How to manage menopause symptoms and when it starts

20 February 2023 dot 5-minute read
Healthy Body Feature Menopause Live Well Women's health
Fashion and lifestyle publication Vogue says menopause is having a "wellness moment". What was once a touchy subject is now a welcome topic. (Credit: Shutterstock)
The World Health Organization reported in 2021 that women over 50 accounted for 26 per cent of menopause cases globally. By 2030, the number of women with menopause is projected to reach 1.2 billion. The relationship between the ageing process and the condition's onset has historically been understudied. As such, many misconceptions about menopause symptoms continue to surround this critical stage of a woman's life.
Most women assume menopause symptoms will only happen in their 50s. In reality, these symptoms can develop much earlier in life. While some of the symptoms may be severe or prolonged, many effective treatments are available, from lifestyle changes to hormone therapy.

What is menopause

Menopause occurs after 12 consecutive months without menstrual period. This happens when the ovaries stop releasing eggs for fertilisation. The changing levels of female hormones produced in the ovaries, oestrogen and progesterone, will lead to menopause symptoms.
When does menopause happen? The global average age of menopause is 51, but this varies in Asia. The age range in India falls between 46 and 48, while it's 49 in Taiwan. Your period pattern offers a better clue when you're about to enter menopause.

Period patterns

Period patterns will be one of the first things your doctor will ask about when diagnosing menopause. (Credit: Shutterstock)
Before you get your final period, you will enter a transition period called perimenopause. Most of the menopause symptoms you're familiar with happen during this stage. In an article for AIA Vitality Australia, general physician Dr Preeya Alexander writes perimenopause typically begins in the mid to late 40s, although it can be earlier.
Perimenopause's hallmark symptom is an irregular menstrual cycle, a sign of fluctuating oestrogen levels. Your flow may be light or heavy, and the length of each cycle can vary. Your period may stop for two months and then reappear monthly again.
Endocrine Society explains an unpredictable menstrual cycle as:
  • More frequent than 21 days or spaced out more than 35 days
  • Less than eight cycles per year
  • More than 90 days without a cycle
Consult an obstetrician and gynaecologist if you experience irregular periods. Other medical conditions unrelated to perimenopause can cause changes in menstrual bleeding.

What does menopause feel like

Dr Nighat Arif of the National Health Service in the UK says women can experience up to 48 physical and psychological menopause symptoms. Here are the most common ones.
Physical symptoms
  • Irregular periods
  • Palpitations
  • Hot flushes
  • Night sweats
  • Vaginal dryness or irritation
  • Lack of sex drive
  • Sleep problems
  • Thinning hair
  • Loss of breast fullness
  • Skin itchiness or dryness
  • Weight gain and slowed metabolism
  • Joint pain
  • Dizzy spells
  • Headaches
  • Bloating
Psychological symptoms
Fatigue, hot flushes, sweating, joint ache and emotional disorder were the top reported symptoms from a study published in the International Journal of Environmental Research and Public Health (IJERPH). The prevalence of these symptoms was higher during the perimenopausal period.
Some women experience hot flushes that wake them up at night, leading to fatigue the next day, according to the American College of Obstetricians and Gynecologists (ACOG). Others experience frequent urination, which increases their risk of urinary tract infections (UTIs).
Dr Alexander says the symptoms of perimenopause may last several months or years. "Around 20 per cent of patients have no symptoms at all. It differs from person to person."
Women who have undergone uterus removal, endometrial ablation or wear an intrauterine device (IUD) may only find out they're menopausal during a blood test, according to the Endocrine Society.

How to cope with menopause symptoms

Managing menopause symptoms starts with healthy habits. (Credit: Shutterstock)
Talk to your doctor when you notice perimenopause symptoms, even mild ones. The time leading to menopause allows you and your doctor to take stock of your health priorities. Protecting your heart and bones becomes paramount because the lack of oestrogen puts you at risk of cardiovascular disease, bone loss and osteoporosis.

Maintain healthy habits

Eating a healthy diet, practising sleep hygiene and exercising regularly are the best non-medical approaches to managing the symptoms.

Know your triggers

Hot flushes, the sensation of sudden heat in the chest and face, may be accompanied by sweating or heart palpitations. Common triggers are:
  • caffeine
  • spicy foods
  • stress
  • heat
  • alcohol
  • smoking

Talk to your doctor about hormone replacement therapy (HRT)

Dr Alexander says HRT is a medical option for people with various persistent symptoms. HRT, which replenishes the declining hormone levels of your body, can relieve hot flushes, night sweats and vaginal dryness and protect against bone loss. Consult a gynaecologist about the benefits and risks of HRT.

Find mental health support

Many women in online support groups talk about experiencing anxiety and panic attacks. Yet they avoid seeking professional help, believing they must deal with it independently. The Chinese women in the IJERPH study only sought treatment if they had more than four menopause symptoms.
You don't have to wait for menopause symptoms to become severe before seeking help. Invest in preventive self-care with the wellness community of AIA Vitality. You can get an expert opinion on lifestyle changes and preventive health check-ups. Allow yourself to make your postmenopausal years one of the best times in your life.
AIA. 2022. Dr Preeya Alexander: What is Perimenopause. [online]  [Accessed on 25 October 2022]
International Journal of Environmental Research and Public Health. 2020. Menopausal Symptoms and Perimenopausal Healthcare-Seeking Behavior in Women Aged 40–60 Years: A Community-Based Cross-Sectional Survey in Shanghai, China. [online]  [Accessed on 25 October 2022]
BBC News. 2021. The Netflix show putting the spotlight on menopause. [online]  [Accessed on 25 October 2022]
BBC News. 2022. Busting the most common myths. [online]  [Accessed on 25 October 2022]
Endocrine Society. 2022. Menopause. [online]  [Accessed on 25 October 2022]
Endocrine Society. 2022. Menopause Map. [online]  [Accessed on 25 October 2022]
The American College of Obstetricians and Gynecologists. 2021. The Menopause Years. [online]  [Accessed on 25 October 2022]
World Health Organization. 2022. The Menopause. [online]  [Accessed on 25 October 2022]
Vogue. 2022. Once a Taboo Topic, Menopause Is (Finally) Having Its Wellness Moment. [online]  [Accessed on 25 October 2022]

This is general information only and is not intended as financial, medical, health, nutritional or other advice. You should obtain professional advice from a financial adviser, or medical or health practitioner in relation to your own personal circumstances.

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