What happens at menopause, and when should you see a gynaecologist?
Medically reviewed by our consultant obstetrician & gynaecologist (MBBS, MS OBG). Last reviewed: 1 November 2026.
Menopause is when periods stop for good, confirmed after 12 months without a period. Most women reach it in their late forties or early fifties. Hot flushes, poor sleep and mood changes are common. Many women need only advice and simple changes. Bleeding after menopause should always be checked. Pai Hospital in Vasco sees women for menopause care.
What are menopause and perimenopause?
Menopause is the time when the ovaries stop releasing eggs and periods stop for good. It is confirmed when you have gone 12 months in a row without a period, with no other reason for it.
Perimenopause is the time before that. It can last a few years. Hormone levels go up and down, so periods may come closer together, further apart, heavier or lighter. You can still become pregnant during perimenopause, so keep using contraception until your doctor says it is safe to stop. See family planning in Goa.
What symptoms are common?
- Hot flushes and night sweats.
- Trouble sleeping and tiredness.
- Mood changes, irritability or low mood.
- Vaginal dryness and discomfort during sex.
- Passing urine more often, or urine infections.
- Joint aches and less interest in sex.
Not every woman has all of these. Some have very few. If symptoms affect your work, sleep or family life, it is worth talking to a gynaecologist.
When does bleeding after menopause need checking?
Always. Once you have gone 12 months without a period, any bleeding from the vagina should be checked, even if it is light or happens only once. Most causes are simple, such as a thin, dry lining. But the doctor needs to find the cause. Read bleeding after menopause and when a hysteroscopy is advised.
During perimenopause, very heavy periods, bleeding between periods or bleeding after sex should also be checked. See heavy or abnormal bleeding.
What if menopause comes early?
When periods stop before the age of 40, it is called premature menopause or premature ovarian insufficiency. Between 40 and 45 it is called early menopause. Both need a proper check-up. Early loss of hormones affects bone and heart health over the years, and it matters a great deal if you still plan a pregnancy. Read irregular periods: PCOS or premature menopause?
Why do bones and heart need more care after menopause?
Oestrogen helps keep bones strong and supports the blood vessels. After menopause, bones slowly become thinner and the risk of heart disease goes up. These changes are silent at first.
Simple daily habits help keep bones and heart in better shape: regular walking and some strength exercise, enough calcium and protein in food, some sunlight, no smoking, little or no alcohol, and keeping weight, blood pressure and blood sugar under check.
Which routine checks may a gynaecologist suggest after 45?
- A Pap smear to screen the cervix.
- Blood sugar and cholesterol tests.
- Thyroid and haemoglobin tests.
- An ultrasound of the pelvis when needed, for example if there is bleeding or pain.
- A breast check, and a blood pressure check at each visit.
The doctor will tell you which checks you need and how often. Pai Hospital has its own laboratory for routine blood, urine and hormone tests. Pelvic and pregnancy ultrasound is done in the hospital for its patients. We do not carry out or offer sex determination of any kind; it is prohibited by law (PCPNDT Act).
What treatment options are there?
Treatment depends on your symptoms, your health and your own wishes. There is no single plan that suits everyone.
Lifestyle changes
Regular exercise, a balanced diet, good sleep habits, cutting down on tea, coffee and spicy food if they set off flushes, and light cotton clothes. For many women this is enough.
Non-hormonal options
Some medicines without hormones can ease hot flushes, sleep problems or mood changes. Vaginal moisturisers and lubricants can ease dryness. The doctor discusses which, if any, suit you.
Hormonal options
Hormone treatment can ease troublesome symptoms for some women. It is not right for everyone. The doctor goes through your medical and family history, explains the benefits and risks for you, and reviews it with you at regular visits.
Please do not start or stop any medicine, or buy hormone products on your own, without speaking to a doctor.
When should I see the doctor?
- Any bleeding after menopause.
- Very heavy, very frequent or painful bleeding during perimenopause.
- Periods stopping before the age of 40.
- Symptoms that disturb your sleep, work or family life.
- A lump in the breast, pain during sex, or leaking urine.
- If you are over 45 and have not had a check-up in the last year.
Where are women seen for menopause care?
Women are seen at Pai Hospital, Vaddem, Vasco-da-Gama, by appointment, by the Pai Hospital Team (see gynaecologist in Vasco). Women from any part of Goa can book a visit. If you live in North Goa, see gynaecologist for patients from Panjim. If you live in South Goa, see gynaecologist for patients from Margao. If you have old reports, send them by WhatsApp before your visit. Directions are on our contact page.
See all our gynaecology services in Goa, or read about hysteroscopy.
At what age does menopause usually happen?
Most women in India reach menopause in their late forties or early fifties. Menopause is confirmed when you have gone 12 months in a row without a period. The changes before that, called perimenopause, can start a few years earlier.
Is bleeding after menopause normal?
No. Any bleeding after 12 months without periods should be checked, even a single spot. Most causes are simple and treatable, but the doctor needs to find the cause. Book a calm, planned visit soon rather than waiting.
What if my periods stop before 40?
Periods stopping before 40 is called premature menopause or premature ovarian insufficiency. It needs a proper check-up, because it affects bone and heart health, and fertility if you still plan a pregnancy.
Do I have to take hormones for menopause?
No. Many women manage well with lifestyle changes alone. Others choose non-hormonal or hormonal treatment. The doctor explains the benefits and risks of each for you, and you decide together.
Which check-ups are useful after 45?
A gynaecologist may suggest a Pap smear, blood sugar, cholesterol, thyroid and haemoglobin tests, and an ultrasound when needed. The doctor will tell you which ones you need and how often.
Where can I be seen for menopause problems in Goa?
At Pai Hospital, Vaddem, Vasco-da-Gama, by appointment. Women from Panjim, Margao and other parts of Goa can book a visit. Send your old reports by WhatsApp before the visit if you have them.
Or call +91 95459 20817 · +91 75582 52088 · 0832 251 3641
This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.