Menopause: Perimenopause Symptoms and Treatments

Menopause is a natural part of ageing but is often considered a taboo subject. Not many women are willing to talk about it openly, know what to do or where to seek help. Several women deal with menopause in silence, believing that they have to "live with it".

To shed some light on this topic, we cover the most common questions about menopause in this blog.


What is Menopause?

Menopause is when a woman stops having her period and can no longer get pregnant as the ovaries produce less oestrogen and progesterone. Periods can sometimes stop suddenly or become less frequent over a few months before they stop altogether. When a woman has not had her period for over 12 consecutive months, she is considered to have reached menopause[1].


At What Age Does Menopause Start?

Menopause can occur between 45 and 55 years of age as women's oestrogen levels begin to decline. In Hong Kong, the average age of menopause recorded is 51[2]. Some women can experience menopause before the age of 40, which is known as premature menopause. 

Menopause can be classified into three stages[3]:

    1. Perimenopause —  The period leading up to menopause. This stage can last for 2 to 10 years, but there are individual variations[4]. This is when women start experiencing symptoms related to the reproductive cycle as the ovaries slowly produce less oestrogen.
    2. Menopause — Diagnosed when a woman has not had their period for 12 consecutive months. 
    3. Postmenopause — The stage after menopause, when women have not had their period for 12 months or longer. 


Symptoms of Menopause

As oestrogen levels lower during perimenopause, physiological and psychological changes start to take place. The duration and severity of these symptoms vary for each person. 

Some common symptoms include[5]:

  • Hot flushes
  • Night sweats
  • A reduced sex drive
  • Vaginal dryness
  • Mood swings
  • Headaches
  • Joint stiffness, aches and pains
  • Difficulty sleeping
  • Difficulty with memory and concentration

These symptoms can have a significant impact on daily life. If it becomes too difficult to manage, you should seek the advice of a general practitioner. 


How Long Do Menopause Symptoms Last? 

On average, most symptoms last around four years from your previous period[5]. The symptoms of menopause will gradually ease during the menopausal and postmenopausal stages. 


When to Consult a Doctor About Menopause

As not every woman experiences menopause the same way, seeing a doctor will depend on the severity and range of symptoms. If you are experiencing symptoms that disrupt your daily life, you should see a doctor for treatment.


Menopause Treatments

There are different ways to treat the various symptoms of menopause, the most common is the use of HRT.


Hormone Replacement Therapy (HRT)

HRT works by replacing the hormones in the body that are missing. It is very effective at relieving the symptoms of menopause such as hot flushes, vaginal discomfort and mood swings[4][1]

HRT can either be taken orally as tablets, as a subdermal implant, gels or adhesive patches and vaginal suppositories[1]. Tablets and skin patches are the most common form of taking HRT.

We recommend consulting your doctor before taking HRT as there are side effects, such as cramps and nausea.


Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) is recommended by the National Institute for Health and Care Excellence (NICE) as a treatment method to help women alleviate mood or anxiety that arise as a result of menopause[6]

CBT is a form of talk therapy that helps develop practical ways of managing problems and provides new coping skills and valuable strategies. You can learn more about CBT and mental health services at MindWorX. 


Lifestyle and Diet Changes

Some risk factors and symptoms linked with menopause can’t be changed, but adopting a healthy lifestyle and good nutrition can help ease the transition, as well as mitigate certain conditions that may develop during and after menopause. 

Some examples include[7]

  • Maintaining a healthy weight as hormonal changes might make it more likely to gain weight.
  • Getting enough calcium, vitamin D and magnesium to lower the risk for osteoporosis, improve sleep and energy. 
  • Exercise regularly to promote better sleep and prevent conditions like heart disease, diabetes, and osteoporosis.
  • Keeping cool by wearing loose-fitting clothing to help manage hot flashes.
  • Avoid smoking and excessive drinking.


Support for Menopause

In Hong Kong, you can seek support for menopause through the family planning association, government hospitals or private clinics.

Educational care is provided to women who are menopausal and perimenopausal to help alleviate symptoms and prevent diseases associated with menopause. Services can include a general physical exam, pap smear, breast examination and urine analysis[8]. Treatment by HRT and CBT can also be advised where necessary. 



1. Family Planning Association. (2021). 'Menopause'. FPAHK. Available at: <> [Accessed 09 July 2021]

2. Family Health Service. (2013). 'When does menopause usually take place?'. Department of Health. April 2013. Available at: <> [Accessed 09 July 2021]

3. Healthline. (2019). 'How long does menopause last?'. Healthline. 07 March 2019. Available at: <> [Accessed 09 July 2021]

4.WebMD. (2020). ‘Perimenopause’. WebMD. 14 June 2020. Available at: <> [Accessed 12 July 2021]

5.National Health Service. (2018). 'Menopause'. NHS. 29 August 2018. Available at: <> [Accessed 09 July 2021]

6. National Institute for Health and Care Excellence. (2019). 'Menopause: diagnosis and management'. NICE Guidelines NG23. 05 December 2019. Available at: <> [Accessed 09 July 2021]

7. Healthline. (2020). ‘Everything You Should Know About Menopause’. Healthline. 13 January 2020. Available at: <> [Accessed 14 July 2021]

8. Family Planning Association. (2021). 'Menopause Services'. FPAHK. Available at: <> [Accessed 09 July 2021]

Topics: Women's Health

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