Everything You Need to Know About Managing Disruptive Menopause Symptoms


Medical Director
IMU Healthcare

I’m still young. Should I be concerned about menopause at this point in time?
“We should speak to women long before they reach menopause, so that, when it happens, they are more prepared and less anxious about it,” says Professor Dr Nazimah Idris.

She adds: “Many women I see wish they had known earlier what they could have done to prepare themselves. As every woman will go through this experience, you should enter this life phase empowered with knowledge.”

What’s menopause, exactly?
According to Prof Dr Nazimah, menopause is when a woman’s ovaries stop producing eggs and she stops menstruating.

Medically, menopause is confirmed when a woman has not experienced menstruation after one year.

Generally, this takes place when a woman is between 45 and 55 years old.

About 5% of women worldwide, however, experience early menopause between the ages of 40 and 45.

It’s also possible to experience menopause after undergoing a hysterectomy, chemotherapy, and other medical procedures that can damage the ovaries and affect menstruation.

Common symptoms of menopause. Click on the image for a larger, clearer version.

Why do some women experience symptoms of menopause even when they are still menstruating?

Prof Dr Nazimah explains that this is likely because the woman is experiencing perimenopausal stage (often called perimenopause for short), which can occur even before a woman enters menopause.

This stage usually lasts 4 to 5 years.

“During this time, it is normal to have irregular menstruation that may include heavier bleeding as well as infrequent or skipped cycles,” she elaborates.

Perimenopause can occur due to changes in a woman’s endocrine system. These changes can cause a reduction in the levels of oestrogen, the female sex hormone.

Because of this reduction in levels, a woman may experience symptoms of menopause such as hot flashes, fluctuating emotional states, difficulty sleeping and vaginal dryness.

She may also experience forgetfulness, low energy levels and reduced libido which, combined with vaginal dryness, can lead to less interest in sex and intimacy.

Once the woman enters menopause, the symptoms can become more severe and last up to another 5 years.

That sounds uncomfortable. Can anything be done about it?

Prof Dr Nazimah admits that a woman going through perimenopause and later menopause may experience around 10 years of symptoms. “This is a long time to be coping with symptoms if they are disrupting your daily life.”

Hormone therapy can help to manage severe and disruptive symptoms.

Tell me more about hormone therapy. Does it work, and how does it work?

“Hormone therapy can be very helpful in relieving hot flashes and improving sleep quality, vaginal dryness and urinary incontinence, among others,” she says.

There are different types of hormone therapy: tablets, topical creams, vaginal ring, and more. Medications may also be prescribed when necessary, such as to reduce the risk of osteoporosis due to low levels of oestrogen in the body.

The doctor will recommend the most suitable option based on a woman’s needs, family history, and other factors.

This sounds intriguing. Is hormone therapy an option for every woman experiencing symptoms of menopause?

Well, for one thing, Prof Dr Nazimah points out that hormone therapy is generally well-tolerated.

Hence, it is an option available to most women even when they have chronic diseases such as type 2 diabetes and high blood pressure.

However, hormone therapy may not be suitable for women that have certain diseases and conditions such as breast cancer, liver disease, thromboembolism, and heart disease.

If you have a health condition and are interested in hormone therapy, Prof Dr Nazimah recommends consulting a doctor for more information.


Certified Chinese Medicine Practitioner
IMU Healthcare

How about natural remedies for menopause symptoms? Do they work?

According to Sin Yen Suan, a certified Chinese medical practitioner, natural remedies such as evening primrose and black cohosh are traditionally turned to for perimenopause and menopause.

However, research on the efficacy on these remedies has yet to uncover any conclusive evidence on their efficacy in relieving the symptoms of perimenopause and menopause.

“However, Chinese medicine may be able to help,” Yen Suan offers.

She explains that the effectiveness of Chinese medicine can be seen by about 3 cycles of treatment, although the whole treatment process for menopause symptoms may last 1 to 2 years.

How exactly can Chinese medicine help?

Yen Suan further elaborates that Chinese medicine treat health problems by addressing imbalances in the body through individualized therapies, based on each person’s health status, needs, and other factoers.

“Many women come to me for help with symptoms such as persistent or heavy vaginal bleeding especially, heavy sweating, hot flashes, and disturbed sleep,” she says. “To help, we use several different treatments such as herbal medications to balance their qi or acupuncture to stimulate blood flow at the meridian points. These methods help to ease their emotional state, so they are able to feel better and sleep better at night.”

Chinese medicine can complement a person’s current Western medicine regime. If you are considering Chinese medicine to complement your current medical treatments, she recommends keeping both your doctor and Chinese medicine practitioner updated on your current forms of treatment.

