appropriate management strategies.
As estrogen levels drop, you might start experiencing symptoms of menopause. Some of these can occur while you’re still at the perimenopause stage.
night sweats
hot flashes
depression
anxiety
irritability and mood swings
insomnia
fatigue
dry skin
vaginal dryness
frequent urination
Perimenopause and menopause can also increase cholesterol levels. This is one reason why women in postmenopause are at an even higher risk for heart disease.
Continue to have your cholesterol levels measured at least once a year.
You don’t necessarily have to call your doctor to obtain a perimenopause or menopause diagnosis but you should see your your doctor if the symptoms of either perimenopause or menopause become severe enough to interfere with your daily life.
For a checklist on what to ask and discuss with your doctor, refer to our website at "What to discuss with your GP"
For details on Treatment options to ease your symptoms refer to our website "Treatment options"
There are various ways to treat the symptoms of menopause, again often depending on the severity of the symptoms. Lifestyle changes outlined on this website including strategies such as exercise, nutrition, stress reduction techniques, sleep help strategies often help many menopause symptoms but, subject to obtaining your own independent medical advice, the following prescription and over-the-counter (OTC) treatments may available for perimenopause and menopause.
Menopause treatments aim to ease symptoms and prevent or manage ongoing conditions that may happen with aging. Any treatment will depend on the person, their family history and medical background, the medication they are already having, their mental health, the severity of their symptoms and their own independent doctor's advice.
Below however are some of the more common treatments used to ease symptoms:
Hormone therapy.
Estrogen therapy works best for easing menopausal hot flashes. It also eases other menopause symptoms and slows bone loss.
Your healthcare professional may suggest estrogen in the lowest dose and for the time needed to relieve your symptoms. It's best used by people who are younger than 60 and within 10 years of the onset of menopause. If you still have your uterus, you'll need progestin with estrogen. Estrogen also helps prevent bone loss. Long-term use of hormone therapy may have some heart disease and breast cancer risks. But starting hormones around the time of menopause has shown benefits for some people. Talk with your healthcare professional about whether hormone therapy may be safe for you.
Vaginal estrogen.
To relieve vaginal dryness, you can apply estrogen to the vagina using a vaginal cream, tablet or ring. This treatment gives you a small amount of estrogen, which the vaginal tissues take in. It can help ease vaginal dryness, pain with intercourse and some urinary symptoms.
Medications to help prevent bone thinning osteoporosis.
Your healthcare professional might suggest medicine to prevent or treat osteoporosis. Several medicines can help reduce bone loss and risk of fractures. Your healthcare professional also might prescribe vitamin D supplements to help strengthen bones.
Oral contraceptives
Heavy or irregular periods and hot flashes may benefit from this medicine that evens out hormonal fluctuations.
Menopausal hormonal therapy
: (Formerly known as HRT) Like oral contraceptives, this is a low dose of hormones to supplement estrogen levels. It helps with hot flashes, night sweats, insomnia, emotional issues and vaginal dryness.
Low-dose antidepressants
Selective serotonin reuptake inhibitors (SSRIs) like Prozac may relieve hot flashes, mood swings and irritability by modifying the brain signals.
Counselling, Menopause Coaches, Psychologist
Brain fog, anxiety, depression, dependence on alcohol, sleep issues - cognitive behaviour and other talking therapy with a qualified psychologist
Lifestyle changes
A healthier diet with less animal fat and processed sugar, exercise, relaxation techniques such as meditation, yoga, and a consistent sleep schedule may relieve some of the symptoms, including weight gain, irritability and insomnia.
Vaginal lubricants
For vaginal irritations, use water-based vaginal lubricants or prescription vaginal creams
Allied health services and holistic integrative therapy
Acupuncture, naturopathy, breathwork, nutritionists, psychologists, counsellors, hypnosis, dermatologist, pelvic floor exercise support, yoga, thi chai mindfulness techniques and massages.
Talk with other people
Reach out and be open about it with others in your life and stay connected socially with people. Don't forget this affects 50% of the population and we can openly chat about our labours, pregnancy, periods etc!
Various supplements may be of help but there is unfortunately little evidence to prove:
Ginseng
St Johns Wart
Melatonin
Hot Flushes
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Night Sweats
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Sleep Disorders
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Mood Swings
Irritability
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Vaginal changes
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Low Libido
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Fatigue
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Weight Gain
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Muscle Tension
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Memory Loss
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Breast Pain & Tenderness
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Bloating
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Lack of Concentration
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skin issues
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Irregular Periods
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Hormonal Headaches
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Heart Palpitations
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Hair Loss
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Osteoporosis
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Panic Disorder
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Dizziness/faint
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Digestive Problems
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Burning Tongue
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Increased Allergies
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Sleep Disorders
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anxiety/depression
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Sleep Disorders
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digestive issues
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tinnitus
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dry, itchy eyes, ears, skin
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loss of confidence/self esteem
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quickly angered/rage
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Don't worry, Pause, we can help!
Your step by step guide to the PAUSE!
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Financial, Legal and Safety wellness
Blended families
If you are part of a blended family, you know that whilst it can be so wonderful, it can present a unique set of legal considerations and potential relationship challenges.
In family law, a 'Blended family', also known as a stepfamily, is a family unit where at least one child is the biological or adopted child of only one parent, and not both. This usually happens when two separate families come together, often through marriage or de facto relationships.
Approximately 12% of couple families with dependent children were classified as either step-families or blended families in the 2021 Australian Federal Census.
