Login

Menopause

What is Menopause?

Menopause is the end of a woman’s menstrual cycles, occurs when the ovaries stop producing  hormones that drive menstrual cycle. It is a natural process of aging and it is not a disease or disorder.  Menopause is diagnosed when you have not had a period for 12 consecutive months. This usually happens between the ages of 45 and 55. But some women can go through menopause early. It can be the result of surgery, for example if their ovaries are removed in a hysterectomy or if there have been damage to their ovaries, such as from chemotherapy. If it happens before age 40, for any reason, it’s called premature menopause.

Signs and Symptoms

Every woman experiences menopause differently. Some women barely have any complaints, while some woman may have very severe menopausal symptoms that could impact their life, including relationships, social life, family life and work. In the months or years leading up to menopause (peri-menopause), you might experience these signs and symptoms:

  • Hot Flushes – A sudden feeling of heat in the upper part or all of your body, often with blushing and heavy sweating. Hot flashes can be very mild or strong enough to wake you up (called night sweats).
  • Irregular Periods – They may be shorter or last longer. You might bleed more or less than usual. 
  • Emotional symptoms – Such as mood swings, anxiety, depression, low self-esteem and problems with memory or concentration.
  • Sleep disturbances – Often due to hot flushes, insomnia, stress or depression and make you feel tired and irritable during the day
  • Vaginal dryness – The walls of the vagina lose volume and moisture and become thin, dry, and easily irritated due to lack of oestrogen. This can lead to painful sex, an increase in vaginal infections, and chronic vaginal discomfort.
  • Palpitations
  • Reduced sex drive
  • Dry and itchy skin
  • Thinning of hair
  • Muscle ache and joint pain

Complications

Once you have gone through menopause, the risk of the development of a number of medical conditions increases. Some examples of possible complications include:

  • Heart and blood vessel (cardiovascular) disease. When your estrogen levels decline, your risk of heart disease increases. So it’s important to get regular exercise, eat a healthy diet and maintain a normal weight.
  • Osteoporosis. This condition causes bones to become brittle and weak, leading to an increased risk of fractures. Postmenopausal women with osteoporosis are especially susceptible to fractures of their spine, hips and wrists.
  • Urinary incontinence. As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine, or the loss of urine with coughing, laughing or lifting. You may have urinary tract infections more often.
  • Weight gain. Many women gain weight during the menopausal transition and after menopause because metabolism slows down. You may need to eat less and exercise more, just to maintain your current weight.

Treatment

There is no specific medical treatment for menopause. The treatments instead focus on the relief of symptoms and preventing or managing chronic conditions that may occur with aging. Common treatments include:

  • Hormone replacement therapy (HRT). You take medications to replace the hormones that your body isn’t producing anymore. HRT comes in several different forms including tablet, implants, and skin patches. They can help with hot flashes and vaginal symptoms, as well as making your bones stronger.
  • Topical hormone therapy. This is an estrogen cream that can be applied into vagina to help with dryness, discomfort with intercourse and some urinary symptoms.
  • Non-hormone medications. Certain anti-depression drug related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. Gabapentin, which is used to treat seizures and the blood pressure drug clonidine has also been shown to help reduce hot flushes.
  • Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures. Vitamin D supplements can also be used to help strengthen bones.

Lifestyle and home remedies

Lifestyle changes help many women deal with menopause symptoms. These steps may help relieving symptoms and improving quality of life during this transition.

  • If you’re having hot flashes, drink cold water, dress lightly, take a cool shower and fan yourself; Avoid hot drinks, spicy food and caffeine.
  • Use an over-the-counter vaginal moisturizer or lubricant for dryness.
  • Exercise regularly to sleep better and prevent conditions like heart disease, diabetes, and osteoporosis.
  • Strengthen your pelvic floor muscles with Kegel exercises to prevent bladder leaks.
  • Stay socially and mentally active to prevent memory problems.
  • Don’t smoke. Tobacco might cause early menopause and increase hot flushes.
  • Limit intake of alcohol, to lower your chance of getting breast cancer and help you sleep better.
  • Maintain a healthy weight and eat low-salt, low-fat, low-sugar, high-fiber diet that’s rich in a variety of fruits and vegetables.
  • Practice things like yoga, deep breathing, or massage to help you relax.

Herbs and Supplements for Menopause

A number of supplements and multivitamins are available that may help ease these symptoms. Examples are:

  • Evening Primrose Oil
  • Calcium Supplements
  • Dong Quai
  • Ginseng
  • Black Cohosh
  • Red Clover
  • Flaxseed
  • Soy
  • Valerian root
  • St. John’s Wort

References

  1. Menopause. NHS.[Internet].NHS.UK.2022[Cited 15 July 2022]. Available from: https://www.nhs.uk/conditions/menopause/#:~:text=Menopause%20is%20when%20your%20periods,chemotherapy%2C%20or%20a%20genetic%20reason.
  • Clinical Practice Guidelines on Hormone Therapy during Menopause in Malaysian Women. MOH/P/PAK/207.10(GU) [Accessed on 15 July 2022]