MENOPAUSE IN A NUTSHELL

Menopause is generally presumed when a woman has stopped her period for the last 12 months.  It is a normal aging process in every woman’s life.  It commonly occurs at the age of 45 to 55 years old.

From the medical point of view, menopause is associated with depletion of eggs (follicles) in the ovaries.  Every woman is born with a finite number of eggs.  These eggs grow and mature every month and ovulates to enable conception.  They also serve to produce the estrogen and progesterone hormones.  The estrogen hormone gives the woman its female characteristics.  Once this egg reserve is exhausted, there is a state of low estrogen (hypoestrogenism). This eventually leads to menopause.

The menopausal state is associated with initial troublesome vasomotor symptoms, followed by health risks including osteoporosis and heart complications in later years.

With better nutrition and medical advancement, women now spend almost a quarter of their life in this menopausal state. In order to age gracefully and live a fulfilled life, it is necessary for women to be aware of menopause and its consequences, and more importantly, to overcome its complications.

Menopausal consequence

The acute symptoms

Besides cessation of menses, the vasomotor symptom (hot flashes), vaginal dryness and sleep disturbance are regarded as core menopausal symptoms.  Most women experience a mild discomfort that eventually passed without much fanfare.  Only a small group of women requires medical treatment.  The severity of these symptoms are affected by variation in cultural and ethnicity (Asian over Caucasian), psychological wellbeing (attitude towards self and life) as well as psychosocial factors.

A hot flash is described as a sudden feeling of heat that rushes to the upper body and face.  It may last for a few seconds to several minutes and is associated with a troublesome sweating.  It is also common to experience vaginal dryness and painful intercourse.  The menopausal woman may have sleep disturbance (trouble falling asleep), reduced interest in sex (libido) and putting on weight.

Menopause Health risks

The estrogen hormone in women helps in absorption of calcium and maintains the bone density.  The low estrogen environment associated with menopause leads to a rapid bone loss and osteoporosis (brittle bone).  This is linked to pathological fracture (especially the spine and hip), and has a high morbidity and mortality in the elderly.

The estrogen hormone has a protective effect on the heart and blood vessel.  The low estrogen level during menopause exposes the women to risks of heart attack and stroke.

Aging gracefully

Menopause marks the end of a woman’s reproductive capacity.  The acute symptoms are usually troublesome but transient.  Many women overcome them through a positive life attitude and lifestyle modifications, rarely needing medical intervention. The long-term consequence of menopause has a more serious implication and medical prevention is helpful.

 

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Author: Dr Ng Soon Pheng

Dr. Ng Soon Pheng MD(USM), M.Med (O&G), Fellow Reprod Medicine (Singapore), AM (Mal) Dr. Ng Soon Pheng qualified from University Kebangsaan Malaysia (UKM), Malaysia. After obtaining his post graduate degree, Dr. Ng Soon Pheng continued his clinical fellowship training in the field of IVF in Singapore. He was also the recipient of Yayasan Sultan Iskandar (Johor) Scholarship for the fellowship stint. Dr. Ng Soon Pheng has more than 10 years of working experience in the field of Obstetrics and Gynaecology in the public and university hospital, with special interests in infertility. He was an Associate Professor with the Department of O&G in Universiti Kebangsaan Malaysia (UKM) specialising in infertility. Dr. Ng Soon Pheng is currently Consultant Obstetrician and Gynaecologist with special interests in infertility at Columbia Asia Hospital - Puchong.