When menopause should not be managed alone

Dr Ramya Raj, Specialist Obstetrician & Gynaecologist, International Modern Hospital Dubai

While many women do move through menopause without formal medical care, certain symptoms should prompt professional guidance. These include hot flushes or night sweats that disrupt sleep or daily functioning, mood changes such as persistent anxiety or low mood, brain fog affecting work or memory, vaginal dryness or pain during intimacy, recurrent urinary symptoms, unexplained weight gain, or changes in blood pressure, cholesterol, or blood sugar. Heavy or irregular bleeding, especially after periods have stopped, should always be medically assessed.Some women also assume that symptoms like mood changes, joint pain, or fatigue are unrelated to menopause and therefore not worth mentioning lets explore what are mood swings during menopause? who gets them?as this question will be haunting most of us,they are extreme abrupt fluctuations in mood common during the menopausal transition and upto 75% of women over 40 going through menopause.

Doctors can make these conversations more approachable by normalizing menopause as a life stage rather than a medical failure. Simple, open-ended questions such as “How are these changes affecting your daily life?” or “What worries you most right now?” help women feel heard rather than rushed into treatment decisions.

Supporting women emotionally and physically during menopause

Healthcare providers can play a crucial role by addressing menopause holistically, not just hormonally. Emotional support is as important as symptom control. Many women feel dismissed or embarrassed discussing sleep disruption, libido changes, or emotional volatility. Acknowledging these experiences as common and valid can significantly reduce hesitation to seek help.There are certain triggers for hot flushes during menopause like stress ,smoking, excessive caffeine intake ,alcohol consumption and having spicy food and hot weather. So Practical support includes individualized care plans that may involve lifestyle adjustments avoiding these triggers, non-hormonal therapies, hormonal treatment when appropriate, mental health screening, and referrals to nutritionists or physiotherapists. Non prescriptive  medications do have a role in alleviating symptoms like isoflavane supplements ,soy products, black cohosh and vitamin E.Regular follow-ups, even brief ones, help reinforce that menopause is an ongoing transition, not a one-time consultation.life style modifications like maintaining a healthy weight ,smoking cessation ,relaxation response techniques and acupuncture do help.

Creating women-friendly clinical environments—longer appointment slots, educational materials, and reassurance that symptoms will be taken seriously—also encourages engagement.

Misconceptions that prevent women from seeking care

Several persistent myths keep women from accessing support. One is the belief that menopause symptoms are something to “just endure.” Another is that treatment, particularly hormone therapy, is universally unsafe—despite strong evidence that it can be safe and effective for many women when appropriately prescribed.systemic estrogen therapy  is the most effective treatment for vasomotor symptoms and only therapy currently approved by US FDA.It has other benefits like preventing alzheimers  disease in the presence of normal brain tissue, increases good cholesterol and reduces atherosclerosis and coronary heart disease, improves bone health and helps in maintaining quality of life in menopausal lady if appropriately prescribed by medical expert ruling out contraindications .Harmone replacement therapy is versatile and can be administered in various forms including transdermal patch,topical preparation, vaginal suppositories and oral medications.This way , its clear and informative that there are multiple options to tailor the treatment to each individuals need.

Doctors can counter these misconceptions by offering clear, balanced information and emphasizing that seeking help does not mean over-medicalizing a natural process. Practical advice includes encouraging women to track symptoms, prioritize sleep and bone health, maintain cardiovascular screening, and understand that early conversations allow for simpler, more effective interventions.

Bottom line: Menopause is a normal life event and not a disease! Menopause does not require medical intervention for every woman, but no woman should feel she has to suffer in silence. Open dialogue, reassurance, and personalized care can transform menopause from an isolating experience into a manageable and well-supported life transition.Maximal Benefit with Harmonal replacement therapy requires early onset of treatment with right dose for the appropriate duration according to an individual patient’s need