Menopause Stigma: Ageing with Grace

As we age as women, we will, sooner or later, be faced with menopause. Dr Joyce Lee Chai Yuit, consultant obstetrician and gynaecologist at Subang Jaya Medical Centre, says menopause is a natural transition period in a woman's life - when she stops having her period (or menses) and can no longer reproduce. Biologically, the ovaries will stop releasing eggs and feminine hormones, namely oestrogen and progesterone.

Understanding the menopause transition

The average age for menopause in Malaysian women is around 51 years old. However, the period of perimenopause, or menopause transition, can start from as early as 10 to two years before menopause. During this stage, the woman will experience symptoms such as hot flushes, night sweats, insomnia, vaginal dryness, loss of libido, mood swings, anxiety and depression in relation to mood swings and memory loss or difficulty concentrating. Dr Lee says these symptoms happen gradually, can vary between women and can be drawn out over a period of years.

Dr Lee shares that hormone replacement therapy is a medical method used to relieve perimenopausal symptoms in women. There are also lifestyle changes women can adopt, such as wearing light, thin clothing and turning on the air conditioner to combat hot flashes and night sweats, utilising hormonal, non-hormonal lubricant or vaginal moisturisers for vaginal dryness, and regular exercise and healthy diet to boost mood and improve sleep. However, the real problem facing women is the nation’s attitude towards menopause.

Overcoming stigma with Eempowerment through relationships

Despite it being a natural occurrence, Dr Lee notes that while Malaysian women are aware that they will stop menstruating at some point in time, many do not know the symptoms attributed to menopause. She suggests that Malaysia’s conservative Asian culture plays a part in this phenomenon.

"Menopause carries a negative stigma among Malaysian women, so most women will go through or deal with the changes alone. If the woman fails to go through the transition well, she is often regarded to be inept in coping with life changes or the physical and emotional needs of her spouse and children."

She says this misconception has led women to carry a great sense of shame and guilt when going through this perfectly natural phase of her life. Hence, many Malaysian women tend to ignore or dismiss the symptoms or treat it as a part and parcel of the ageing process and suffer in silence.

Contrarily, Dr Lee notes that, from her experience, other cultures are generally more well informed about menopause and openly discuss it. They also usually deal with menopause together as a couple, and open communication is practiced, ensuring the woman does not go through it alone.

Teamwork conquers all hormonal changes struggles

The onset of menopause does not just cause discomfort to a woman, but can also negatively impact her relationship with her spouse and family. Dr Lee explains that hormonal changes can affect a woman’s personality, and that is exactly what occurs during perimenopausal period. This change of personality can cause confusion and misunderstandings between spouses. Dr Lee says there may be times a woman will blow up suddenly because of mood swings or decline sexual intercourse because of a lowered libido, fear of pain because of vaginal dryness or lack of sleep the night before.

"Hence, if the couple is not aware that this change in behaviour is caused by the hormonal changes, it can lead to frustration, anger and even resentment in the marriage," she says.

Dr Lee emphasises that it is neither the woman’s nor her spouse’s fault. She advises the only way to tackle this issue is for the couple to be aware of the situation, have honest communication and mutual understanding and work together to go through this phase of the woman’s life together.

Embracing menopause with confidence

Aside from sharing this experience together with your spouse, menopausal women can also find non-medical support systems in the community. The Malaysia Menopause Society is a good social support network for women and their spouses to gather and share their struggles and challenges while spurring and encouraging each other on.

She appeals to patients to open up and talk to their gynaecologists about their symptoms, no matter how trivial. "In my experience, I can see the change in the woman’s expression when she finally meets someone who listens and understands what she is going through. It actually makes a huge difference in their transition experience."

Finally, she advises all women to not approach menopause with fear and negativity. "Many people are going through this, so you are not alone. And when you finally make it through this phase gracefully, you can say that yes, you have done it well and have lived well."

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