Avisena Specialist Hospital Logo
Appointments +(603) 5515 1966
General Line +(603) 5515 1888
Highlights / Health Articles

Health Articles

July 24, 2024

A Helpful Guide to Navigating the Menopause Journey

Menopause is a natural phase that signals the end of a woman’s reproductive years. It is characterised by no periods for 12 months and brings physical, emotional, and psychological changes and typically occurs between ages 45-55.

This guide provides information on the stages of menopause, symptoms, challenges, and tips for managing changes through lifestyle modifications, emotional well-being, and seeking professional help. It aims to empower women to confidently navigate the menopause journey.


Understanding Hormonal Changes During Menopause

Menopause is a major life transition for women, marked by hormonal changes that impact physical and emotional well-being. Understanding these shifts is key to managing symptoms and maintaining health. This section explores the hormonal dynamics of menopause and how they affect women.


Key Hormones Involved in Menopause

Oestrogen

Oestrogen is a vital hormone for women, regulating the menstrual cycle and reproductive system. As women age and approach menopause, the ovaries produce less oestrogen, causing fluctuations and eventual decline, leading to menopausal symptoms.

Progesterone

Progesterone works in tandem with oestrogen to regulate the menstrual cycle and maintain pregnancy. It prepares the uterine lining for a potential pregnancy each month.

Similar to oestrogen, progesterone levels decline during menopause. This decrease contributes to irregular menstrual cycles during perimenopause and eventually leads to the cessation of menstruation.

Follicle-stimulating hormone (FSH)

FSH is produced by the pituitary gland and is crucial for stimulating the growth of ovarian follicles, which contain eggs, during the menstrual cycle. As ovarian function declines, FSH levels increase in an attempt to stimulate the ovaries. High levels of FSH are often used as an indicator of menopause.

Luteinising Hormone (LH)

LH works with FSH to trigger ovulation and the release of an egg from the ovary. Like FSH, LH levels also rise as the ovaries become less responsive, contributing to the cessation of the menstrual cycle.

Testosterone

Though typically associated with male biology, testosterone is also present in women and contributes to libido, energy levels, and muscle mass. Testosterone levels decline with age, which can affect sexual desire and energy levels in menopausal women.


Stages of Hormonal Changes

Menopause happens in stages, which are:

Stage 1: Perimenopause

Perimenopause is the transitional phase leading up to menopause, typically starting in a woman’s 40s but sometimes occurring earlier. During this stage, hormonal fluctuations are common, and the following changes occur:

  • Irregular Oestrogen Levels: Oestrogen levels fluctuate significantly, leading to symptoms such as hot flashes, night sweats, and irregular periods.
  • Decreased Progesterone: Progesterone levels gradually decline, which can result in heavier or lighter menstrual bleeding and longer or shorter cycles.
  • Increased FSH and LH: The pituitary gland releases more FSH and LH in response to declining ovarian function, which can cause symptoms like mood swings and sleep disturbances.

Stage 2: Menopause

Menopause is officially diagnosed when a woman has gone 12 consecutive months without a menstrual period. The hormonal landscape during menopause is characterised by:

  • Low Oestrogen and Progesterone: Both hormones remain at low levels, leading to the cessation of menstrual cycles and contributing to symptoms such as vaginal dryness, thinning hair, and skin changes.
  • High FSH and LH: These hormone levels remain elevated but are less effective in stimulating ovarian function, reinforcing the end of menstruation.

Stage 3: Postmenopause

Postmenopause refers to the period after menopause, during which symptoms may persist but often become less severe. Key hormonal changes include:

  • Stable Low Oestrogen and Progesterone: These hormones remain at consistently low levels, which can increase the risk of osteoporosis and cardiovascular disease.
  • Elevated FSH and LH: These hormone levels stabilise at higher-than-premenopausal levels but are no longer effective in triggering ovarian activity.

Impact of Hormonal Changes on the Body

Let’s understand what impacts these hormones can have on a woman’s body.

