Menopause isn’t just hot flashes
When most people think about menopause, hot flashes are often the first and sometimes only symptom that comes to mind.
In reality, menopause is far more complex.
There are over 70 recognised symptoms associated with perimenopause and menopause, and many of these are still under-recognised, not just by women, but sometimes even in clinical settings. This can make it difficult for people to connect what they’re experiencing with hormonal changes, especially in the earlier stages.
“Many menopause symptoms are still under-recognised, often mistaken for stress, ageing, or the effects of a busy lifestyle.” Says Dr. Nav Uppal, GP, River Valley Doctors.
Understanding the changes
Perimenopause can begin several years before menopause itself. During this time, hormone levels, particularly oestrogen, fluctuate, which can affect different systems throughout the body.
Oestrogen receptors are present in many areas, including the brain, skin, joints, and cardiovascular system. This is why symptoms can appear in ways that don’t immediately seem related to menopause.
For some women, the first signs are not hot flashes at all.
Instead, they may notice changes such as disrupted sleep, mood fluctuations, joint discomfort, or irregular menstrual cycles. These symptoms can develop gradually and are sometimes attributed to stress, ageing, or lifestyle factors.
Symptoms are often overlooked
In a fast-paced environment like Singapore, it’s not uncommon for symptoms such as fatigue, poor sleep, or low mood to be dismissed as part of a busy lifestyle.
However, these changes can sometimes be linked to hormonal shifts.
Sleep disturbance, in particular, is one of the most significant but under-recognised symptoms. Poor sleep can affect energy levels, concentration, mood, and overall wellbeing.
Similarly, emotional and mental health symptoms — such as increased anxiety, irritability, or low mood, can also be influenced by hormonal changes during this stage of life.
Some may have minimal symptoms, while others may find that these changes affect their day-to-day quality of life. There is no single pattern, which is why awareness and understanding are so important.
Recognising that menopause is not limited to one or two symptoms can help women better understand what their bodies are going through and seek the right support when needed.
There is no single “menopause experience”
Every woman’s experience of menopause is different.
There is no single “menopause experience” Every woman’s experience of menopause is different.
Some may have minimal symptoms, while others may find that these changes affect their day-to-day quality of life. There is no single pattern, which is why awareness and understanding are so important.
Recognising that menopause is not limited to one or two symptoms can help women better understand what their bodies are going through and seek the right support when needed.
Support and treatment options
The good news is that there are many ways to manage symptoms and support overall health during this time.
These can include lifestyle adjustments, as well as medical options such as hormone replacement therapy (HRT), which is a safe and effective treatment for many women when appropriately prescribed.
The most important thing is that care should be individualised. What works for one person may not be suitable for another, and decisions should always be made in consultation with a healthcare professional who is familiar with menopause care.
Starting the conversation
Because symptoms can be varied and sometimes subtle, many women may not realise that what they are experiencing is related to perimenopause or menopause.
If you feel that your body is changing, or you’re experiencing symptoms that don’t quite make sense, it’s worth having a conversation.
Early understanding and support can make a meaningful difference not just in managing symptoms, but in maintaining overall health and wellbeing through this stage of life.
Dr. Nav is now seeing patients at River Valley Doctors. If you’re experiencing changes and not sure why, book a consultation.
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