As a fundamental aspect of the ageing process, menopause brings about a series of physical, emotional, and hormonal changes. While it signifies the conclusion of fertility, it also marks the beginning of a new chapter in a woman’s life that offers opportunities for growth, self-discovery, and redefinition of well-being.

What is Menopause?

Menopause is a natural and inevitable stage in a woman’s life that marks the end of her reproductive years. It is a significant biological milestone between 45 and 55, although the exact timing can vary for each individual.
This transformative phase involves the gradual cessation of menstrual cycles and the decline of reproductive hormones, primarily estrogen and progesterone, which have played crucial roles throughout a woman’s childbearing years.

What Are the Stages of Menopause?

Menopause is a multi-stage journey encompassing distinct phases, each characterised by hormonal shifts and changes in a woman’s body. These stages mark the transition from reproductive to post-reproductive years and bring about various physical and emotional experiences. Let’s explore the stages of menopause in detai


Perimenopause, or the menopausal transition, typically starts several years before menopause. During this phase, which can last anywhere from a few months to several years, a woman’s body gradually produces fewer reproductive hormones, leading to changes in the menstrual cycle.
  • Symptoms – Irregular periods, changes in menstrual flow, hot flashes, night sweats, mood swings, sleep disturbances, vaginal dryness, and fluctuations in libido.


Menopause is when a woman has not had a menstrual period for 12 consecutive months. It’s a significant marker of the end of the reproductive years.
  • Symptoms – Hot flashes, night sweats, mood changes, sleep disturbances, vaginal dryness, changes in sexual function, and potential changes in bone density.


Postmenopause follows menopause and refers to the years after a woman’s last menstrual period. During this stage, hormonal fluctuations tend to stabilise, and the body adapts to the new hormonal balance
  • Symptoms – While many symptoms from perimenopause and menopause may diminish, some, such as hot flashes and mood changes, can continue during postmenopause. Additionally, bone health becomes a focus as the risk of osteoporosis increases.

Beyond Menopause

After the initial years of postmenopause, women enter the phase of “beyond menopause.” During this time, the body adjusts to lower hormone levels, and women may experience various aspects of ageing and its associated health considerations.
  • Symptoms – Some symptoms of menopause may continue, and women might also encounter age-related health issues, such as cardiovascular concerns and changes in metabolism.
Each woman’s experience of these stages can vary widely. Some women may transition relatively smoothly, while others might face more pronounced symptoms. Understanding these stages can help women anticipate and manage the changes that come with menopause. While the physical aspects of menopause are significant, it’s also a period of personal growth, self-discovery, and empowerment as women embrace the next chapter of their lives.
Some women go through menopause with not much complaints while others may need some help in managing their symptoms while they transit through menopause.
Treatment options include hormone replacement therapy (HRT) as well as non-hormonal medications. Please discuss with your doctor to decide which option is most suitable for you.

Can You Still Be Fertile During Menopause?

As women go through perimenopause, their ability to have babies becomes less because of changing hormones, but they can sometimes get pregnant due to occasional egg release. When menopause arrives (after a year without periods), chances of getting pregnant become low. It’s important to use birth control until menopause is certain.
If someone wants to have a baby during perimenopause, they should talk to a doctor for advice. Decisions about having kids should be based on personal situations.

How Does Menopause Impact Emotional Well-being?

Menopause can impact emotional well-being due to hormonal shifts and physical changes accompanying this transition. The fluctuation and eventual decline of estrogen and progesterone hormones can influence mood, emotions, and overall mental health. Common emotional experiences during menopause include mood swings, irritability, anxiety, and even episodes of depression.
Hot flashes, night sweats, and sleep disturbances can also contribute to mood disruptions. The emotional aspect of menopause is unique to each woman, and while some may navigate this phase with ease, others might find it more challenging.
Engaging in stress-reduction techniques, maintaining a healthy lifestyle, seeking support from loved ones, and, if needed, talking to a mental health professional can all contribute to managing emotional well-being during this transition.

How Does Menopause Affect Bone Health?

Menopause directly impacts bone health due to reduced estrogen, a hormone that helps maintain bone density. As estrogen levels decline, women become more susceptible to bone loss, leading to osteoporosis—a condition characterised by weakened and brittle bones that are more prone to fractures. The risk of osteoporosis increases significantly during and after menopause.
To protect bone health, it’s important to adopt a calcium-rich diet, engage in weight-bearing exercises, and ensure adequate vitamin D intake, which helps the body absorb calcium. Healthcare specialists may recommend bone density tests to assess risk and determine the need for interventions like calcium and vitamin D supplements or prescription medications.

Dr. Cho Li Wei 朱丽薇医生

Consultant Endocrinologist
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