Navigating Menopause: Understanding Female Menopause

Menopause is one of those periods in a woman’s life that is often shrouded in fear and uncertainty. From mood swings to weight gain, to the loss of sleep, hair, and libido—not to mention those horrendous and unpredictable hot flushes that interrupt everyday life—it can feel like a daunting transition. Many women describe it as the end of their womanhood. But it doesn’t have to be that way.

In this blog post, we explore what menopause is, commonly experienced symptoms, and finally, what holistic and medical treatment options are available to turn this frightening transition into one of grace and empowerment.

What is Menopause?
Menopause marks a single point in time—12 consecutive months without menstruation that is not due to any other cause. It signals the end of a woman’s reproductive years and occurs as a result of the depletion of ovarian follicles. The average age of menopause is around 51, although it can vary widely. Factors such as smoking, autoimmune conditions, living at high altitudes, and being a fragile X carrier can bring menopause on earlier.

Before menopause comes perimenopause, the transition phase that can last several years. It is often marked by irregular menstrual cycles, fluctuating flow, and dramatic shifts in hormone levels—sometimes minute to minute. These hormonal fluctuations, particularly of oestrogen and progesterone, are responsible for much of the emotional and physical upheaval women experience, including mood swings, fatigue, and disrupted sleep. It’s important to remember that although fertility declines during perimenopause, pregnancy is still possible.

As oestrogen and progesterone decline further, the symptoms tend to intensify. The most commonly reported include hot flushes, weight gain, sleep disturbances, brain fog, and low libido. While most symptoms last 5–10 years, some women may experience them for 20 years or longer.

Urogenital Changes
One of the lesser-discussed but highly distressing consequences of menopause is the increased frequency of urinary tract infections (UTIs), often accompanied by unusual discharge or foul odour. These changes are due to the drop in oestrogen, which alters the vaginal pH and reduces the urogenital tract’s natural ability to clear infections.
Another common concern is vaginal atrophy, where the vaginal lining becomes thinner, drier, and less elastic, making intercourse painful and increasing the risk of infections and incontinence.

The Natural Course of Untreated Menopause
If left untreated, the primary concern is oestrogen deficiency. Without this key hormone, several systems are affected:

1. Bones: Decreased bone mineral density leads to osteoporosis and an increased risk of fractures.
2. Vagina & Bladder: Vaginal dryness, painful intercourse, recurring infections, and urinary incontinence.
3. Fat Distribution: Loss of peripheral fat and a shift to abdominal fat, often described by patients as “the tube.”
4. Mood & Sleep: Increased rates of depression, anxiety, insomnia, and irritability.
5. Sexual Health: Libido often disappears completely.

The Good News: Treatment Options

Thankfully, we’re no longer in the dark ages when it comes to menopause treatment. There are now safe, effective, and individualised options available to support women during this transition.

At Medihub, we take a holistic and tailored approach. Based on your medical history, symptoms, clinical examination, and blood results, we create a treatment plan unique to you. Below is an overview of commonly used interventions—from conservative to more advanced:

Menograine
What it is: A herbal supplement blend often containing Black Cohosh, Dong Quai, and other botanicals.
Benefits: May ease hot flushes, improve mood and reduce hormonal headaches.
Contraindications: Liver dysfunction, hormone-sensitive cancers, or concurrent use with certain medications (e.g., blood thinners). Always check with your doctor before use.

Ashwagandha & Lion’s Mane
What they are: Adaptogenic herbs used to reduce stress and support cognitive function.
Benefits: Ashwagandha may ease anxiety and support adrenal health. Lion’s Mane promotes brain health, reducing memory lapses and brain fog common in menopause.
Contraindications: Autoimmune diseases, thyroid disorders (Ashwagandha may stimulate the thyroid), and mushroom allergies (Lion’s Mane). Use under medical supervision.

Melatonin
What it is: A naturally occurring hormone that regulates the sleep-wake cycle.
Benefits: Improves sleep quality and onset in menopausal women with insomnia or disrupted sleep.
Contraindications: Use with caution in people with depression, autoimmune diseases, or on medications that affect melatonin metabolism (e.g., warfarin). Long-term use should be monitored.

Vaginal Oestrogen
What it is: A low-dose, local oestrogen applied as a cream, pessary, or vaginal ring.
Benefits: Effectively treats vaginal dryness, atrophy, painful intercourse, and recurrent UTIs without significantly increasing systemic oestrogen levels. Newer Formulations contain the vagina-specific bacteria Lactobacillus and works effectively at preventing those UTIs.
Contraindications: Generally considered safe even for women with a history of breast cancer, but always requires specialist input in such cases. Rare systemic absorption may occur.

Topical HRT (Hormone Replacement Therapy)
What it is: Oestrogen applied as a gel, spray, or patch absorbed through the skin.
Benefits: Bypasses the liver (unlike oral HRT), has a lower clotting risk, and relieves hot flushes, mood swings, and bone loss.
Contraindications: History of hormone-sensitive cancer, unexplained vaginal bleeding, active liver disease, or history of blood clots.

Oral HRT
What it is: Oestrogen (with or without progesterone) taken by mouth.
Benefits: Effective for systemic symptoms—hot flushes, night sweats, mood disturbances, bone protection, and more.
Contraindications: History of breast or endometrial cancer, liver disease, clotting disorders, or uncontrolled hypertension. Also carries a slightly higher risk of blood clots and stroke compared to transdermal routes.

Final word:
Menopause is a transition, not a diagnosis. It can be uncomfortable, yes—but it can also be a deeply empowering time of life when supported correctly. The right combination of lifestyle support, medical guidance, and hormonal balancing can help you move through menopause with strength, vitality, and grace.

If you’re struggling or even just curious about your options, we’re here to guide you. Book a consultation with one of our doctors at Medihub—we’ll walk this journey with you.