We should speak to women long before they reach menopause so that , when it happens , they are more prepared and less anxious about it . Many women we see wish they had known earlier what they could have done to prepare themselves .

As every woman will go through this experience , you should enter this life phase empowered with knowledge .

THE REALITY OF MENOPAUSE & PERIMENOPAUSE

Let ’ s begin with the basics . Menopause is when a woman ’ s ovaries stop producing eggs , and she stops menstruating . Medically , menopause is confirmed when a woman has not experienced menstruation after one year .

Generally , this takes place between the ages of 45 and 55 . The global average menopausal age is 51.4 years old , with five per cent reaching early menopause between 40 and 45 .

However , before this happens , women go through a perimenopausal stage which usually lasts four to five years . During this time , it is normal to have irregular menstruation that may include heavier bleeding and infrequent or skipped cycles .

This is due to changes in a woman ’ s endocrine system that leads to reduced oestrogen levels and is often accompanied by hot flashes , fluctuating emotional states , difficulty sleeping and vaginal dryness . In turn , these may also contribute to forgetfulness , low energy levels and reduced libido , which , combined with vaginal dryness , can lead to less interest in sex and intimacy . Once menopause has occurred , the symptoms can become more severe and last up to another five years .

Overall , the entire process can take around 10 years and this is a long time to be coping with symptoms if they are disrupting your daily life . For example , around 80 per cent of women experience hot flashes , which is far more serious than just feeling warmer than usual .

Hot flashes can be severe , with intense waves of heat that worsen at night , disturb sleep , and cause irritability or difficulty concentrating . This can be managed with hormone therapy , but only 30 per cent actually seek treatment , either because they are unaware that treatment exists or prefer natural , home remedies instead .

GETTING HELP TO MANAGE SYMPTOMS

Although several natural remedies , such as black cohosh and evening primrose ,

BY PROF DR NAZIMAH IDRIS AND

SIN YEN SUAN

have been researched for their efficacy in relieving symptoms of perimenopause and menopause , results have been inconclusive . However , Chinese Medicine ( CM ) may be able to help . The effectiveness of CM can be seen by about three cycles , although the whole process of CM treatment for menopause symptoms may last one to two years .

Women with problems of a gynaecological nature range from fertility issues to menopause . CM can treat health problems by addressing imbalances in the body , using individualised therapies . For women going through perimenopause and menopause , their bodies are undergoing a lot of changes and some women find it hard to cope with them .

Many women need help with symptoms such as persistent or heavy vaginal bleeding especially , heavy sweating , hot flashes , and disturbed sleep . To help treat this , there are several different treatments such as herbal medications to balance their qi or acupuncture to stimulate blood flow at the meridian points .

These methods help to ease their emotional state so they are able to feel better and sleep better at night . While CM can complement Western medicine , it is best to keep your CM practitioner and doctor advised on any treatment you are taking .

Hormone therapy is generally well-tolerated and can be very helpful in helping to relieve hot flashes and improve sleep quality , vaginal dryness and urinary incontinence , among others . Hormone treatment can come in various forms , and your doctor will recommend one based on the needs of the individual and their family history .

Options include tablets to relieve overall symptoms , or topical creams to reduce vaginal dryness . Your doctor may recommend tablets that contain both oestrogen to relieve symptoms and progesterone to protect the uterus , or , for women who have already gone through a hysterectomy ( a procedure to remove the

uterus ), a treatment that only contains oestrogen , such as a tablet or vaginal ring . There is also a medication known as tibolone that helps reduce the risk of osteoporosis , closely related to oestrogen deficiency .

Most women , unless they have breast cancer or conditions such as liver disease , thromboembolism and heart disease , are able to receive hormone therapy as it is generally considered safe for women who are in good health , even those with chronic conditions , so long as they are well-managed .

ACCEPTING MENOPAUSE WITH CONFIDENCE

Menopause signals a new stage in every woman ’ s life and can be embraced with confidence . It means an end to dealing with menstrual cramps and bleeding , shrinkage of possible pelvic growths and no further concerns of possible pregnancies or the need for contraceptives .

Also , now that the children have grown and retirement is around the corner , you can now have new adventures and a healthy sex life during menopause is still possible as well .

In order to enjoy this time , remember to stay in good health by going for the relevant health screenings and managing any chronic conditions well . Women are advised to speak to their doctors about mammograms to detect lumps in the breast , pap smears to check for signs of cervical cancer and colonoscopy to check for bowel cancer as these are three leading causes of cancer among women in Malaysia . Other recommended tests include blood tests for conditions like anaemia and diabetes and bone density scans for osteoporosis .

Dietary and lifestyle measures can be taken as well . For women above 51 , it is advisable to increase calcium intake to 1,200mg a day along with Vitamin D3 to prevent osteoporosis . Menopausal women are also advised to quit smoking and carry out regular Kegel / pelvic floor exercises , weight-bearing exercises ( such as walking , running etc .) and strength training with weights .

At the end of the day , menopause is not a disease and neither is it the end of the world . Being more knowledgeable about the changes your body goes through will mitigate any anxiety . Help pass along this information from mother to daughter , friend to friend so that other women can also understand what to expect before and after menopause . – The Health

Prof Dr Nazimah Idris is a Professor of Obstetrics & Gynaecology and Medical Director at IMU Healthcare , while Ms Sin Yen Suan is a certified Chinese Medicine practitioner at IMU Healthcare .