Physical Effects

  • Fluctuating oestrogen levels affect the body’s temperature regulation, leading to sudden feelings of intense heat and sweating.
  • Lower oestrogen levels cause the vaginal tissues to become thinner, drier, and less elastic, which can lead to discomfort during intercourse and increased risk of urinary infections.
  • Oestrogen plays a crucial role in maintaining bone density. Its decline can lead to an increased risk of osteoporosis and fractures.
  • Reduced oestrogen levels are associated with changes in cholesterol levels and an increased risk of heart disease.
  • Hormonal changes can slow metabolism and lead to weight gain, particularly around the abdomen.

Emotional and Cognitive Effects

  • Hormonal fluctuations can lead to emotional instability, causing mood swings, irritability, and increased stress.
  • Some women experience heightened anxiety and depression during menopause, influenced by hormonal changes and the psychological impact of this life transition.
  • Menopause can bring about memory lapses and difficulty concentrating, often referred to as “brain fog.

Tips for Managing Hot Flashes and Night Sweats

Hot flashes and night sweats are among the most common and disruptive symptoms of menopause. Characterised by sudden, intense feelings of heat and sweating, they can significantly impact daily life and sleep quality. Managing these symptoms involves a combination of lifestyle changes, home remedies, and medical treatments.

Here are some practical tips to help manage hot flashes and night sweats effectively.

Lifestyle Modifications

  • Maintain a Healthy Weight: Being overweight or obese can increase the frequency and severity of hot flashes. Aim for a healthy weight through a balanced diet and regular physical activity.
  • Stay Hydrated: Dehydration can exacerbate hot flashes and night sweats. Drink plenty of water throughout the day to stay hydrated.
  • Regular Exercise: Physical activity helps regulate body temperature and improve overall well-being. Aim for at least 150 minutes of moderate aerobic exercise per week, such as walking, swimming, or cycling. Include strength training exercises twice a week. Read more about this later in this article.
  • Dietary Adjustments: Certain foods and beverages can trigger hot flashes. Avoid spicy foods, caffeine, and alcohol. Instead, focus on a diet rich in fruits, vegetables, whole grains, and lean proteins. We have discussed more about this in the next section of this article.
  • Quit Smoking: Smoking is linked to more frequent and severe hot flashes. Seek support to quit smoking, such as nicotine replacement therapy, counselling, or smoking cessation programmes.

 Home Remedies and Environmental Adjustments

  • Keep Cool: Reducing your body temperature can help prevent hot flashes and night sweats. Use fans, air conditioning, or open windows to keep your environment cool. Dress in lightweight, breathable fabrics and use cooling pillows or mattress pads.
  • Layer Clothing: Wearing layers allows you to adjust to temperature changes easily. Wear lightweight, moisture-wicking layers that can be easily removed during a hot flash.
  • Cold Water and Cool Showers: Cooling down quickly can alleviate the intensity of hot flashes. Drink cold water or take a cool shower when you feel a hot flash coming on.
  • Relaxation Techniques: Stress and anxiety can trigger or worsen hot flashes. Practise relaxation techniques such as deep breathing exercises, yoga, meditation, or progressive muscle relaxation to reduce stress.

 Sleep Hygiene for Night Sweats

  • Cool Sleeping Environment: A cooler sleeping environment can help reduce night sweats. Keep your bedroom cool by using fans, air conditioning, or opening windows. Use light, breathable bedding and wear moisture-wicking sleepwear.
  • Establish a Sleep Routine: A regular sleep routine can improve overall sleep quality. Go to bed and wake up at the same time every day, even on weekends. Create a calming bedtime routine, such as reading or taking a warm bath before bed.
  • Avoid Heavy Meals and Caffeine Before Bed: Heavy meals and caffeine can disrupt sleep and trigger night sweats. Avoid eating large meals, spicy foods, or consuming caffeine close to bedtime.

Healthy Diet During Menopause

As women experience menopause, their nutritional requirements change. Understanding these changes and adapting your diet accordingly can help manage symptoms and promote long-term health. Here are some key nutritional considerations:

