Obstetrics & Gynaecology

Mood, Menses, Lumps & Bumps

  • March 1, 2020
  • 2 minutes read

Mood swings across a spectrum of emotions is just one sign of women entering menopause. Biological changes may be expected, too. While women going through ‘the change’ could be facing a rough ride, symptoms can be managed by medical intervention.

During menopause, oestrogen levels decline. With that, many women experience hot flushes, fatigue, irritability and, occasionally, difficulty in concentrating,” says gynaecologist and obstetrician Dr Ann Tan. “There is often a sense of loss of one’s youth and virility, which affects them negatively, too.”

But it’s not just dipping oestrogen levels that are responsible for menopausal women’s mercurial temperament. According to Dr Tan, the simultaneous lack of progesterone may also adversely impact their mood. “They tend to get more anxious or depressed. Sleep may also become more difficult or patchy,” she describes.

As challenging as menopause sounds, Dr Tan assures that there are ways for women to stay balanced during such a phase:

  • Taking things in one’s stride
  • Using natural herbal remedies to alleviate symptoms
  • Increasing physical activity, which generate endorphins, the ‘feel good’ hormone
  • Reducing stress and avoiding stimulants like caffeine and alcohol
  • Using Hormone Replacement Therapy to manage if the symptoms are negatively impacting her

Due to the oestrogen-progesterone imbalance, the time leading up to menopause is also when some women go through irregular and possibly abnormal heavy menses. There have been cases when the menstrual flow cannot be contained without a double dose of sanitary napkins or frequent napkin change — and these episodes can last longer than seven days.

Beyond being inconvenient, heavy bleeding can lead to fatigue and other health concerns, such as anaemia.

Apart from mood swings and heavy bleeding, menopausal women need to watch out for growths in their reproductive organs, such as cysts and fibroids.

Ovarian cysts are fluid-filled sacs that can develop in an ovary. Most cysts grow unnoticed. After menopause, though, there is an increase in the risk of ovarian cancer. Most cysts are diagnosed using the safe and painless ultrasound imaging. If cancer is suspected, further tests such as pelvic CT scan are often required. Surgery may be necessary when the cyst shows suspicious features, especially when the cyst is a new finding in a menopausal woman.

Uterine fibroids, on the other hand, are small and non-malignant tumours that grow on a woman’s uterine wall. They often develop in women who are at childbearing age, but may be undetected until after menopause. “As hormone levels drop, new fibroids become rare and existing ones tend to reduce in size,” says Dr Tan. Although benign, they can cause pain and other discomfort in perimenopausal women, such as heavy bleeding, frequent spotting and menstrual-like cramping. Treatment options for fibroids are dependent on the severity of symptoms. Pain relievers are recommended for minor pains. Should the fibroids continue to grow, surgical procedures (myomectomy, hysterectomy, or uterine artery embolisation) may be needed.

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