Gan Pou Wee
M.Pharm, MBBS, BCPS, R.Ph
There comes a time in a woman’s life when her monthly period stops. It is around this time when her ovaries stop producing the hormones progesterone and oestrogen and stop releasing eggs. This is menopause and typically occurs around 45 to 55 years of age with the average age being around 51 years.
Symptoms of menopause
Menopause may come with a myriad of symptoms. If you are around the age where menopause typically occurs and notice the following symptoms, you might be going through menopause:
- Periods become irregular (i.e. they come earlier or later than expected)
- Duration of period bleeds become shorter
- Missed periods
- Hot flashes – where a woman feels a heat wave starting from the chest to the face and possibly throughout the body
- Night sweats – this is hot flashes that occur during sleep or night time which can cause considerable disturbance to sleep
- Sleep disturbance – even without hot flashes, some women may experience trouble falling asleep
- Dryness of the vagina – this is due to the lack of oestrogen which can cause sexual intercourse to be painful or uncomfortable
- Depression – Due to hormonal imbalances, some women may feel depressed or anxious. The risk is higher in women who have had depression before menopause. See the symptoms of depression here.
Image: Women having depression
In women who have had their uterus removed but still have their ovaries preserved in their bodies (known as a hysterectomy), it might be difficult to tell if they are going through menopause as the changes in periods bleeds would not occur. As for patients who have both their ovaries removed with menopause (also known as surgical menopause) occurs at the point of removal of ovaries.
The symptoms of menopause are usually temporary and will go away after 1 to 2 years. There are several things a woman can do to relief herself from some of the discomforts that come with menopause.
- Sleep disturbances
- Avoid caffeine before sleep
- Have good sleep hygiene
- Exercise and stay active
- Join group therapies or social support for women with similar conditions
- Hot flashes
- Avoid hot drinks
- Use a cold and wet cloth around neck during hot flashes
- Quit smoking as smoking make hot flashes worse
- Vaginal dryness
- Use lubricants before sexual intercourse
When to seek professional help?
If you are experiencing the symptoms of menopause at the age where menopause is expected, there is usually no need to see a doctor unless the symptoms are affecting your quality of life. For example, disturbances to sleep, day-to-day activities, work or if you encounter symptoms of depression.
There are also several other situations where you would want to see a doctor as it might indicate certain conditions which are more sinister such as:
- Having heavy bleeds during menstrual period.
- Periods occurring very often (less than every 3 weeks).
- Spotting (spots of blood, may be fresh blood or brown spots) in between periods.
- Sudden bleeding even if it’s just a drop of blood despite having completed menopause with the absence of periods for the past 12 months or more.
It is still possible to get pregnant as long as periods still occur even if they are occurring less frequently. However, once periods stop for more than 12 months, the chances of pregnancy become remote.
Osteoporosis refers to the loss of bone density, making the bone brittle. Since bone density is very dependent on the presence of oestrogen, post-menopausal women are very prone to osteoporosis. Calcium and vitamin D supplements may be helpful for such condition. Speak to your doctor or pharmacist about it. Light exercises may also help to keep bones strong. It’s also a good idea to speak to your doctor if you need a bone density test and medications to maintain bone density.
- Schorge J, Hoffman B, Bradshaw K, Halvorson L, Schaffer J, Corton M. Williams gynecology. 3rd ed. McGraw Hill; 2008.
- Kasper D, Harrison T. Harrison’s Principles of internal medicine. 18th ed. New York: McGraw-Hill Education; 2015.
- Patient education: Menopause (The Basics) [Internet]. Uptodate.com. [cited 12 September 2017]. Available from: https://www.uptodate.com/contents/menopause-the-basics