HOW MENOPAUSE IS DIAGNOSED
Clinical diagnosis includes when menopause is defined – 12 consecutive months without a period. The most common symptoms Singapore women experience are new-onset joint and muscle aches, disturbed sleep, sexual health and urinary issues, physical and mental exhaustion, and vasomotor symptoms such as hot flushes and night sweats.
Unlike Western populations, where hot flushes and night sweats are most commonly reported, Singapore women most frequently experience joint and muscle aches and sleep disturbances.
MENOPAUSE HORMONE THERAPY IS SAFE AND EFFECTIVE
The recommendations reaffirm that menopause hormone therapy (MHT) is safe and effective in treating hot flushes and menopause-related mood issues, and for the prevention and treatment of postmenopausal osteoporosis (bone loss).
They also state that the benefits of MHT significantly outweigh the risks for most women under 60 within 10 years of menopause who are suitable candidates for it.
For women who cannot or prefer not to use MHT, non-hormone treatments, like antidepressants or newer medications, can be considered for hot flushes. However, custom-made hormone preparations are not recommended as there is limited evidence about their effectiveness and safety.
HELPING WOMEN WITH EARLY MENOPAUSE
Women who experience early menopause (when menstruation stops permanently before the age of 45), whether naturally, from medical treatments like chemotherapy, or surgical procedures such as ovary removal, will require specialised management as early loss of oestrogen affects long-term cardiovascular, bone and brain health.
Women who are likely to experience early menopause due to medical or surgical treatments will be offered counselling pre-and post- treatment. This includes discussing fertility risks and preservation options with a fertility specialist, as well as consulting with a menopause expert to prepare for sudden symptoms and manage long-term health risks.
Some women may have premature ovarian insufficiency (POI), which is the loss of normal ovary function before the age of 40, leading to irregular or absent menstruation and low oestrogen.
As POI significantly reduces fertility, these women will be offered counselling to manage fertility loss and to discuss fertility preservation where appropriate. The framework recommends that women with POI, start MHT promptly to mitigate menopause symptoms.