  • Calcium and Vitamin D: Calcium and vitamin D are essential for maintaining bone health and preventing osteoporosis, which becomes a greater risk after menopause due to decreased oestrogen levels. Dairy products (milk, cheese, yoghurt), leafy green vegetables (kale, broccoli), fortified foods (orange juice, cereals), and fish (salmon, sardines) are rich sources of calcium. Vitamin D can be obtained from sunlight exposure, fortified foods, and supplements if needed.
  • Iron: Iron is important for maintaining healthy blood cells and preventing anaemia, especially since menstrual blood loss decreases after menopause. Red meat, poultry, fish, beans, lentils, spinach, and fortified cereals are good sources of iron.
  • Protein: Protein is essential for maintaining muscle mass, which tends to decrease with age. Lean meats, poultry, fish, eggs, dairy products, beans, legumes, nuts, and seeds provide high-quality protein.
  • Fibre: Fibre supports digestive health, helps maintain a healthy weight, and reduces the risk of heart disease. Fruits, vegetables, whole grains, legumes, nuts, and seeds are rich in fibre.
  • Healthy Fats: Healthy fats are important for heart health and overall well-being. Avocados, nuts, seeds, olive oil, and fatty fish (salmon, mackerel) provide healthy fats, particularly omega-3 fatty acids.
  • Phytoestrogens: Phytoestrogens are plant compounds that mimic oestrogen in the body and may help alleviate some menopausal symptoms. Soy products (tofu, tempeh, soy milk), flaxseeds, sesame seeds, and legumes contain phytoestrogens.

Exercise Recommendations for Menopausal Women

Regular physical activity is crucial for menopausal women to manage symptoms, maintain bone and heart health, control weight, and improve well-being. Let’s discuss some personalised exercise recommendations and practical tips for incorporating different types of physical activity into daily life.

Aerobic Exercise

Improves cardiovascular health, burns calories, and boosts mood. Aim for at least 150 minutes of moderate-intensity aerobic exercise per week or 75 minutes of vigorous-intensity aerobic exercise. Examples include walking, jogging, swimming, cycling, and dancing. Choose activities you enjoy to stay motivated. Incorporate variety to prevent boredom and reduce the risk of injury.

Strength Training

Builds and maintains muscle mass, strengthens bones, and improves metabolism. Perform strength training exercises at least two days per week, targeting all major muscle groups. Examples include weight lifting, resistance band exercises, and bodyweight exercises (such as squats, lunges, and push-ups). Start with lighter weights and gradually increase resistance. Focus on proper form to prevent injury. Consider working with a trainer to develop a personalised programme.

Flexibility and Stretching

It enhances flexibility, reduces muscle stiffness, and improves range of motion. Include flexibility exercises in your routine at least two to three times per week. Examples include stretching, yoga, and Pilates. Stretch after warming up or at the end of your workout. Hold each stretch for 15-30 seconds without bouncing.

Balance and Stability

These exercises improve balance, coordination, and reduces the risk of falls. Perform balance exercises at least two to three times per week. Examples include standing on one leg, heel-to-toe walking, and specific yoga or tai chi poses. Practise balance exercises in a safe environment. Use a chair or wall for support if needed.

Mind-Body Practices

It reduces stress, improves mental clarity, and enhances emotional well-being. Incorporate mind-body practices into your routine as often as needed. Examples include yoga, tai chi, and meditation. Join a class or follow online videos to learn proper techniques. Focus on breathing and mindfulness during practice.


Menopause is a Natural Phase of Life

Navigating the menopause journey can be challenging, but with the right information and support, it can also be a time of growth and self-discovery. Understanding hormonal changes, managing symptoms through a healthy diet and regular exercise, addressing mental health, and exploring medical and alternative treatments can help make this transition smoother and more manageable.

Remember to consult with healthcare providers for personalised advice and support. By taking proactive steps and prioritising self-care, women can navigate menopause with confidence and embrace this new chapter in their lives.


Frequently Asked Questions

1. When is menopause?

Menopause typically occurs between the ages of 45 and 55, marking the end of menstrual cycles and that of a woman’s reproductive phase.

2. What are the signs of menopause in a woman?

Signs of menopause in a woman include hot flashes, night sweats, irregular periods, mood swings, and vaginal dryness.

3. What happens to the body during menopause?

During menopause, the body experiences hormonal changes that lead to the cessation of menstrual periods, hot flashes, mood swings, and various physical and emotional symptoms.


Require expert advice or specialized treatment? Please arrange an appointment with our specialist.

Dr Norleen Mohd Salleh
Consultant Obstetrician & Gynaecologist

Go to Specialist Profile



Back to All Highlights