Hot flushes. Feeling faint. Night sweats. Thankfully, discussions about the menopause have moved on from hushed conversations about temperature-related symptoms associated with ‘the change’. However, there is still much to be learned. In the UK, Dr. Louise Newson and Dr. Rebecca Lewis, globally recognised menopause specialists and co-founders of Newson Health (newsonhealth.co.uk), believe that education around menopause needs to evolve. It should extend beyond just symptoms to encompass a woman’s future health as a whole – especially considering the long-lasting changes the hormones affected by perimenopause and menopause will bring.
“Menopause should be seen as a potential long-term hormone deficiency with health risks, rather than just a natural transition for women to endure,” said Dr. Newson when she and Dr. Lewis stopped in Singapore on their way to a gathering of global menopause experts at the Sydney Opera House, Australia. While in town, Osler Health had the privilege of hosting them at their Menopause Summit, and ANZA had the opportunity to speak with Dr. Newson about why both healthcare professionals and women themselves need to change their approach to menopause for the sake of future wellness.
Your work in the UK around menopause is prolific. What conversations do you hope to share in Singapore?
I’d like to encourage a shift in how we view menopause, recognising it instead as a long-term hormonal deficiency that carries health risks. It’s crucial for women to understand the consequences of not addressing symptoms, rather than continuing the long-standing focus on the risks of Hormone Replacement Therapy (HRT) treatment.
What does HRT do exactly?
HRT can assist in replenishing the hormones that decline during menopause. It can be an effective way to manage symptoms, reduce future health problems and promote longevity.
So longevity should be considered when seeking help?
Absolutely. When we reach menopause, our oestrogen levels – the hormone that plays a vital role in regulating reproductive health, bone density, and other bodily functions – drop to less than 5% of what it was when we were younger. Administering hormones through HRT can reduce these issues. It’s important to note that once someone is menopausal, they remain so forever. So it’s essential to factor in a woman’s longevity when making a diagnosis.
What’s the major long-term health risk of menopause?
Osteoporosis can become a major issue. The last time Rebecca and I were in Singapore, we noticed many women with obvious signs of osteoporosis, evident through their postural curvature. I’m menopausal myself and without the help of HRT, my symptoms might have been better or worse, but by not taking HRT I would have also faced potential increased risks of osteoporosis, diabetes, dementia, and more.
How does Singapore fare in comparison globally when it comes to menopause treatment?
Like all countries, Singapore has a journey to go on in terms of normalising the conversation around menopause. I would suggest women identify a clinic like Osler Health because they know a lot, care deeply, and are very conscious about getting the right information to people. They are striving to spread reliable knowledge because the majority of women could benefit.
It seems like menopause brings endless symptoms …
It does! There is an updated list of 72 symptoms on my website, including signs like palpitations; headaches; dry, itchy skin; and cystitis. Hot flushes and sweats still affect 68% of women – a significant majority – but these are not the most common symptoms.
If hot flushes are not the most common, what is?
I surveyed nearly 6,000 women and issues affecting the brain, such as brain fog, memory issues, anxiety, low mood, and fatigue, are very common. However, they can also be vague and easily attributed to factors like busy jobs or juggling family life. But it’s important not to overlook the underlying cause and to avoid blaming external pressures like busyness.
How do you know symptoms are not just you feeling a bit rubbish?
When several occur together, such as hair changes alongside muscle or joint pain for example, it becomes easier to connect the dots and consider that perimenopause or menopause might be the cause.
What are some more surprising symptoms you uncovered?
Internal tremors – tremulous sensations within the body. It’s that “about to sit an exam” sensation, but without the clear cause, which distinguishes it from anxiety. Tinnitus (ringing in the ears) is another common sign. Many women don’t realise the range of symptoms they experience until they see them listed. They’re often shocked to discover that issues like dry eyes and palpitations may be connected. In fact, 10% of women leave the workplace due to menopausal symptoms such as anxiety, fatigue, and memory problems. They may feel unable to perform their job or no longer enjoy it, without realising that fluctuating hormones caused by menopause could be the key to getting them back on track.
Can you be ‘tested’ for menopause?
There’s no simple blood or saliva test to reach a diagnosis. We can do a blood hormone test, but because hormones fluctuate, it’s only a guide. Rather, we talk to our patients , and this is where an official symptoms checklist can be helpful. Some women may find they have symptoms similar to what they had before their periods started. Together we discuss nutrition, exercise, and look at menopause in a larger context.
Is this when you discuss HRT?
Yes. Once women understand what happens to their hormones and what can occur when they no longer have the hormones they need, they can decide if they want to opt for HRT based-treatment for their future health.
How does HRT work today?
We still give patches, pessaries, and replace hormones like-for-like. We administer oestradiol – the natural, anti-inflammatory type of oestrogen – through patches or gels, which are absorbed into the bloodstream through the skin. Natural progesterone is typically taken in oral capsules or as a vaginal or rectal pessary. Testosterone is used as a gel or cream applied to the skin. In Singapore, local vaginal oestrogen can be transformational, not only for vaginal dryness or discomfort, but also for urinary symptoms such as cystitis and urinary tract infections.
What advice would you give to those who suspect they may be perimenopausal?
Don’t wait to get advice until you’re menopausal (a year after your last period). Download my Balance app (balance-menopause.com) which lists potential hormonal symptoms and allows you to monitor hormone fluctuations. It’s crucial to stay in tune with your body before this point, and if you notice symptoms, it’s important to understand what they are and how they might be affecting you. This way, you can make informed decisions when you’re feeling well. Remember, hormonal changes can make decision-making difficult as your brain doesn’t process things the same way, so don’t delay.
Understanding Menopause
- Menopause is the biological process marking the end of a woman’s menstrual cycles, officially diagnosed after 12 consecutive months without a period
- It results from a decline in ovarian function, leading to reduced estrogen and progesterone production
- Perimenopause refers to the transitional period leading up to menopause
- It typically occurs between ages 45 and 55, with the average age being 51
- After menopause, women enter postmenopause, a stage with lower hormone levels
If you’re looking for more menopause resources please visit www.newsonhealth.co.uk or visit Osler Health www.osler-health.com
The views expressed here are those of the author(s) and do not necessarily reflect the views of ANZA Magazine. The information provided is for general informational purposes only. Always consult with a qualified healthcare professional before making any health-related decisions
