Embark on the next thrilling phase of your life’s journey—menopause! A natural and inevitable stage for every woman, menopause typically occurs around the age of 51 in Sri Lanka. With remarkable progress in medicine, contraception, and obstetric care, women’s life expectancy has soared from about 47 years in the early 1900s to an astounding 78 years today. This increase is attributable to factors such as reduced maternal mortality rates, advanced medical knowledge, improved healthcare access, and efficient control of infectious diseases. Consequently, approximately one-third of a woman’s life now unfolds after menopause. Although menopause can introduce various physical and emotional changes, gaining knowledge about the process and available treatments can empower you to embrace this new chapter confidently. This article will delve into the normal menstrual cycle, female hormones, menopausal symptoms and debunk some prevalent myths about hormone replacement therapy.
The Menstrual Cycle and Female Hormones
The female body is an intricate system regulated by a delicate balance of hormones. The menstrual cycle is primarily controlled by oestrogen and progesterone. Oestrogen plays a crucial role in maintaining your skin, hair, breasts, bones, heart, cognitive function, and mood. Progesterone, on the other hand, is essential for preparing the uterus for pregnancy.
Menopause: A Natural Transition
Menopause marks the end of a woman’s reproductive years, occurring when the ovaries cease to produce eggs and the levels of oestrogen and progesterone decline. The average age of menopause in Sri Lanka is 51 years, but it can vary from woman to woman. This hormonal shift can lead to menopausal symptoms such as hot flushes, night sweats, mood swings, and sleep disturbances.
Menopausal Hormone Therapy (MHT)
To alleviate menopausal symptoms and maintain optimal health, many women opt for menopausal hormone therapy (MHT). This treatment aims to replenish the body with oestrogen, sometimes combined with progesterone, depending on the individual’s needs. MHT can significantly improve the quality of life for women experiencing menopausal symptoms.
National Institute for Health and Care Excellence (NICE) guidelines recommend individualised MHT based on patient needs and preferences. Similarly, The North American Menopause Society and The Endocrine Society provide guidelines for the use of hormone therapy in menopausal women, emphasising individualised hormone therapy based on patient needs and preferences.
Myths About Hormone Replacement Therapy
Despite its benefits, there are several misconceptions surrounding hormone replacement therapy. Some believe that it increases the risk of cancer, heart disease, and stroke. The British Menopause Society discusses the benefits and risks of HRT, highlighting that the risks associated with HRT are generally small and should be balanced against the potential benefits. While slight risks may be associated with MHT, they are minimal for most women when used appropriately and under a doctor’s guidance. Discussing your health history and risk factors with your doctor is crucial to determining if MHT is right for you.
Alternatives to Hormone Therapy
For women seeking alternatives to hormone therapy, the Royal College of Obstetricians & Gynaecologists (RCOG) recommends non-hormonal treatments, such as lifestyle changes and complementary therapies. These alternatives can also help alleviate menopausal symptoms for those who may not be suitable candidates for hormone therapy or prefer not to use it.
MHT Options in Sri Lanka
Currently, there are various MHT options available in Sri Lanka to suit your individual needs. These include local oestrogen creams, oral combined hormone replacement, and oral oestrogen-only therapies. Your doctor will help you determine the best course of treatment based on your symptoms, medical history, and preferences.
Hormone Therapy and Cardiovascular Disease
The relationship between hormone therapy and cardiovascular disease is often a topic of concern. The Cochrane Database of Systematic Reviews conducted a review on the use of hormone therapy for preventing cardiovascular disease in postmenopausal women. The conclusion was that there is insufficient evidence to support the use of hormone therapy for the sole purpose of preventing cardiovascular disease in postmenopausal women. Instead, hormone therapy should be used primarily for managing menopausal symptoms.
Embracing menopause with confidence starts with understanding the changes in your body and exploring available treatment options. It is essential to be aware of the potential benefits and risks associated with hormone therapy, as well as the alternative treatments available. A healthcare provider can guide you through this significant life transition and help you make informed decisions about your health.
At Sugabi Clinic Ragma, our specialised women’s health clinic provides personalised care and guides you through this important life phase. For more information, visit our website at www.sugabi.lk or call +94 716 921 921 to schedule a consultation. We’ll help you navigate menopause with grace, strength, and confidence.
- National Institute for Health and Care Excellence. Menopause: diagnosis and management [NG23]. NICE; 2015. Available from: https://www.nice.org.uk/guidance/ng23
- British Menopause Society. Benefits and risks of hormone replacement therapy (HRT). BMS; 2020. Available from: https://thebms.org.uk/education/principles-practice-of-menopause-care/bms-ppmc-resources-toolkit/what-are-the-benefits-and-risks-of-hrt/
- Royal College of Obstetricians & Gynaecologists. Alternatives to HRT for the management of symptoms of the menopause. RCOG; 2017. Available from: https://www.rcog.org.uk/guidance/browse-all-guidance/scientific-impact-papers/alternatives-to-hrt-for-the-management-of-symptoms-of-the-menopause-scientific-impact-paper-no-6/
- Office for National Statistics. National life tables, UK: 2017 to 2019. ONS; 2020. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/bulletins/nationallifetablesunitedkingdom/2017to2019
- The North American Menopause Society. The 2017 hormone therapy position statement of The North American Menopause Society. Menopause. 2017;24(7):728-753.
- American College of Obstetricians and Gynecologists. Menopause. ACOG; 2020. Available from: https://www.acog.org/topics/menopause
- World Health Organization. Research on the menopause in the 1990s. WHO; 1996. Available from: https://apps.who.int/iris/handle/10665/41841
- The Endocrine Society. Treatment of symptoms of the menopause: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(11):3975-4011.
- Boardman HM, Hartley L, Eisinga A, Main C, Figuls MR, Cosp XB, et al. Hormone therapy for preventing cardiovascular disease in postmenopausal women. Cochrane Database Syst Rev. 2019;3(3):CD002229.