Menopause
About Menopause
Menopause refers to the changes a woman goes through just before and after she stops menstruating, marking the end of her reproductive years. All women experience menopause as they age. In Hong Kong, the average age for a woman to reach menopause is 51, but this can vary from person to person.
Menopause not only effect menstruation but also triggers a range of physiological and psychological changes, such as hot flashes, night sweats, vaginal dryness, osteoporosis, changes in cardiovascular health, and mood swings.
Women experiencing menopausal symptoms should consider undergoing a physical examination and evaluation. Doctors will provide appropriate treatment recommendations based on individual circumstances, including bone density testing. Hormone therapy or newer generation non-hormonal therapies can help alleviate discomfort caused by the sudden drop in female hormone levels.
Common Symptoms and Management of Menopause
Menopausal symptoms can be mainly divided into four categories:
1. Vasomotor Symptoms(VMS)
2. Physiological Changes
3. Urogenital Symptoms
4. Osteoporosis
Vasomotor symptoms (VMS) are the most common symptoms, affecting approximately 80% of all women, and mainly include hot flashes and night sweats. Decreased estrogen levels affect the hypothalamus's thermoregulation function, making it overly sensitive to temperature changes. This leads to excessive vasodilation and heat dissipation, causing hot flashes and night sweats.
These symptoms usually appear in early menopause, or even begin when menstruation is still regular, and can last for several years to more than a decade, significantly impacting quality of life.
1. Vasomotor Symptoms (VMS)
a. Hot Flashes
Hot flashes are a sudden feeling of heat, often starting in the face, chest, or upper body, accompanied by sweating, rapid heartbeat, and facial flushing. Each episode can last from several minutes to ten minutes, followed by a feeling of coldness, creating an uncomfortable alternating sensation of hot and cold.
Hot flashes can be categorized by severity:
i. Mild: Feeling hot but not sweating.
ii. Moderate: Feeling hot with sweating, but normal activity is still possible.
iii. Severe: Severe feeling of heat and sweating, requiring cessation of activity to alleviate the symptoms.
Treatment: Relax, avoid spicy foods, wear breathable cotton clothing, and avoid tight-fitting nylon materials.
b. Night Sweats
Night sweats are a hot flash symptom that occurs at night. It may cause women to wake up in the middle of the night due to excessive sweating, sometimes even soaked through, affecting sleep quality and daily life.
2. Psychological Changes
Menopausal women may experience insomnia, impatience, irritability, emotional instability, anxiety, fatigue, and paranoia. Manage these emotional changes by talking to trusted friends or healthcare professionals or by participating in social activities that help reduce stress.
3. Urogenital Symptoms
a. Estrogen Depletion
As estrogen levels decline in a woman, her breasts, ovaries and uterus begin to shrink. Her vagina also loses elasticity and she may experience vaginal dryness, which tends to lead to itching and may cause atrophic vaginitis. Vaginal lubricant or estrogen cream can be used to treat this condition and reduce discomfort during sexual intercourse.
b. Incontinence
As the bladder and pelvic floor muscles weaken, women become more susceptible to incontinence. Some women may experience urine leakage with physical activities such as coughing, running and laughing. Kegel exercises, also known as pelvic floor exercises, can prevent or control urinary incontinence. Seek professional advice from a Urologist would be recommended.
4. Osteoporosis
As women age, their estrogen levels gradually decrease, leading to calcium loss from bones, making them thinner and more prone to osteoporosis. Prevent osteoporosis by regularly performing weight-bearing exercises such as speed walking, jogging, tai chi and yoga, by always maintaining a good posture, eating a calcium-rich diet (good sources of calcium include milk, cheese, tofu, sardines etc.) and by reducing tea and coffee intake.
Menopausal Treatments
Menopause is a natural stage in a woman's life when ovarian function gradually declines and hormone secretion decreases, often accompanied by symptoms such as hot flashes, night sweats, and mood swings. Treatment methods are divided into hormone therapy and non-hormone replacement therapy, and must be evaluated by a doctor.
When using medicine to treat menopausal symptoms or prevent osteoporosis, it is important to know whether the medication is suitable for you, understand the side effects, and be aware of the precautions to take before using it.
1. Hormonal Replacement Therapy (HRT)
Hormone replacement therapy offers various treatments, including oral medications, vaginal creams, injections, and topical patches. Never purchase these on your own. Hormone therapy is not suitable for women with severe liver disease, breast cancer, endometrial cancer, stroke, or thrombosis.
Before starting any medication, a thorough examination of the breasts by a doctor is necessary to ensure there are no gynaecological tumours and that liver and kidney function are normal. Regular follow-up appointments are also required to monitor for any adverse effects and to determine if continued use is appropriate.
2. Non-Hormonal Therapy
Non-hormonal therapy is suitable for women with contraindications, high cancer risk, family history of cancer, history of thrombosis, or other restrictions on hormone therapy, providing a safe and effective alternative for those who cannot or do not wish to receive hormone therapy.
A doctor's evaluation is necessary before starting any non-hormonal oral therapy. One daily oral neurokinin 3 receptor antagonist (NK3 Receptor antagonist) can effectively relieve moderate to severe hot flashes and night sweats. It works by targeting the neural mechanisms in the brain that regulate body temperature, avoiding hormone-related risks and side effects.
Our Team
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