The periods may cease suddenly but this is unusual. More often, there is a reduction in the amount of bleeding and occasional periods are missed. The total change may take several months or even a year or two.

Sometimes the reverse happens and the periods become heavier and more frequent, due to some associated disorder.

Most women worry about the possibility of becoming pregnant at this time and are concerned about when they should discontinue contraception.

Those woman who have shown their fertility by still having children into the forties are more likely to conceive than those who may not have had a child for 10 or 15 years and yet have not been too careful in avoiding conception.

Because ovulation may still occur, most doctors would advise their menopausal patients to practise contraception until a full year from the last period.

Most women go through the menopause, or climacteric, with a minimum of discomfort and few symptoms. Unfortunately, for others this time of their lives may become a nightmare and they suffer severe physical and mental symptoms.

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