Menopause

Menopause is the medical term for the end of a woman's menstrual periods. It is a normal and natural part of aging, and occurs when the ovaries stop producing eggs and making female hormones. In Singapore the average age of menopause is about 51 years.

Menopause is also known as "the change of life." It starts when the female hormones, estrogens fall permanently to a very low levels and menstrual periods stop. It is confirmed when the woman stop menstruating continuously for 12 months. This change usually does not happen all at once. There is a transition period before menopause called perimenopause, when the body starts making less of the female hormones estrogen.

Low estrogen levels are linked to some uncomfortable symptoms in many women.

• During this time, there are symptoms such as hot flashes (sudden intense waves of heat usually appearing on the face) followed by sweating.
• Some women find that these hot flashes disrupt their sleep, and others report mood changes.
• The menstrual period may become irregular and prolonged.
• Vaginal inflammation (yellow or smelly discharge) and urinary tract infections (pain and frequency in passing urine) become more common.
• Urinary incontinence (leakage of urine or inability to control urine flow) may be present.
• Because of the changes in the urinary tract and vagina, some women may have discomfort or pain during sexual intercourse.
• Many women also notice changes in their skin, digestive tract, and loss of hair during menopause.
• In the long term, some women may experience problems such as osteoporosis and heart disease.

Menopause Timing

Women reach menopause at different times. The timing is not related to:

• Age of menarche (first period)
• Race
• Social class
• Number of pregnancy
• Duration of breastfeeding
• Whether the women is fertile or not
• Taking of oral contraceptive pill
• Age at last pregnancy

Menopause Hot Flashes

About 75% of women report troublesome symptoms during menopause, but the severity and frequency of symptoms varies from woman to woman. The most common symptoms are hot flashes. It is the most common reason for seeking treatment. It produces a sudden sensation of warmth or even intense heat that spreads over various parts of the body, especially the chest, face, and head. Flushing and sweating usually occur as well, followed by a chill. Some women feel their heart beating very fast. This makes them feel anxious.

These flashes last from a few seconds to several minutes. How often they occur varies from woman to woman. Fortunately, for most women, their hot flashes usually subside the first 2 years after menopause. However, occasionally some women may have them for a few years after menopause.

Induced or Surgical Menopause

Women who undergo surgery to remove the uterus leaving the ovaries in place will not have menstrual periods. They will also not have menopausal symptoms because their ovaries will continue to make hormones. Since the female hormones are still circulating in the body, they need not take hormone pills.

Occasionally, younger women need surgery to remove the uterus and the ovaries to treat problems such as severe endometriosis or ovarian cancer. After the surgery, they will enter into what is known as induced or surgical menopause. This is menopause that happens straight away, and is brought on by the surgery. The patients will no longer have periods and may have many menopausal symptoms right away, instead of gradually as the ovaries are removed.