Manage your menopause

There’s a good reason why menopause is cheekily referred to as “puberty’s evil older sister.” If girls have to deal with unsightly acne, painful menstrual cramps, and uncontrollable mood swings in their teens, middle-aged women endure years of the classic symptoms that come with the end of menstruation—that is, going without your menstrual period for 12 consecutive months: hot flashes, night sweats, vaginal dryness, difficulty sleeping, irritability, incontinence, memory problems, and weight gain from a slower metabolism. 

“But menopause can also be an empowering experience that offers benefits that far outweigh the discomfort of hot flashes,” says Arlene Ricarte-Bravo, MD, of the Obstetrics and Gynecology Department of top hospital in the Philippines Makati Medical Center (MakatiMed)

But first, perimenopause. According to Dr. Bravo, menopause is a natural biological process that occurs after perimenopause, or the stage where shifting levels of the female hormones estrogen and progesterone results in irregular periods, heavier or lighter flows, insomnia, and weight gain. “Perimenopause happens in the 40s and lasts from months to years until menopause,” she says. “Menopause period varies from woman to woman, but the average age is 51.” 

Symptoms may vary as well: some experience the whole nine yards; others just one or two. And while these symptoms may last for years, the good news is they are only temporary and can be addressed with lifestyle changes and home remedies, depending on the doctor’s advice. 

Consider hormone replacement therapy (HRT). Fluctuating levels of the female hormones estrogen and progesterone cause the dreaded symptoms of menopause. “HRT helps restore hormonal levels, thus relieving a woman of the symptoms,” Dr. Bravo explains. HRT comes in tablet, patch, implant, and gel form: ask your doctor to recommend the best option for your case. Discuss the pros and cons as well of taking HRT. Bloating, breast tenderness, headaches, mood swings, nausea, and vaginal bleeding are among its side effects. HRT is also not advised for women who have had cancer, stroke, blood clots, heart or liver disease, and heart attack. 

Keep your cool. Hot flashes come unannounced, so deal with them from the get-go. “Wear clothes made of light, breathable fabrics or dress in layers that you can remove and put on again,” Dr. Bravo advises. Bring a tumbler of iced water when you go out, try to stay in well-ventilated places, and avoid hot and spicy foods.  

Exercise. An hour of moderate exercise daily targets many of menopause’s symptoms. “It keeps your weight down, releases endorphins or happy hormones to elevate your mood, makes you sleep better, and strengthens your bones, which are prone to becoming brittle due to lower levels of estrogen,” Dr. Bravo points out. Include Kegel exercises in your routine. Otherwise known as pelvic floor exercises, they strengthen the muscles that support your uterus, bladder, small intestine, and even rectum—thereby preventing you from accidentally peeing or passing gas. How do you know you’re doing it right? “When you sit on the toilet, to pee, hold the flow for a few seconds by contracting your muscles, feeling a ‘lift’ inside your vagina, then release,” she says. 

Eat balanced meals. As Dr. Bravo says, “A well-rounded diet includes healthy fruits and vegetables, whole grains, and lean protein. High-calcium diet is also recommended because women in menopause are also prone to osteoporosis. Practice portion control, too.”

Give up bad habits. If you have a habit of smoking, quit immediately, especially when signs of menopause are already present. “Smoking puts you at greater risk of heart disease, stroke, cancer, and osteoporosis—and it may increase your hot flashes.” 

Have a positive attitude. You can choose to look at menopause as a sign of aging—or you can see it as a liberating experience and exciting new chapter in your life. “Many of my patients are thrilled to be free of their monthly periods—no more sanitary napkins, tampons, and dysmenorrhea,” shares Dr. Bravo. “Others admit that intimacy with their partner has gotten better because they no longer worry about getting pregnant.”  However, older women should also watch out for signs of vaginal atrophy (or the drying and inflammation of vaginal walls due to the lack of estrogen) which may cause dyspareunia or painful sexual intercourse. You may ask your doctor for safe remedies available for this condition.

“I find that women in their 50s have achieved a quiet confidence,” concludes Dr. Bravo. “They’re self-assured and don’t sweat the small stuff like menopause symptoms, which they have come to accept as a part of life and temporary inconvenience.” 

For more information, please contact MakatiMed On-Call at +632 8888 8999, email  [email protected], or visit

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