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When menopause struck, Ms X, who works in the service sector, experienced hot flushes, night sweats, and mood swings. Having hot flushes while dealing with customers embarrassed her so much that she contemplated leaving her job. Unlike her usual cheerful demeanour, she often got angry over minor issues. Unable to manage her symptoms and feelings of guilt for venting on family members, Ms X sought help from KK Women’s and Children’s Hospital (KKH).
Menopause is a natural process where the ovarian function gradually declines and permanently stops due to age or when both ovaries are surgically removed. Every woman’s menopause experience is unique — some go through this period with little to no issues, while others may experience hormonal changes that result in hot flushes, sleep disturbances, mood disorders, and sexual dysfunction. Navigating this period can be daunting and isolating.
“Few women seek support for menopause as they are convinced that this is just a phase. For those who do, they traditionally turn to a gynaecologist. This alone may not be sufficient, as they usually have nongynaecological- related symptoms, including body aches, weight gain, skin rashes, and mood changes,” said Associate Professor Rukshini Puvanendran, Head and Senior Consultant, Family Medicine Service, KKH.
Assoc Prof Rukshini is also Co-Director of the KK Menopause Centre, a multidisciplinary clinic staffed by specialists in gynaecology, dermatology, family medicine, and mental health. Opened in October 2023, it aims to holistically address various aspects of menopause — physical, emotional, mental and sexual — as well as chronic disease screening and disease prevention. The centre provides interventions such as advice on lifestyle adjustments, hormonal therapy, and non-hormonal therapy. Together with counselling and patient education, it aims to increase women’s awareness of menopause and promote women’s general well-being and healthier ageing.
The most effective treatment for menopausal symptoms is menopause hormone therapy (MHT), shared Assoc Prof Rukshini. Data showed that the five-year use of MHT in women in their 50s has several beneficial effects, such as reducing heart disease, fractures, and allcause mortality, including cancer mortality. MHT has been shown to be safe and effective in most women.
Like any medication, MHT can cause side effects, including transient breast tenderness and nausea. Some women may experience unexpected vaginal bleeding or spotting. Longer-term use of MHT has been associated with a slight increase in the risk of breast cancer.
“We encourage all women who have experienced moderate to severe menopausal symptoms to seek a detailed consultation to assess their suitability for MHT,” said Assoc Prof Rukshini. The benefits and risks of taking MHT depend on a woman’s age, menopausal symptoms, and any risk factors she may have. In women under the age of 60 with bothersome menopausal symptoms and at low risk of breast cancer and blood clots, the benefits of MHT likely outweigh the risks, she added.
For Ms X, who received MHT and counselling to address her symptoms, her symptoms improved. “When she came back for her follow-up appointment, she was back to her former cheerful self. She has been maintaining this status since and is on regular follow-ups to ensure that she stays in optimal health,” shared Advanced Practice Nurse (APN) Chua Mei Tuan, Nurse Clinician, Family Medicine Service, KKH. APN Chua encourages family members of menopausal women to familiarise themselves with the changes that their loved ones may be going through so that they understand the physical and emotional changes that their loved ones may be experiencing and can provide better support.
“Patients of KKH can join the Dynamite Daisies menopause interest group so that we can journey with them,” APN Chua said. The interest group aims to promote awareness of general women’s health and support for women undergoing menopause transitions. Together with its panel of medical specialists, the group organises educational talks, events and activities related to women’s health. It is a platform for women to share their menopause experiences and tips to overcome symptoms. Members of the interest group meet every three to four months. For more information about the group, email to [email protected].
Tips for managing menopausal symptoms
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