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Menopause is a natural process that all women experience, and while every woman’s experience with menopause can be different; a woman is considered to have reached menopause when she does not go through menstruation for 12 consecutive months. This stage indicates the end of a woman’s ability to conceive.
When menopausing, many women experience physical symptoms such as hot flashes, and often symptoms related to menopause may also interfere with your sleep, decrease your energy, or impact your emotional health.
Menopause, a stage that happens naturally in women’s lives, occurs due to the loss of ovarian follicular function and a decrease in the levels of oestrogen circulating in the bloodstream.
The menopausal transition in females usually starts between the ages of 45 and 55, but it can happen earlier depending on the individual.
Natural menopause indicates the permanent ending of menstruation that occurs without any medical treatment. There are three stages of menopause that every female gradually experiences through their lives:
Perimenopause, also known as “menopause transition”, begins typically in your 40s. This process can start around eight to 10 years prior to menopause, during which your ovaries gradually produce less oestrogen.
Perimenopause extends until menopause, which is the stage when your ovaries stop releasing eggs. In the last one to two years of perimenopause, the drop in oestrogen speeds up. Many individuals might encounter symptoms of menopause during this period of time. Nonetheless, your menstrual cycles will still continue, and there is a possibility of you getting pregnant during this time.
Menopause is the stage where you no longer have menstrual periods. Your ovaries would have stopped releasing eggs and producing most of their oestrogen at this point. Your doctor usually diagnoses you with menopause when your menstrual period is absent for 12 consecutive months.
Post-menopause refers to the time when you miss out on your period for an entire year or the rest of your life after menopause. Menopausal symptoms such as hot flashes may improve.
However, some women’s menopausal symptoms still persist for a decade or longer following the menopausal transition. Women in the postmenopausal phase face an increased risk of several health conditions, including osteoporosis and heart disease due to reduced oestrogen levels.
If you are experiencing any of these signs, you may be transitioning into the menopausal stage:
Menstrual periods usually span a duration of four to seven days and have a cycle of approximately 28 days. Examples of irregular periods include those that occur less than every 21 days or more than 35 days apart, missing three or more consecutive periods, and experiencing menstrual flow that is heavier or lighter than the norm.
A woman’s prime reproductive years span between the late teens and late 20s. As you reach 30 years old, fertility (the ability to get pregnant) begins to decline, making it harder for you to conceive. This decline accelerates once you enter your mid-30s until you reach the age of 45. Fertility would have declined so much to the point whereby getting pregnant naturally becomes unlikely.
An increase in body heat is also called “hot flashes”, which describes a sudden surge of heat, sweating, and discomfort. Hot flashes are a common symptom of menopause, but everyone’s experiences of hot flashes can vary in terms of severity and length of time.
Sleep disturbance refers to the condition in which your well-being and functioning are negatively affected due to poor sleep, a lack of sleep, having trouble falling or staying asleep.
One of the most common changes in the vagina when you are experiencing the menopausal stage is vagina dryness. It is a painful symptom that affects a woman’s lifestyle. Vaginal dryness can cause pain and discomfort during sitting, exercising, peeing, and engaging in sexual intercourse.
Urine problems are related to bladder problems, also called incontinence. You might experience a sudden urge to urinate, or urine may leak during activities like exercising, sneezing, or laughing. The initial step in treating incontinence is to consult a doctor. Bladder infections also can also be a concern in midlife.
You may experience some emotional changes during the menopausal period, usually leading to unstable emotions such as irritability, mood swings, or mild depression.
The menopausal stage may cause you to go through changes in the skin and hair. Your skin, eyes, and mouth may feel dry. You may experience hair loss or thinning as well.
Your estrogen decreases rapidly during menopause, causing a huge impact and decrease in your libido and sexual satisfaction. It can lower your desire to engage in sexual intercourse and make it harder for you to become aroused.
The hormonal changes of menopause usually increase the possibility that women will gain weight around the abdomen, instead of the hips and thighs. However, it is important to note that hormonal changes alone may not be the only cause of weight gain.
If you are experiencing body aches, especially joint and muscle aches and pains, it is a symptom of menopause. Oestrogen possibly plays an important role as it impacts your cartilage (which is the connective tissue in joints) together with the replacement of bone, causing inflammation and pain.
Mastalgia is the medical term for breast pain, it is an extremely common experience during menstruation. Sore breasts during menopause may also feel different. Some women may feel burning or throbbing pain in their breasts instead of a dull ache.
Migraines related to hormonal changes can become more frequent and intense in the years leading up to perimenopause. Some women see improvement in their migraines once their periods stop. However, tension headaches frequently worsen. If your headaches persist, you probably can continue your medicines or opt for other therapies.
Osteoporosis is caused by a lack of oestrogen; your body’s oestrogen production slows down due to menopause which leads to bone loss. Just because you do not have joint pain or broken bones, that does not mean you are safe from the risk of getting osteoporosis. The symptoms will not show unless you break a bone.
Oestrogen has a protective effect on your heart. It helps to control your cholesterol levels and reduces the risk of fat building up in your arteries. It also helps keep your blood vessels healthy. If your oestrogen levels fall, then fat can build up in your arteries causing them to become narrower. This increases your risk of developing hypertension, coronary heart disease, or stroke.
As menopause is a natural process that every woman has to go through, sometimes it may not be necessary to receive treatment. While discussing menopausal treatment options with your doctor, it is mainly about treating symptoms of menopause that disrupt your life.
HRT is a safe and effective treatment for the majority of women experiencing menopause and perimenopause. Your doctor will discuss any potential risks associated with this treatment with you. HRT involves using oestrogen to substitute for the declining levels of this hormone in your body during the menopausal period.
Antidepressants can be beneficial for managing mood symptoms if you have been diagnosed with depression or anxiety during the menopausal period. There are two main types of antidepressants: selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs). Your doctor will talk to you about the potential advantages and risks of these medications.
When you enter the menopausal stage, your body becomes increasingly reliant on vitamins and nutrients to maintain your health, as your oestrogen production decreases, and your metabolism slows down. Your doctor may recommend intake of calcium and vitamin D.
Menopause is a natural stage that is experienced by every woman in life, but everyone experiences and deals with it differently. Here are some helpful tips that can help you cope with menopause:
Menopause is a natural and normal stage of a woman’s ageing process. Therefore, it is normal to experience symptoms such as hot flashes, vaginal dryness and more.
However, if the symptoms persist and disrupt your everyday life, it is recommended to consult a doctor. Be open to your doctor about your symptoms, so they are able to suggest the best treatments to manage your symptoms and make you comfortable.
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.
This article has been medically reviewed by Obstetrics & Gynaecology (O&G) specialist, Dr Tan Ying An.
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