Health Tips

Menopause always carries a negative connotation for women– it’s commonly used to imply that a woman’s “youth” has expired, and a woman who is undergoing menopause has a stereotype of “being difficult” to manage. 

While it’s true that menopause affects women typically aged between 45 and 55 years old, menopause is an important transition of a woman’s life that deserves attention. Without proper knowledge and care about menopause, many women suffer from its symptoms.

What’s menopause?

Menopause is defined as the time in a woman's life, usually between age 45 and 55 years, when the ovaries stop producing eggs (ovulating) and menstrual periods end. After menopause, a woman can no longer get pregnant.

A menopause is a gradual process; most women experience several years of changes in their menstrual periods before they stop completely. It usually lasts about 7 years but can last as long as 14 years. During this period, many women also start to have menopausal symptoms, such as:

• Have periods more or less often than usual (for example, every 5 to 6 weeks instead of every 4)

• Have bleeding that lasts for fewer days than before

• Skip 1 or more periods

• Hot flashes

• Night sweats

• Trouble falling asleep

• Vaginal dryness

• Mood changes

• Nausea 

• Trouble concentrating or remembering things

• Depression

All these are due to the declining levels of oestrogen. 

Menopause is a normal part of aging and does not always need to be treated. However, the changes that happen before and after menopause can be disruptive. As you can see above, menopause can affect both the physical and mental health of a woman. 

Health risks of menopause

Beside the discomforts mentioned above, women who have gone through menopause (known as post-menopause) are more vulnerable to osteoporosis, i.e. weak and brittle bone. This is because oestrogen, a hormone that helps to protect strong bones, is reduced during menopause. In a longitudinal, multiethnic cohort study of 862 women followed for 10 years, it was found that the women suffered from significant loss in bone mass one year prior through two years after the final menstrual period. A weak and brittle bone may put women at higher risk of bone fracture. Good news is, study has found that weight-bearing exercise appears to be beneficial for reducing bone mass loss among women who are undergoing menopause.

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Fun fact: oestrogen has cardiovascular-protective effect. That’s why women who are undergoing menopause are also at higher risk for heart disease, due to the declining level of oestrogen. Study showed that women who are undergoing menopause tend to have higher levels of total cholesterol, low density lipoprotein cholesterol, triglycerides, and lipoprotein(a)– all of which are the “bad guys” that increase your odds of developing heart diseases.

Treatment for menopause symptoms

Not all women need treatment for menopausal symptoms. Depending on the severity of symptoms experienced, women may choose not to receive treatment or consult a healthcare professional for a suitable therapy.

Ways to cope with mild symptoms of menopause

1. Hot flashes and night sweats

   • Avoid hot drinks

   • Put a cold, wet washcloth against your neck during hot flashes

   • Quit smoking if you smoke, as it can worsen hot flashes

2. Vaginal dryness

   • Use lubricant before sexual intercourse

3. Difficulty to fall asleep

   • Go to sleep and get up at the same time every day, even when you don't sleep well. (Taking naps can make the problem worse.)

   • Practise good sleep hygiene, such as avoid using mobile phone or computer 2 hours before sleep, avoid doing other activities other than sleeping on your bed, and ensure the sleeping environment is cool and dark

4. Depression

   • Try to stay active. Exercise helps ward off depression

   • Seek meaningful social support especially from women who are undergoing the same phase

   • If necessary, seek professional help from counsellors, clinical psychologists or a psychiatrist. You may need an antidepressant. You may also read our article on the benefits of seeing a therapist.

Menopausal hormone therapy (Oestrogen)

Oestrogen is the most effective treatment for hot flashes. While there have been concerns in the past about the safety of hormone therapy, for most healthy women who are seeking help with symptoms of menopause, it is safe, low risk, and effective. It should be started before the age of 60 years and is generally given for up to five years. It is not recommended for women with a history of (or at high risk for) certain medical problems, including breast cancer, heart disease, and stroke. Your doctor will evaluate your risks and benefits of starting an oestrogen therapy.

Photo by Anna Shvets from Pexels

Hormone therapy usually involves a combination of estrogen and progestin (a progesterone-like medication), although women who do not have a uterus (eg, after a hysterectomy) need only estrogen. Hormone therapy is available in a pill that you take by mouth, a skin patch, a vaginal ring, and a skin gel, cream, or spray. They can relieve a wide range of menopausal symptoms such as hot flashes.

If you don't need hormone therapy for hot flashes but you have problems with vaginal dryness, vaginal estrogen can help. This is different from the estrogen preparations used to treat hot flashes; it comes in a much lower dose and does not need to be taken with progestin. It is available as a cream, tablet, or flexible plastic ring that you insert into the vagina. The versatility of menstrual hormonal treatment allows menopausal women to find the choice that works best for them.

Non-hormonal treatment

If you’re suffering from menopausal symptoms but are not eligible for hormonal therapy due to medical reasons, other options are available too. Various medications can be offered to manage your symptoms separately. You may discuss with a healthcare professional.

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Would menopause arrive earlier than it should?

Menopause that starts before age 45 is considered early. There are many reasons women experience menopause – a medical condition called spontaneous primary ovarian insufficiency; and surgeries such as hysterectomy (removal of uterus) and surgical removal of the ovaries– can trigger menopause.

Support women with menopause

This time in a woman's life is often full of other transitions—not just physical ones. Women may be caring for aging parents or relatives, supporting their children as they move into adulthood, or taking on new responsibilities at work. Therefore, it’s not easy to be a woman with multiple responsibilities, let alone having to deal with menopause. If you know anyone you love or around is bothered by menopause, encourage them to seek treatment or recommend this article to them!

Don’t wait until it’s too late. Check your health condition here.

A word from Doc2Us

If you have any questions related to menopause, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

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References

1. National Institute of Aging - What Is Menopause?

2. UpToDate - Patient education: Menopause (Beyond the Basics)

Cover image credit: Photo by RODNAE Productions from Pexels

Written by

Ms Joyce Toh