March 16, 2015
Menopause can cause changes in physical, mental and even social well-being. As they affect the quality of life, it is very important to understand these changes so that you are best prepared to cope with menopause and improve your quality of life. 

Understanding “Menopause”

The World Health Organization defines menopause as the permanent cessation of menstruation resulting from a loss of ovarian follicular activity. Menopause can be confirmed after going 12 consecutive months without a period. The average age of menopause in Thai women is approximately 48-50 years, while the average age of menopause in Western women is around 50 years.

Menopause Symptoms

Menopause can affect women in different ways. While some women will experience no symptoms at all, others may have symptoms which vary from mild to so severe that they affect their daily activities. Menopause can cause the following mental and physical symptoms:
  • Physical Symptoms
    • Hot flashes are one of the most common symptoms that affect the quality of life. The hot flashes make the face and upper body feel hot, sometimes causing perspiration to run down the face. They can occur at any time of the day or night. Hot flushes usually appear in the first year after the final period and may last for up to 15 years.
    • Night sweats
    • Sleep problems
    • Frequent, sudden, and strong urges to urinate
    • Reduced sex drive, difficulty in reaching orgasm, and painful intercourse due to the thinning and drying of the vaginal walls. These factors can potentially lead to relationship and family problems. 
    • Vaginal itching, burning and irritation due to the drying and thinning of the vaginal walls affecting the acid-alkaline ratio and leading to increased susceptibility of infection
    • Random episodes of heart palpitations, causing anxiety due to unknown cause
    • Migraines and headaches
    • Bone and joint pain
  • Mental Symptoms: Mental symptoms are no less common than the physical symptoms. In most cases, the physical and mental conditions are associated and it is often hard to say which condition occurs first. Common mental symptoms include forgetfulness, poor concentration and moodiness. Depression is the most common mental symptom and affects social interactions.

Coping with Menopause 

Generally, women who experience few or no symptoms can reduce or prevent the effects by improving aspects of their lifestyle, including diet, emotion, exercise, environment and medical checkups. 
  • Food: Eat healthy food with high calcium content, add more fibrous food to your diet, drink plenty of water, reduce carbohydrates and sugar, and avoid high-fat food 
  • Emotion: Manage your emotions, keep a positive outlook, and try to remain calm
  • Exercise: Exercise for 30 minutes at least 3 times a week
  • Medical Checkup: Have annual checkups as well as regular pap tests and breast checks
  • Environment: Live and work in a clean and healthy environment
If improving the lifestyle does not reduce the symptoms and has an adverse effect on the quality of life, or other menopause-related diseases occur, please consult a doctor.

Menopause Treatment

Hormone replacement therapy or Bioidentical hormone therapy (HRT) is the gold standard treatment for menopausal women. By effectively reducing the symptoms of menopause, such as hot flashes, depression, forgetfulness, and bladder and vaginal problems, HRT helps to improve the quality of life.
However, HRT must be prescribed by an experience doctor based on findings and results from the following tests and diagnosis: 
  • Review of medical history, such as previous hormone replacement therapy, family history of breast cancer, history of blood clots and heart disease
  • Physical examination
  • Pelvic examination
  • Laboratory tests for blood hormone level, breast cancer screening with mammogram and ultrasound, pelvic ultrasonography, bone density test, liver and kidney function test, and blood cholesterol level and blood sugar level tests
The prescription of HRT depends on the individual’s personal and family history of certain hormone related cancers, such as breast cancer and uterine cancer (whether it is unconfirmed or already being treated) or abnormal menstruation from unknown cause. The doctor will use HRT only where appropriate and necessary. With proper guidance and advice from an experienced doctor, HRT can be safe and effective for long term use.
Once the treatment begins, it is important for women receiving HRT to have a checkup once a year to assess the specific benefits, risks and complications resulting from the therapy. 
If you are reaching menopausal age, or have already begun menopause, and would like to find out if you are suitable for HRT, contact us at the Women’s Center, 2nd Floor, Bumrungrad Hospital Building. 
By Asst. Prof. Dr. Pansak Sugkraroek, Reproductive Endocrinologist, Women’s Center, Bumrungrad Hospital
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