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# Menopause: symptoms, self-care, bone and heart health, and what to teach about hormone therapy

- Safe practice

The nurse asks about menopause symptoms, teaches self-care for sleep, bones and heart, and helps the woman weigh hormone therapy with her doctor.

Updated Nov 13, 2026

## Key points

- Menopause: 12 consecutive months without a period, usually between 45 and 55; before 40 it is early and needs evaluation.
- Pregnancy is still possible in perimenopause: contraception until 12 months without a period.
- Symptoms: hot flushes, night sweats, insomnia, mood changes, depression, anxiety, vaginal dryness, pain with sex and incontinence.
- Long term: bone loss (osteoporosis and fractures), higher heart risk and pelvic organ prolapse.
- Hormone therapy: the doctor weighs benefit and risk; usually the lowest dose that works for the shortest time needed. Vaginal bleeding during therapy needs a visit.

## What it is

Menopause is confirmed after 12 months in a row without a period, with no other cause; most women reach it between 45 and 55 (WHO). The years around it bring hot flushes, night sweats, poor sleep, mood changes and vaginal dryness. Falling oestrogen also raises the risk of osteoporosis and heart disease. Nursing care is to ask about symptoms that women often do not mention, teach self-care, talk about sexual health and explain the benefits and risks of hormone therapy so the woman can decide with her doctor.

## What it requires

- Menopause can also be induced by removal of both ovaries, radiotherapy or chemotherapy.
- Hormone therapy eases hot flushes, night sweats, vaginal dryness and sleep problems; it is no longer used to prevent osteoporosis (MedlinePlus).
- Risks discussed with hormone therapy: blood clots, stroke, breast cancer with long combined use, heart disease if started late, endometrial cancer with oestrogen alone in a woman with a uterus, and gallstones.
- Hormone therapy is not usually used after stroke, heart attack, blood clots, breast or endometrial cancer, or with liver disease.
- WHO asks health workers to address sexual health in menopause too: STI risk, safer sex and testing.

## Components

- Symptom assessment: periods, vasomotor symptoms, sleep, mood, genitourinary and sexual symptoms.
- Bone and heart risk: smoking, weight, activity, blood pressure and screening tests due.
- Self-care teaching.
- Information on hormonal and non-hormonal options, for a shared decision with the doctor.

## How it is applied (and why)

- Ask directly about periods, hot flushes, sleep, mood, vaginal dryness and urine leakage — many women do not bring them up.
- Ask about bleeding after menopause and refer it to the doctor — WHO lists it among the warning symptoms of cervical cancer.
- Screen mood and ask about anxiety or depression — mood changes are common and treatable.
- Teach self-care for hot flushes: layered clothes, a cool, dark room, and less alcohol, caffeine and spicy food — these ease symptoms without medicines.
- Encourage regular physical activity, a healthy weight and stopping smoking — they protect bones and heart and improve sleep and mood.
- Check that blood pressure and the screening tests of her age are up to date — heart risk rises after menopause.
- Explain lubricants and that the doctor may offer local vaginal treatment for dryness — painful sex is treatable.
- Explain benefits and risks of hormone therapy in plain words and list her questions for the doctor — the decision is shared and personal.
- Warn that supplements and «natural» creams have mixed evidence and may interact with medicines — she should check with her doctor first.

## In nursing practice

- During hormone therapy: report vaginal bleeding or other unusual symptoms; therapy raises the risk of blood clots and stroke, so new symptoms are checked.
- Remind contraception in perimenopause until 12 months without a period.
- Menopause before 40 is early (WHO): refer to the doctor to look for the cause.
- Continue cervical and breast screening by the route's schedule.

## Common mistakes

- Thinking hot flushes are «just age» and not offering help.
- Ignoring bleeding after menopause.
- Stopping contraception at the first missed period.
- Not asking about sexual health and urine leakage.

## Test yourself

Think of the answer, then tap the question to see it.

## When is natural menopause confirmed?

After 12 consecutive months without a period, with no other obvious cause.

## Until when should a woman in perimenopause use contraception?

Until she has had 12 months without a period, because pregnancy is still possible.

## Which long-term risks rise after menopause?

Bone loss with osteoporosis and fractures, heart disease and pelvic organ prolapse.

## Which symptom during hormone therapy should the woman report?

Vaginal bleeding or other unusual symptoms.

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## Elsewhere in DurgiPedia

- [Menopause](https://durgical.com/en/physiology/menopause/)

## Connections

## Related 2

- [Nursing the older adult: functional assessment and geriatric syndromes](https://durgical.com/en/nursing/nursing-the-older-adult-functional-assessment-and-geriatric-syndromes/)
- [Sexuality and sexual health in nursing care](https://durgical.com/en/nursing/sexuality-and-sexual-health-in-nursing-care/)

## Related conditions 2

- [Menopause and climacteric syndrome](https://durgical.com/en/conditions/menopause-and-climacteric-syndrome/)
- [Genitourinary syndrome of menopause (atrophic vaginitis)](https://durgical.com/en/conditions/genitourinary-syndrome-of-menopause/)

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Menopause (fact sheet)](https://www.who.int/news-room/fact-sheets/detail/menopause) (World Health Organization, 2024); [Menopause](https://medlineplus.gov/menopause.html) (MedlinePlus, U.S. National Library of Medicine, 2026); [Deciding about hormone therapy](https://medlineplus.gov/ency/patientinstructions/000694.htm) (MedlinePlus, U.S. National Library of Medicine, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/nursing/menopause-symptoms-self-care-bone-and-heart-health-and-what-to-teach-about-hormo/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/menopause-symptoms-self-care-bone-and-heart-health-and-what-to-teach-about-hormo/