Menopause: More than just hot flashes - Expert urges open discussion

KUALA LUMPUR - Menopause, the natural biological process marking the end of a woman's reproductive period, remains shrouded in misconception and lack of awareness, discouraging many from openly discussing it.

Dr Syeda Nureena Zaidi, an Obstetrics and Gynaecology Consultant at Sunway Medical Centre, clarifies that menopause is not an end but a transitional phase, that usually occurs 12 months after the last menstruation and that it can be a challenging phase for women.

She emphasises that women deserve support and understanding as their bodies go through hormonal changes by stopping the production of oestrogen around the age of 50, manifesting in noticeable symptoms like sudden hot flashes, fatigue, vaginal dryness, and intensified insomnia.

Dr Syeda recommends that women can effectively navigate these symptoms by gaining a comprehensive understanding of menopause, preparing themselves, and engaging in open discussions within their support groups.

"As women go through menopause, they encounter many health impacts that extend beyond the cessation of menstrual cycles. Menopause is also associated with an increased risk of cardiovascular disease, osteoporosis, type 2 diabetes, and dementia," she said.

"Oestrogen also aids in preventing skin ageing by increasing collagen content, maintaining skin moisture, and potentially improving wound healing.

"The risk of heart disease among postmenopausal women is increased due to the lack of oestrogen that also works to protect the heart," she said in a statement recently.

Dr Syeda highlighted that menopause poses a heightened concern for women dealing with Polycystic Ovary Syndrome (PCOS), as it significantly increases the prevalence of subclinical atherosclerosis in middle-aged women with the syndrome.

PCOS alters hormonal balance at a younger age and necessitates meticulous monitoring and specialised care to regulate hormone levels and address irregular menstrual cycles.

For women facing severe symptoms, Dr Syeda noted that Hormone Replacement Therapy (HRT) is a viable option, explaining that it involves oestrogen plus progestin therapy (EPT) and oestrogen-only therapy (ET), to help replenish hormone deficiencies, significantly improving symptoms like hot flashes and mood changes.

Additionally, oestrogen replacement therapy can reduce the risk of coronary heart disease, improve blood flow, and decrease atherosclerosis, which is not only effective in alleviating discomfort and symptoms but also enhances the overall quality of life during this phase.

"However, the key to HRT treatment is to start early (within the ten years of menopause ) as the long-term impacts of HRT will last longer for women and would be more beneficial, ” she added.

Dr Syeda stressed the importance of making informed decisions about HRT.

She emphasises the need for careful patient selection, taking into account factors like family history and overall health.

She advocated consistent monitoring and transparent communication with healthcare professionals to mitigate potential risks, allowing women to make decisions that align with their overall well-being.

She encouraged women not to bottle up their experiences, as this could lead to mental distress or depression, especially if they do not have an appropriate outlet to discuss their symptoms.

Discussing symptoms with a support network or even getting the advice of a gynaecologist to monitor menopause symptoms, can empower women to navigate this phase confidently with a positive mindset, she said. - BERNAMA