Menopause – What to Expect and How to Breeze Through It

It is undeniable that every woman goes through menopause around their late 40s to late 50s signifying the end of fertility. However, the word “menopause” is a taboo! It is often negatively linked with aging, fluctuation in weight, tiredness and moodiness making women suffer menopause symptoms in silence due to embarrassment and unwillingness to talk about it even with healthcare professionals. In fact, sharing and discussing it openly with healthcare professionals, family or trusted friends aids to elevate your understanding about what to expect during menopausal transition, sorting through all the unpleasant feeling and symptoms while enjoying your “golden years”.

Do you know that the menopausal transition consists of three stages? They are perimenopause, menopause, and postmenopause.

What to Expect and How to Breeze Through?

The menopausal experience varies among women. Some are lucky enough to go through menopausal transition without any symptoms. Most women experience the symptoms within 5 years after onset; a substantial proportion of women, however, continue to experience symptoms beyond 5 years.So, what to expect during menopausal transition and how to sail through it?

1. Hormonal change that causes fluctuation of menstrual cycles

The progressive loss in estrogen production results in irregular menstrual cycle because the low level of estrogen isn’t enough to support a menstrual cycle.4 Estrogen deficiency during menopausal transition has been associated with several symptoms up to 85% of menopausal women. At the same time, the marked reduction in estrogen has shown to increase levels of oxidative stress in the body.17

2. Gradual thinning and dryness of skin

Do you know that the decreasing estrogen level causes development of dry skin? Estrogen stimulates collagen synthesis,14 affecting the skin condition. Many studies have reported that estrogen deprivation is associated with several skin issues, such as dry skin caused by reduced skin moisture; development of fine wrinkles due to reduced skin collagen, and skin thinning.5,12&13

3. The rise of total cholesterol and LDL levels

Women approaching menopause have been reported to have increased cholesterol levels, with increment of about 9% on LDL and about 6.5% on total cholesterol.7 Postmenopausal women also has significantly higher values of both total cholesterol and LDL.6,15

4. Weight gain, reduced bone mass and muscle tone

Estrogen is needed in maintaining bone and muscle mass. With declining estrogen, women can lose up to 20% of their bone density in 5-7 years after menopause, 16 resulting in higher risk for osteoporosis. Meanwhile, with reduced muscle mass, menopausal women tend to look less toned and fit. On the other hand, due to decreasing metabolism, the body’s energy requirement is lesser which also means lesser calories intake is needed. Having a sedentary lifestyle will lead to unwanted weight gain.

5. Poor sleeping quality

Women in this transition stage usually face sleep disturbance. The possible reasons may be due to hot flashes at night that causes sweat or change in sleeping pattern.

6. Increased susceptibility to certain diseases, such as liver disease

Declined estrogen level results in many biological changes. One of it is the increased susceptibility to liver diseases especially non-alcoholic fatty liver.10  Furthermore, this will also accelerate the progression of fibrosis in liver diseases such as viral liver disease.


Women experiencing menopause would encounter hormonal change as one of the biggest change leading to unfavourable symptoms, and increase of risk for certain diseases, such as high cholesterol and liver diseases. Thus, do not suffer these symptoms in silence. Consult medical professionals, take precaution and preventive actions in managing health can help to improve and maintain the quality of your next phase in life.

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Reference

  1. Steward DE. 2007. Menopause: A Mental Health Practitioner’s Guide. USA: American Psychiatric Publishing, Inc. Retrieved on 13 April 2017.
  2. Gracia C et al. 2005. Defining menopause status: creation of a new definition to identify the early changes of the menopausal transition. (abstract only) The Journal of The North American Menopause Society. Vol 12 (2): pp. 128-135. Retrieved on 13 April 2017.
  3. Goodman NF et al. 2011. American Association of Clinical Endocrinologists Medical Guidelines For Clinical Practice For The Diagnosis and Treatment of Menopause. Endocrine Practice. Vol 17 (supplement 6): pp. 1-25.
  4. Philips E. 2003. Everything You Need to Know About Menopause: A Comprehensive Guide to Surviving–And Thriving–During This Turbulent Life Stage. USA: Rodale. Retrieved on 13 April 2017.
  5. Hall G and Phillips TJ. 2005. Estrogen and skin: The effects of estrogen, menopause, and hormone replacement therapy on the skin. (abstract only) Journal of the Academy of Dermatology. Vol 53 (4): pp. 555-568. Retrieved on 13 April 2017.
  6. Pasquali R et al. 1997. Influence of menopause on blood cholesterol levels in women: the role of body composition, fat distribution and hormonal milieu. (abstract only) Journal of Internal Medicine. Vol 241 (3): pp. 195-203. Retrieved on 13 April 2017.
  7. Harding A. 2012. Cholesterol Jump, Study Shows. Health.com. Retrieved on 13 April 2017.
  8. Boyles S. 2009. LDL Rises Around Time of Menopause. Retrieved on 13 April 2017.
  9. Brady CW. 2015. Liver disease in menopause. World Journal of Gastroenterology. Vol 21 (25): pp. 7613-7620.
  10. Florentino GSA et al. 2013. Nonalcoholic Fatty Liver Disease in Menopausal Women. Arquivos de Gastroenterologia. Vol 50 (3): pp. 180-185.
  11. NHS Choices. 2015. Menopause – Symptoms. Retrieved on 20 April 27.
  12. Brincat M et al. 1985. Long term effects of the menopause and sex hormones on skin thickness. British Journal of Obstetrics and Gynaecology. Vol 92: pp. 256-259.
  13. Brincat MP et al. 2005. Estrogens and the skin. Climacteric. Vol 8: pp. 110-123.
  14. Stevenson S and Thornton J. 2007. Effect of estrogens on skin aging and the potential role of SERMs. Clinical Interventions in Aging. Vol 2 (3): pp. 283-297.
  15. Campos H et al. 1988. Differences in Low Density Lipoprotein Subfractions and Apolipoproteins in Premenopausal and Postmenopausal Women. (abstract only) The Journal of Clinical Endocrinology and Metabolism. Vol 67 (1): pp. 30-35. Retrieved on 20 April 2017.
  16. NHS Choices. 2015. Menopause and your bone health. Retrieved on 20 April 2017.
  17. Doshi SB et al. 2013. The role of oxidative stress in menopause. Journal of Mid-Life Health. Vol 4 (3): pp. 140-146.
  18. Miquel J et al. 2006. Menopause: A review on the role of oxygen stress and favorable effects of dietary antioxidants. Archives of Gerontology and Geriatrics. Vol 42: pp. 289-306.