Of these, step-families comprised 8% of all couple families with dependent children (182,229 families), while blended families made up 4% (99,564 families).
Legal tips to consider for Blended Families
When families merge through new relationships, forming a ‘blended family’, a range of unique legal scenarios can arise. Understanding these can help ensure everyone’s rights and responsibilities are upheld.
In Australia, The Family Law Act 1975 sets out the rights and responsibilities of parents and step-parents, including matters related to children’s living arrangements, financial support, and decision-making.
Additionally, state and territory laws may also apply in specific situations.
While the fundamental principles of family law remain consistent between a traditional and blended family, their application can vary in blended families:
- Step-parent generally don’t have the same automatic parental rights as biological parents. However, if you live with your stepchildren and their parent, you have a responsibility to care for them as you would your own children. This includes providing for their basic needs, ensuring their safety and well-being and contributing generally to their upbringing. It may, in some instances, also include financial obligations.
- Parental rights in a blended family are usually primarily based on what is in the best interests of the child (as required for a traditional family).
- While biological parent’s parental rights and responsibilities are clearly defined under The Family Law Act (custody, decision making and financial support) these rights can be recognised by the Family Courts if the step-parent has been a very significant caregiver or if there are formal agreements made between the biological parents and the step-parent through court orders or agreements.
- Step-parents may need to seek court orders for parental responsibility or establish their standing through de facto relationships.
Child Support Payments and Blended Families
- In most cases, the amount of child support that a person or their former partner is liable to pay will not change if they remarry or enter into a new relationship. You should however carefully check with child support as it is a complex calculation.
- A parent can successfully change their child support assessment by showing special circumstances for example if they are supporting other children (it will potentially reduce their capacity to pay child support).
- If you have an existing child support agreement and your family situation changes due to a new relationship, it’s important to review and potentially update the agreement.
- If the child's birth mother remarries and her new partner wants to adopt the child, the birth parents are usually responsible for raising the child. The new stepfather is not liable for children who are not his biological children, and the biological parent may still be required to make regular child support contributions.
Adopting a step-child
- One of the most significant legal steps that a step-parent can take is to adopt their step-child. This is a complex process that involves a number of legal steps, but it can provide many benefits for both the child and the step-parent. Adoption gives the step-parent legal recognition as the child’s parent and provides them with the same rights and responsibilities as a biological parent.
- There are different laws and rules of eligibility that need to be complied with in order to adopt. You should seek legal advice.
Wills & Estates for Blended Families
When someone with a blended family passes away and leaves their entire estate or a large part of it to some family members, but not to others, it can put their estate at risk of an excluded family member(s) can legally challenge the distribution of the deceased person's assets.
Family members who are not adequately provided for in a Will are often entitled and eligible to make a claim against the deceased person's estate, even if they are not blood related.
Custody when a blended family relationship breaks down
Custody arrangements in blended families usually rely on the existing custody agreements or orders from previous relationships. The child’s biological or adoptive parents usually hold primary custody rights, determining where the child lives and making major decisions about their upbringing.
However, step-parents can obviously play a significant role in a child’s life, and arrangements for visitation or shared care can still be negotiated or ordered by the court.
These arrangements are often made with the child’s best interests as the paramount consideration. Factors like the child’s age, their relationship with each parent and step-parent, and the stability of each household are all considered. Communicating openly with all parties involved is crucial to create a plan that works for everyone.
We recommend you seek legal advice in relation to any of these more complex 'blended family' issues.
Key Emotional Challenges of blended family
The first step to improving your blended family problems is to identify if things aren’t blending well. Here are some signs to look out for:
Step-siblings don’t get along and there is a lot of fighting or lack of any communication/interraction
When jealousy rears its head between the children or even partners and their step child
Family gatherings and meal time are tense and uncomfortable
When parenting styles don’t align and you cannot agree on rules for the household
When the children develop new behavioural issues
Your step children wont listen or respect your authority.
Your step-children only ask their biological parent for permission and help and don't come to you - or vice versa with your partner.
When there is an obvious split in the household rather than a ‘blend’
Tips to Resolving Blended Family Problems
Don’t panic. It can take some time and there are strategies you can you take to address the issues you may have mixing your families.
Show a united front
Children will usually be led by their parent’s example and if you and your partner aren’t completely unified, chances are the kids will follow. Make sure that you and your partner put in the effort to stay consistent and act together. Don’t contradict each other’s rules or negate each other’s parenting styles.
It may take a lot of long, even difficult, conversations to get on the same page about the rules and standards you want to put in place for your household. This is an effort that is not only worth making but is absolutely critical to make in order to allow your blended family to truly blend.
Respect the old ways
Transitioning to a blended family can feel very threatening for children who may fear the loss of a previous life that they were attached to. Respect the traditions that you had before to give them more comfort.
Start new family traditions
Find common ground between what both sides of the family like for example pizza night Tuesday and BBQ Sunday. Let your kids take an active part and even lead the way forward so they feel invested in and excited by their family’s future instead of alienated by it.
It won’t just happen overnight
Change takes time. Respect and validate each others feelings, especially the children. Try to have really calm open communication - talk things out openly instead of sweeping them under the rug. You’re all in this together, and the process may understandably take some time to get a happy rhythm.
Family Counselling help
Sometimes family problems go beyond what you can be addressed at home. A Family Counsellor can really assist families to find strategies to work together to resolve issues and find ways to work together and better communicate.
Utilising family dispute mediation services can also be beneficial. These services provide a supportive and neutral environment for families to discuss and resolve conflicts, with the aim of reaching a mutually agreed outcome.
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