  • Menopause is not the end of life as you know it. Embrace new experiences, learn new things, take up a new hobby, make new friendships and rekindle old ones—the list goes on and on.
  • Speak to your doctor about health screenings such as Pap smear, mammograms, and colonoscopy, which are useful in detecting early stages of cancer and other health issues.
  • Also consider tests such as blood tests for anaemia and diabetes as well as bone density scans for osteoporosis.
  • Women over 51 should increase their calcium intake to 1,200 mg a day and consume vitamin D3 to keep their bones healthy and reduce their risk of osteoporosis.
  • Do regular Kegel or pelvic floor exercises, weight bearing exercises, and strength training to keep your body in good working condition.
  • Quit unhealthy habits such as smoking.

Here’s How Post-Menopausal Women Can Manage Their Vaginal Dryness


Founder and Medical Director

As we get older, our bodies start to go through normal and expected changes.

It can be upsetting to find yourself unable to keep up with activities and lifestyles that were once simple and effortless, but we must learn to accept that aging is a natural part of life.

Changes in our physical capabilities become more noticeable as we age, and vaginal function, like many other areas of the body, can be affected by age.


Vaginal dryness is a common menopausal symptom that many Malaysian women experience. Furthermore, 56.1% and 39.9% of postmenopausal women had sexual problems and vaginal dryness, respectively.

However, according to one study, only 38% of the respondents with vaginal dryness sought treatment.

These statistics show that, despite its prevalence, many Malaysian women do not seek treatment for it. This could be due to a lack of awareness about the condition and available treatment options, as well as the societal stigma associated with it.

Decrease in oestrogen levels
  • One of the most common causes.
  • Oestrogen plays an important role in maintaining the health of the vaginal lining, ensuring that it remains thick, elastic, and well-lubricated.
  • Its levels tend to drop in older women.
Certain medications Examples: antihistamines, antidepressants, and birth control pills.
Certain medical conditions Examples: diabetes, Sjögren’s syndrome, and lupus.
Lifestyle habits Examples: smoking and inadequate water intake.
  • Vaginal itching
  • Burning, pain, or discomfort in the vaginal area
  • Vaginal bleeding after intercourse
  • Vaginal bleeding or spotting between periods
  • Frequent urinary tract infections

While experiencing vaginal dryness can be frightening, it does not mean the end of the world.

Over-the-counter lubricants or moisturisers
  • These can help to relieve symptoms and make intercourse more comfortable.
  • They can help provide temporary relief from the symptoms of vaginal dryness, but they may not be effective for all women and may need to be used frequently.

Natural remedies

  • Examples include coconut oil and aloe vera gel, which can also be used to moisturise the vagina and relieve discomfort.
  • These natural remedies can also help improve of overall skin texture, reduce of inflammation, and relieve itching or burning sensations.
Hormone therapy
  • This can help to replace oestrogen and improve vaginal lubrication.
  • Can be prescribed in a variety of ways, including vaginal rings, tablets, and creams.
  • However, hormonal therapy is not the best choice for everyone, so it is important to talk to a doctor or speak to a specialist before you begin.
Ultra Femme 360 
  • This is a non-surgical radiofrequency treatment for both internal and external vaginal rejuvenation.
  • It can help improve muscle strength and laxity in the vagina, giving you a tighter, firmer vagina.
  • There is no downtime or scarring.

Although vaginal dryness can be treated at home or with non-invasive treatments, you should seek medical attention if you have symptoms such as:

  • Bleeding or unusual vaginal discharge
  • Discomfort from the vaginal dryness interfering with your daily activities
  • Bleeding between periods or after sexual intercourse.

It is important to note that vaginal dryness can be a sign of an underlying medical condition, such as vaginal infections or sexually transmitted infections.

If the vaginal dryness is severe or long-term, it is best to consult with a specialist, such as a gynaecologist. They can help determine the cause of vaginal dryness and recommend the best treatment option for you.


  1. Abdullah, B., Moize, B., Ismail, B. A., Zamri, M., & Mohd Nasir, N. F. (2017). Prevalence of menopausal symptoms, its effect to quality of life among Malaysian women and their treatment seeking behaviour. The medical journal of Malaysia, 72(2), 94–99. https://www.e-mjm.org/2017/v72n2/menopausal-symptoms.pdf
  2. Nik Hazlina, N. H., Norhayati, M. N., Shaiful Bahari, I., & Nik Muhammad Arif, N. A. (2022). Prevalence of psychosomatic and genitourinary syndrome among menopausal women: A systematic review and meta-analysis. Frontiers in medicine, 9, 848202. https://doi.org/10.3389/fmed.2022.848202