Menopause

What is Menopause?

Menopause refers to the time when women stop having periods completely due to the decline of reproductive hormones, primarily estrogen and progesterone. It is officially diagnosed after 12 consecutive months without a menstrual period.

The typical age for menopause is between 45 and 55, although it can occur earlier or later. The average age of menopause in Malaysia is around 50-51 years. While menopause is a natural process, it brings its own set of challenges and symptoms. 

Transition to Menopause (Perimenopause)

Before entering menopause, women go through perimenopause, the transition phase that can last several years. During this stage, estrogen and progestogen levels swing up and down before settling down, which can cause many symptoms such as:

• Irregular periods: Cycles become unpredictable, longer, or shorter. Any change in periods should always be investigated
• Hot flashes and night sweats: Sudden heat in the upper body, often accompanied by sweating and redness.
• Generalised joint pains, non-specific pains over any joints in the body, which can lead to discomfort and problems moving
• Mood swings: Fluctuating hormone levels can lead to anxiety, irritability, or depression.
• Sleep disturbances: Insomnia or poor-quality sleep which are often linked to night sweats.
• Vaginal dryness: Reduced estrogen can cause dryness, discomfort, or pain during intercourse.
• And many more other symptoms such as palpitations, dry skin, vertigo, etc etc
  

While some take it lightly, it is important to know that the hormonal changes occur during the menopause period can have long-term effects on woman’s body:

• Bone Health
• Cardiovascular Health
• Cognitive or brain functions
• Weight Gain
• Urogenital Issues

Diagnosis and Testing

Although menopause is usually diagnosed based on the absence of menstruation for 12 consecutive months, certain tests may be used to confirm the transition, especially in women who experience symptoms at an earlier age. Diagnosis can involve:

• Hormone levels: Blood tests may check levels of follicle-stimulating hormone (FSH) and estradiol to assess reproductive hormone production.
• Thyroid function tests: To rule out thyroid disorders, which can mimic menopausal symptoms.

Lifestyle Changes

Just like every other disease, it always comes back to one’s lifestyle modification in order to adapt with new conditions. Making healthy lifestyle choices can help manage menopausal symptoms and reduce long-term health risks. Here are some recommendations:

1. Maintain a healthy weight
2. Stop smoking or vaping
3. Cut down spicy food and excessive coffee intake
4. Minimise intake of polyunsaturated fats, trans fats, salt, and sugar
5. Minimise alcohol consumption
6. Blood pressure control
7. Exercise 5 days a week; 30 minutes each time. Incorporate strength training exercises to build muscle
8. 6-9 hours of sleep every night
9. Reduce and manage stress levels
10. Support group programs (in particular spousal support)

Menopause Hormone Therapy (MHT)

Menopause Hormone Therapy (MHT) is hormone therapy for women who are struggling with the menopausal changes that interfere with their quality of life.  It consists of estrogen therapy which can be given as oral tablets, gels, creams or sprays. Women with an intact uterus need additional progestogen therapy. MHT is the recommended treatment to relieve symptoms like hot flashes, night sweats, and vaginal dryness. MHT can also help prevent bone loss and reduce fracture risk.

However, discussing the risks and benefits with a healthcare provider is essential, as MHT may not be suitable for everyone. There are alternatives for women with estrogen dependent tumors, strokes, or at a higher risk of VTE.

PHKL is committed to providing compassionate and comprehensive care for women transitioning into menopause. Our approach involves a detailed understanding of each woman's journey, beginning with an in-depth medical history review, general health examination, and exploring family history to uncover potential health patterns.

We take the time to understand her personal struggles during this phase, ensuring a holistic approach to her care. Along with lifestyle adjustments, including nutrition, exercise, and stress management, we also offer menopausal hormone therapy when needed, empowering women to navigate this phase of life with confidence and support.