From headaches to hot flashes and the dreaded night sweats – menopause can be a testing time for many women. Dr Tan Lih Yi from the International Medical Clinic explains what happens to the body during menopause and how to combat the symptoms. “Most women know what menopause is, but many women don’t really know when it will occur or what to expect when it happens,” says Dr Tan. “But it can be very manageable if you have all the right information and treatment options.”
The Different Stages
Menopause is considered premature when it occurs before a woman turns 40. The reason for its early arrival can simply be genetic (ask your mum when it happened to her) or caused by autoimmune processes such as thyroid disease, rheumatoid arthritis, diabetes and medical procedures such as surgery or cancer treatment. Smokers can also reach menopause around two years earlier than non-smokers – a good reason to quit!
In a woman’s mid to late forties (or anytime from forty) she may start experiencing perimenopause, the transition leading up to menopause. It usually lasts six years or more and officially ends a year after your final period.
During perimenopause, the ovaries’ production of hormones becomes more erratic, (causing changes in the menstrual cycle). For a few women, menstrual periods simply stop one day. For most woman, however, there’ll be subtle changes in flow and/or frequency of periods over many years.
Early in perimenopause, the menstrual cycle usually gets shorter, meaning that periods occur more frequently than usual. Bleeding may last fewer or more days and may be heavier or lighter or only spotting. Late in perimenopause, it’s common to miss one or more periods.
*Not all menstrual changes are due to the onset of menopause so be sure to consult your doctor if you experience extremely heavy or overly frequent periods.
The average age of menopause is 51 years and is defined as the final menstrual period. How does a woman know which period is her last? She won’t. We usually can’t be certain that any given menstrual period is the final one until 12 months have passed without another one—as long as there are no other obvious causes for missed periods.
This refers to the years after menopause ends when symptoms of menopause would gradually decrease for most women (usually a time for celebration!).
Physical and emotional changes
Symptoms of perimenopause and menopause are different for every woman but can include hot flashes (although in Singapore, hot flashes are common for everyone!) anxiety, mood swings, depression, loss of concentration, trouble sleeping, and vaginal changes.
Treatment, although not always necessary, can include hormone replacement therapy (HRT) to artificially boost a lack of naturally occurring hormones in the body. It’s important to note, however, that these hormones are no longer routinely prescribed. For some women, the potential risks of hormonal therapy and its links to breast cancer, may outweigh the benefits. Instead you can opt for topical HRT creams or gels that can help to manage the symptoms including vaginal dryness.
SSRIs (a form of anti-depressant which boosts serotonin) can help with mood disorders and blood pressure medication Clonidine can manage hypertension and related symptoms.
Leading a healthy lifestyle can also reduce the side effects of menopause. It’s important to maintain a healthy weight, exercise regularly and ensure your eating plenty of calcium. Some women swear by herbal or complementary therapies such as eating soya nuts or the herbal remedy Black Cohosh. However, there is still limited evidence available to prove their efficacy and safety, so tread carefully and consult your doctor first.
For more information about menopause, speak with your physician. Excellent resources can also be found on the websites for the British Menopause Society, American Academy of Family Physicians, the Mayo Clinic, Jean Hailes and The North American Menopause Society.