Mature Adult

Enjoying Your Golden Years:
50 years and above

Menopause
Pelvic Floor Dysfunctions (Pelvic Organ Prolapse, Urinary Incontinence)
Vaginal Laxity and Dryness
Well-woman Screening
Gynaecological Cancers

1. Menopause

What is Menopause?

Menopause is a gradual, naturally-occurring process that happens when a woman’s menstrual periods have stopped for 12 months. Menopause marks the end of a woman’s reproductive lifespan. A woman is born with a fixed number of eggs in her 2 ovaries; with each menstrual cycle, the number of eggs declines and menopause occurs when there are no more useful eggs left in the ovaries. In women, menopause occurs at an average age of 51, but can happen anytime between 45 to 55 years of age.

This decline of hormones, which are released by the ovaries, begins a few years before the onset of menopause. This is known as the peri-menopausal period and it is characterised by common symptoms such as:

Irregular menstruation (delayed or more frequent menstrual periods)
Changes in period flow (lightening of periods or heavy bleeding)
Increase in pre-menstrual symptoms (breast tenderness and swelling, bloating, water retention, headaches, mood swings, hot flushes and sleeping difficulties)
Tiredness
Poor concentration and memory loss
Weight gain around the middle and hips
Decline in libido
Vaginal dryness
Night sweats

These symptoms may last for several months or years until menopause is completely over. Menopause also increases the risk of chronic conditions such as heart disease or osteoporosis, due to the loss of protective effects by female hormones, which are significantly reduced during menopause.

Managing Menopause

For most menopausal women, management methods are targeted at the symptoms and preventing post-menopausal conditions. Menopause should not be altered as it is a natural and healthy condition for most women. Approaches to manage menopause may include:

Lifestyle changes
Non-prescription medication like phyto-oestrogens which are naturally found in certain plants, fruits and herbs
Hormone replacement therapy
Specific treatments for symptoms linked to menopause (vaginal rejuvenation, anti-depressants)
Preventive medication or supplements for chronic post-menopausal conditions such as osteoporosis

These interventions help improve function and delay symptoms of ageing such as tiredness, sleep disorders, weight gain, memory loss and reduced exercise tolerance.

2. Pelvic Floor Dysfunctions
(Pelvic Organ Prolapse, Urinary Incontinence)

Pelvic floor disorders affect up to 25% of women aged 30 – 70 globally and are caused by weakened pelvic muscles or tears in the connective tissues holding the pelvic organs (bladder, bowels and reproductive organs) in place. A pelvic organ prolapse occurs when the muscles are unable to hold the organs in place and they drop downwards into the vagina.
Pelvic floor dysfunction is commonly caused by strain during previous childbirths, ageing or increase in abdominal pressure.

Depending on the severity, pelvic floor dysfunction can present a variety of symptoms:

Urinary incontinence (loss of bladder control or urine leakage when coughing, sneezing or exerting yourself)
Bulge or sensation of heaviness in the vaginal area
Pelvic pressure
Pain during sex
Lower back pain

Treatments for pelvic floor dysfunction and uterine prolapse include lifestyle measures such as exercises to strengthen the pelvic muscles, inserting a pessary to support the prolapsed tissue, or removal of the uterus (hysterectomy) for severe prolapse cases.

3. Vaginal Laxity and Dryness

The onset of menopause may bring about sexual dysfunction and vaginal discomfort.

During menopause, a drop in estrogen levels may lead to decreased libido and lack of hydration and thinning of the vaginal walls, causing dryness and irritation or pain during sex. Impaired sexual function may affect relationships, productivity and undermine other aspects of one’s life.

One of the approaches to managing these changes in the vagina is vaginal rejuvenation. It is a non-invasive laser treatment with no downtime which helps restore vaginal function and reduce vaginal discomforts.