Healthy Lifestyle

When she was 48, Elena Tan started to experience intermittent hot flushes throughout the day. She also started to perspire profusely.

So much so that in a day, Elena could easily change her clothes six times because they became drenched with perspiration.

It was frustrating and very uncomfortable, she recalled. Initially, she sought medical advice from an endocrinologist who ruled out thyroid, as women with hyperthyroid could also suffer from excessive perspiration.

She sought a second opinion, and this time round, the doctor confirmed that she was experiencing menopausal symptoms.

According to the World Health Organization, it is estimated that by 2025, 1.1 billion women will be 50 years and above, and an unprecedented number of these women can expect to live for several decades after reaching menopause.

That is why there is an urgent need to dispel commonly held myths about menopause, and to provide accurate information to women so they can better understand the symptoms of menopause.

Today, World Menopause Day is recognised around the world. The aim is to remind all healthcare providers to educate women about menopause so they are in a better position to make a well-informed decision about their health.

Managing the transition

Women normally experience menopause between 45 and 55 years of age. In Singapore, menopause typically happens around the age of 51.

Around the time when a woman stops menstruating ? menopause is the last menses ? she may experience symptoms of hormonal changes in her body.

This is perimenopause or the transition period.

Postmenopause refers to the years after menopause is confirmed (12 months period free after the last menses).

Though these are natural phases of life, there seems to be a stigma that women will lose their fertility and femininity with the onset of menopause, said Dr Chua Yang, a consultant obstetrician and gynaecologist and director of A Clinic for Women.

But while most women manage the transition well without many symptoms, “for some women, the symptoms may be agonising”, said Dr Chua.

Like Elena.

The 57-year-old homemaker experienced hot flushes and excessive perspiration throughout the day. Elena could not consume hot soups or hot drinks, and whenever she became angry or sad, the perspiration increased.

“At one point, I felt like I was raining sweat from my forehead,” she said. Elena could also not remain in any place for a long time without a fan or an air-conditioner. “I had to install two fans in my kitchen, and four in my living room just so that I could remain in a cooling environment all the time,” she said.

But women should not have to suffer from the symptoms, particularly if these affect their lifestyles or relationships, said Dr Chua, as there are many options for relief from such ailments.

Treatments

There are currently many different options for managing menopause symptoms, such as lifestyle modifications, hormone replacement therapy (HRT) and natural remedies. Dr Chua, for instance, actively encourages her patients to try various lifestyle modifications first.

For example, not consuming hot and spicy food, staying in cooler places or taking cool showers can help relieve the discomfort of hot flushes.

Meditating can also help to calm irritability. Regular exercises will help maintain good heart and bone health and they can also alleviate the mood, and by “sweating it out”, can help cool the body down as well.

While HRT is a known treatment option, it may not be suitable for all, although some will need to consider it to help them through a difficult transition.

The current opinion, based on recent studies, is that women could start HRT if they have moderate to severe menopause symptoms ? but only after detailed risk assessment by their doctors, said Dr Chua.

In Elena’s case, upon her doctor’s prescription, she took hormone tablets for three months.

But she did not take too well to the tablets, and asked to try another type of hormonal tablet. About six to seven months later, her perspiration improved “by 50 per cent and I only had to change clothes three to four times a day”, she said.

Another treatment option is the use of natural remedies that offer support for the management of menopausal symptoms.

One such botanical remedy is Nutrafem, a natural phytoestrogenic supplement that helps to manage mild symptoms and discomfort commonly associated with menopause.

Treatment options are many, so women do have help to manage their menopausal symptoms.

Hair loss can affect anyone, at any age ? so have it treated before it’s too late.

You could be just 12 or 13, and still have male or female-pattern hair loss.

This is no exaggeration ? some of the youngest patients Dr Joyce Lee, an associate consultant with the National Skin Centre, has encountered in her practice here have been of that age.

And she’s found that hair loss is a very common problem that affects both genders equally. The condition can start at any time after puberty and gradually progress with age.

Its causes are varied. It can be partly due to genes ? those whose parents or siblings experience hair loss problems might be prone to having the condition themselves.

It could also be due to hormonal factors.

In men, the male hormone, known as dihydrostesterone, causes some hair follicles to shrink. This leads to the miniaturisation of the hair, resulting in short, fine hairs in place of the long, thick hair that one might previously have had.

The hair-thinning process affects particularly the crown and frontal hairline. In advanced cases, the hair-thinning process can leave these areas completely bald.

In females, women with increased androgens (male hormones) in their bodies may also experience earlier, more severe thinning of their hair.

Said Dr Lee: “Some women may experience worsening hair loss after using oral contraceptives or around menopause.”

Medicative treatment

There are many causes of hair loss, with male-pattern hair loss being the most common.

According to Dr Lee, it is important to establish an accurate diagnosis for the person who has a hair-loss problem before treatment is prescribed, as “there is no single treatment that can treat all forms of hair loss”.

In males, assuming that the person has male-pattern hair loss, there are two FDA-approved methods of treatment currently available to treat the condition.

The first is a form of oral medication, finasteride.

“Taken once a day, it has been shown in clinical trials to halt the miniaturisation process of hair follicles in most patients,” said Dr Lee.

Another medication, minoxidil lotion, is available in various concentrations, ranging from two per cent to five per cent.

“Applied twice a day on a dry scalp, it has also been shown to halt the hair-loss process in a good proportion of patients, and improve hair regrowth in some,” said Dr Lee.

Not everyone will experience hair regrowth with these treatments, said Dr Lee ? although using them should allow most to maintain the amount of hair they have.

In women who look to be suffering from female-pattern hair loss, it is important once again to seek an accurate diagnosis of what type of hair loss they have first, as “patients with chronic illnesses, such as a lack of iron or thyroid diseases, may have hair loss that is indistinguishable from female-pattern hair loss”, according to Dr Lee.

Only minoxidil lotion is FDA-approved to treat female-pattern hair loss. It is used twice daily on a dry scalp.

Said Dr Lee: “A good proportion of women using minoxidil may notice reduced hair loss, with some having modest hair regrowth.”

Don’t fret

Both male and female-pattern hair loss will become permanent if left untreated. The earlier one starts treatment, the more hair one is likely to retain.

Hair weaving, hair transplantation or the use of wigs and hairpieces are possible alternatives for those with more advanced cases of hair loss.

So, solutions are available. While you may lose some of your crowning glory, you need not have to lose any sleep over it.

TREAT IT RIGHT: Female-pattern, above, and male-pattern hair loss, below, can be treated with minoxidil lotion.