Getting older comes with benefits: you have experience under your belt, more confidence … and you know the difference between a full-bodied chardonnay and an aromatic riesling! One of the less enjoyable issues for women, however, is menopause.
“Menopause is defined as having no menstrual period for one year caused by decreased production of oestrogen and progesterone in your ovaries,” explains DR NICHOLA SALMOND, a General Practitioner at a central practice in Hong Kong. But while it can be challenging, there is help at hand. Here, Dr Salmond shares her knowledge so you can prep properly.
#1 Menopause can be genetically determined
The age you experience menopause can vary, but it typically occurs around 50. There’s no official test for it, but your doctor can test your oestrogen and progesterone levels to determine whether it’s menopause, life circumstances or hormonal changes. The age your own mother went through menopause is worth noting, too, as it can be genetically determined.
#2 Play close attention to the run-up
Perimenopause is the time right before menopause begins, when women may start to suffer from symptoms such as irritability, poor sleep, joint pain or weight gain, or their periods may become heavier than usual. This is caused by a drop in levels of progesterone, the female “relaxing hormone”, and can be easily helped with a low dose of bioidentical progesterone (see #6).
#3 Feeling mad is normal!
During menopause, your ovarian follicles decline, and your ovaries become less responsive to the hormones involved in reproduction, causing a host of (frankly, annoying) symptoms. Aside from those mentioned above, these can include brain fog, memory loss, low libido, hair loss, bloating and vaginal dryness. Also, feeling like you’re going a little mad is natural and perfectly understandable!
#4 Hot flush or hot weather?
Hot flushes/flashes are common, and unfortunately you won’t be able to attribute them to an extra sweaty Hong Kong day. This rush of heat can lead to sweating, heart palpitations, dizziness and blotchy skin, and afterwards you may feel cold. When stripping off entirely isn’t an option, a fan at work or home can help bring your temperature down.
#5 Don’t forget your bones
Decline in oestrogen production can affect the calcium in your bones, which can lead to osteoporosis, or hip, spine and other bone fractures. Keep your bones healthy by eating foods including lots of calcium such as dairy products or dark leafy greens, taking vitamin D supplements, and reducing alcohol and smoking.
#6 Medication can help
Bioidentical hormone replacement therapy (BHRT) can offer a “natural” solution to many symptoms of menopause and perimenopause. These hormones are identical chemically to those our bodies produce naturally, but differ from those used in traditional hormone replacement therapy (HRT) as they’re derived from plant oestrogens and are given in much lower doses.
#7 Support at every step
Bioidentical hormones come in pill, patch, cream and gel form, and your doctor will monitor you to ensure the lowest effective dose. Regular hormone checks ensure oestrogen levels are kept at a safe level, and regular mammograms and pelvic ultrasounds are essential (frequency will depend on your past history and family history). Some medical conditions may prevent you from using hormone therapy, so speak to a professional first.
#8 Lifestyle changes are key
Lifestyle tweaks can help relieve menopausal symptoms on their own, or in conjunction with hormonal intervention. Opt for a diet with plenty of calcium, reduce your sugar intake, and avoid foods that aggravate symptoms. Aim for at least 150 minutes a week of moderate exercise (or 75 of intense exercise, such as running). Lastly, be kind to yourself. Listen to your body, get support from your doctor, and remember that you don’t have to go through menopause alone.
This article first appeared in the Autumn 2020 issue of Expat Living magazine. Subscribe now so you never miss an issue!