Menopause is a near-universal transition for women, yet causal evidence on its health and healthcare consequences is scarce. Using Australian survey data linked to administrative healthcare records, we exploit variation in the age of natural menopause in a stacked difference-in-differences event study to estimate its effects on non-hospital healthcare use, health outcomes and costs. Service use spikes in the year of and the year after menopause, driven by general practitioner, specialist, investigative and therapeutic services. Care for musculoskeletal, skin and cancer conditions remains elevated beyond this spike, corroborated by more diagnoses of arthritis and osteoporosis and greater limitations in physical functioning; we find no increase in psychiatric, neurological, respiratory, endocrine or gynaecological care. Non-hospital medical costs rise by about 10 per cent per woman per year in the short term. Government expenditure returns to baseline within two years, whereas women’s out-of-pocket costs rise before menopause and remain elevated three years after. Menopause is thus a significant health shock with financial implications for women and governments, underscoring the need for targeted health policy and service planning.