Menopause: A Comprehensive Guide with FAQs

Menopause, a natural biological phenomenon, marks the period in a woman’s life when her menstrual cycles cease after not having a menstrual cycle for 12 months consecutively. Following menopause, a woman is no longer able to conceive. While it is a natural process, the symptoms that come with it can disrupt a woman’s emotional health and sleeping patterns and even lower their energy levels.

This guide provides an in-depth explanation of menopause, covering its stages, symptoms, causes, health risks, diagnosis, and available treatments.

When Does Menopause Start?

Menopause typically occurs naturally between the ages of 45 and 55. This transition is driven by hormonal shifts, predominantly the decline of oestrogen and progesterone production.

Menopause can be induced by surgical procedures such as hysterectomy with bilateral oophorectomy, antioestrogen treatment, or chemotherapy drugs used to treat cancer.

Menopause unfolds across three stages:

Perimenopause: Perimenopause is a transitional phase between a woman’s reproductive years and menopause. It generally begins years before menopause.
Menopause: Defined by 12 months without menstruation, menopause is a distinct stage.
Postmenopause: Following menopause, this stage extends for the rest of a woman’s life. Although menopausal symptoms may alleviate, health risks such as osteoporosis and heart disease become pertinent due to reduced oestrogen levels.

What Are the Signs of Menopause?

Although women experience menopause differently, they usually share some common symptoms, including:

Changes to your period: Perimenopause often causes irregular menstrual cycles. Periods may become shorter, longer, heavier, or lighter before stopping altogether.
Hot flashes: Hot flashes and abrupt sensations of warmth, accompanied by redness and sweat, are symptoms of menopause. The intensity varies from mild to severe, arising from oestrogen level fluctuations. Hot flashes may disrupt some women’s daily life. For others, they can be moderate, making them feel they do not need to adjust their lifestyle or seek treatment choices. However, if hot flashes affect you, there are certain precautions you may take.
Bladder control: Some women encounter urinary incontinence or heightened urination urges due to weakened pelvic floor muscles and declining oestrogen levels. Urinary incontinence impacts over 50% of women who have undergone menopause.
Sleep disturbances: Sleep disturbances, including insomnia and nocturnal awakenings, can arise during menopause. Hormonal fluctuations and night sweats contribute to sleep-related issues. Managing these challenges can help in the management of sleep disorders.
Mood changes: Hormonal fluctuations can induce mood swings, irritability, and feelings of anxiety or depression. This process encompasses hormonal changes, with oestrogen playing a pivotal role.
Vaginal health: Symptoms include vaginal dryness, itching, and discomfort during intercourse.
Changes in your body: Body composition alterations, like weight gain, particularly around the abdomen, are common during menopause. Changes such as enlarged waistline, muscle loss, and joint pain may occur during menopause.

Find out more about the signs of menopause that a woman may be experiencing.

What Are the Health Risks Associated with Menopause?

Women who have pre-existing health conditions before menopause have a higher risk of complications during the transition. Potential risks include:

Osteoporosis: Menopausal women face an elevated risk of developing osteoporosis, characterised by weakened bones prone to fractures, due to reduced oestrogen levels in the body.
Coronary artery disease: Decreased oestrogen levels during menopause can elevate the risk of cardiovascular disease. This may lead to the narrowing of coronary arteries, heightening the likelihood of coronary heart disease or stroke. Consequently, prioritising a healthy lifestyle and actively managing factors elevating heart disease risk becomes critical. Regular physical activity, a balanced diet, and diligent blood pressure and cholesterol monitoring are crucial for heart health during and after menopause.

How Is Menopause Diagnosed?

A woman who is over 45 years old and has not had a period for at least 12 consecutive months or exhibits vasomotor symptoms such as hot flashes and night sweats alongside irregular periods (or solely experiences symptoms if she does not have a uterus) provides sufficient information for diagnosing menopause.

What Are the Treatments That May Be Required During Menopause in Some Women?

As women navigate the transformative phase of menopause, various hormonal and nonhormonal treatments may be needed to ensure optimal well-being.

Hormone therapy: Hormone therapy encompasses oestrogen alone or in conjunction with progestin. It effectively alleviates various menopausal symptoms. Oestrogen therapy is suitable for women without a uterus, while oestrogen progesterone/progestin hormone therapy applies to those with a uterus.
Non-hormonal treatments: Non-hormonal approaches encompass lifestyle modifications such as balanced nutrition, avoidance of hot-flash triggers, regular exercise, plenty of rest, meditation, and supplements. Support groups also offer valuable emotional aid.

Frequently Asked Questions About Menopause

1. Why do hot flashes occur during menopause?

During menopause, a woman’s body naturally produces less oestrogen, which can affect the hypothalamus (a brain structure regulating body temperature). This can cause the hypothalamus to become sensitive and wrongly perceive the body as too warm, causing hot flashes.

2. How do you cope with hot flashes?

Managing hot flashes involves strategies like layered clothing, fans, stress management, trigger avoidance, and discussing treatment options with a doctor.

3. Does menopause cause weight gain?

Hormonal changes during menopause can lead to weight gain, particularly around the abdomen. However, this can be managed through a combination of regular physical activity and a balanced diet.

4. Is diarrhoea a symptom of menopause?

Though less common, hormonal fluctuations during menopause can contribute to digestive changes, including diarrhoea.

5. Can I get pregnant after menopause?

While highly improbable, pregnancy can occur if full menopause has not been reached and ovulation persists.

6. Is spotting a sign of menopause?

Spotting can be a sign of perimenopause, the transitional period leading up to menopause, during which hormonal fluctuations can cause irregularities in the menstrual cycle. However, it is crucial to approach this symptom cautiously, as spotting could also stem from other underlying medical conditions.

7. Is it normal to still have periods at 50?

Although less frequent, some women might experience sporadic periods or spotting in their 50s. Consultation with a physician is advised for any unusual bleeding.

8. Will menopause affect my sex life?

Menopause can cause vaginal dryness and other changes that might influence sexual comfort. Open communication and lubricants can mitigate these effects.

9. Will fibroids shrink after menopause?

Yes, fibroids can shrink after menopause.

10. How to prevent heart disease after menopause?

Maintaining a healthy lifestyle can mitigate heart disease risk by embracing a balanced diet, regular exercise, abstaining from smoking, and managing factors like high blood pressure and cholesterol.

11. Why does menopause cause osteoporosis?

Menopause contributes to osteoporosis primarily due to the decline in estrogen levels. Oestrogen plays a crucial role in maintaining bone density by regulating the activity of osteoblasts (cells responsible for bone formation) and osteoclasts (cells responsible for bone resorption). When oestrogen levels decrease during menopause, there is an imbalance between bone formation and resorption, leading to a net loss of bone mass and increased susceptibility to osteoporosis.

12. Can you have menopause at 40?

Yes, premature menopause, occurring before age 40, is possible.

13. What is early menopause?

Early menopause denotes menopause transpiring before age 45, either naturally or induced medically.

14. How to delay menopause?

Extending or delaying menopause beyond its natural timing is not currently feasible as it constitutes an intrinsic and inevitable biological transition that marks the conclusion of a woman’s reproductive phase. However, there are other options that women can explore, such as freezing embryos as a way to preserve fertility.

Make an Appointment at Pantai Hospitals

Menopause represents a natural life phase characterised by hormonal shifts and the cessation of menstrual cycles. Grasping the stages, symptoms, causes, and treatment options empowers women to navigate this journey with poise and understanding.

Get in touch with us to book an appointment with our team of gynaecologists today, or find out more about our Obstetrics and Gynaecology Services at your nearest Pantai Hospital.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.