13/08/2025

WEDNESDAY | AUG 13, 2025

6

‘Awareness on menopause needed’

KUALA LUMPUR: Lim Ai Jing feels like she has been a bad daughter. When her 54-year-old mother calls to complain about poor sleep, Lim used to dismiss it as normal gripe. “Initially, I took it lightly. But now, when I read through everything, it’s like, oh my God, this can be quite serious,” said Lim, 29, a clinical psychologist at Sunway Medical Centre Velocity. She was referring to her research on the long-term health effects of perimenopause, when estrogen levels start declining, and menopause, the permanent end of menstrual cycles. Long regarded as a natural process requiring no intervention, experts say early menopause care is key to preventing non-communicable diseases (NCDs) and saving lives and money. Malaysian Menopause Society president Dr Ho Choon Moy said many are unaware of the dangers of untreated menopause, often seeking help only after developing diabetes. “There’s zero budget for menopause. They are putting out the fire but not the root cause,” she said at the Asia-Pacific Menopause Federation 10th Scientific Meeting. Menopause, which averages at age 50.7 in Malaysia, marks higher risks of disease. “One-third of women’s lives will be without estrogen, making them susceptible to problems from heart disease to osteoporosis and cancers,” former health minister Khairy Jamaluddin had said in the Health Ministry’s guidelines. o Early intervention key to preventing NCDs, saving lives, money, say experts

misinformation and fear. Nik Hazlina said ignorance is often generational, with many women, especially in rural areas, seeing menopause as something to be endured, Bernama reported. “This ignorance is not only rife among the public but also among the medical and healthcare sector.” One woman, Nadirah, said an oncologist acquaintance warned her to take HRT for only five years to avoid breast cancer. Ho said she often sees patients told by their doctors to stop MHT. “Patients come to see me, saying ‘doctor, I’m confused, my GP gave me MHT, but the gynaecologist asked me to stop.’” While combined HRT slightly raises breast cancer risk by about 0.4% according to Ireland’s Health Service Executive, estrogen-only MHT does not increase the risk, especially in women without a uterus. Non-hormonal care exists for those at higher cancer risk, but it only relieves symptoms and does not protect against cardiovascular disease, osteoporosis or other NCDs. Ho blames patriarchy for the lack of awareness, even among doctors. “In medical school, they only have one small chapter on menopause.” Lim agreed. During her psychology training, menopause was never considered a root cause of mental health issues. “We were always told to look for bipolar, for other physical issues. But no one asked us to look at menopause,” she said. Asked what she would do with her new knowledge, Lim said she would start by listening to her mother. “I think it’s time for me to sit down and talk with her about this and see how I can help with her sleep.”

common symptoms among working women include joint pain, sleep problems, brain fog, mood swings and digestive issues. “The most destructive symptom (is) sleep disturbance and the most important one we cannot ignore is cognitive problems,” said Lim. Brain fog hampers concentration, memory and decision-making. Hot flashes cause discomfort at work, while fatigue from poor sleep erodes focus. Women aged between 45 and 55 often report reduced productivity and decline promotions or resign early, studies from the United Kingdom and Ireland show. “You know, they have a lot of experience. If they go, it’s really a waste,” said Ho. Malaysia’s female labour participation rate was 56.4% as of May 2025, up from 56.2% in 2023, while Singapore’s was 62.6% and Thailand’s 60.6% in 2023. Menopause also raises the risk of anxiety and depression. Vaginal dryness which makes sex painful can worsen mental health while mood swings may strain relationships. “(Women) easily get hot-tempered. This can sometimes cause problems between husband and wife,” said Malaysian Menopause Society vice-president Prof Dr Nik Hazlina Nik Hussain. She stressed the need for open spousal communication, so that wives feel supported to seek help and husbands can address their own issues such as erectile dysfunction. MHT, including contraceptives and hormone replacement therapy (HRT), is recommended to relieve menopausal symptoms. The guidelines say estrogen therapy may protect the heart if started within 10 years of menopause or before age 60, but it is not advised for primary or secondary prevention of heart disease. Uptake of MHT remains low due to stigma,

Ho said early care such as Menopausal Hormone Therapy prevents conditions like diabetes, hypertension, high cholesterol, heart disease and fractures. – AMIRUL SYAFIQ/THESUN Ho said early care such as Menopausal Hormone Therapy (MHT) prevents conditions like diabetes, hypertension, high cholesterol, heart disease and fractures. “When you treat women having symptoms, it is cardiac protective.” From 2013 to 2019, women made up 57.1% of diabetes cases, according to the National Diabetes Registry. Studies also show most hip fracture patients are women with osteoporosis. “Give free MHT in government clinics. It will cut down expenses 10 to 20 years down the road.” She said early treatment could also keep women in the workforce longer. A study by obstetrician and menopause advocate Dr Premitha Damodaran found that

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