Perimenopause Symptoms in Singapore: Signs Many Women Miss

Menopause is something almost every woman will eventually experience, yet it remains one of the least discussed health transitions.

In fact, women may spend almost one-third of their lives after menopause. Despite this, many women are unfamiliar with early signs that their bodies are beginning to change.

During an International Women’s Day talk, Dr Bosty Chan from Dame spoke about why menopause remains an “unspoken word” and why greater awareness is needed – especially during the years leading up to it.

Many women experiencing perimenopausal symptoms assume they are simply stressed, ageing, or overworked. In reality, these symptoms may signal a natural hormonal transition that deserves attention and support.

Watch: Menopause – The Unspoken Word

In this 10-minute International Women’s Day talk, Dr Bosty Chan explains what menopause is, why many women miss the early signs, and how modern healthcare – including telemedicine – can help women navigate this stage of life.

What is Menopause?

Medically, menopause is defined as 12 consecutive months without a menstrual period.

Most women reach menopause between age 45 and 55, with the average age around 50.

However, the transition rarely happens suddenly. Before menopause occurs, women typically go through a phase called perimenopause.

This stage can last several years and is when many symptoms begin to appear.

You can think of perimenopause as a “second puberty”, when hormonal fluctuations affect multiple systems in the body.

What is Perimenopause?

Perimenopause is the period leading up to menopause when the ovaries gradually produce less estrogen.

During this time, hormone levels fluctuate significantly. These fluctuations can lead to a wide range of emotional and physical symptoms.

Because the changes can be gradual and varied, many women do not immediately realise they are experiencing perimenopause.

Instead, they may attribute their symptoms to stress, ageing, or lifestyle factors.

Common Perimenopause Symptoms

Many people associate menopause mainly with hot flushes, but the reality is much broader.

Common symptoms include:

• Irregular menstrual cycles
• Mood swings or irritability
• Sleep disturbances
• Skin and hair changes
• Vaginal dryness
• Reduced libido
• Mental fatigue or “brain fog”
• Weight gain around the abdomen
• Muscle aches or joint pains

Interestingly, research and clinical observations suggest that Asian women may experience menopause symptoms differently from Western populations.

For example, muscle and joint pain may be one of the most common complaints, sometimes more noticeable than hot flushes.

Because these symptoms are not always recognised as menopause-related, many women do not seek medical advice.

Why Many Women in Singapore Don’t Seek Help

Despite experiencing symptoms, many women hesitate to speak to a doctor.

Some of the most common reasons include:

• Assuming symptoms are part of normal ageing
• Being too busy with work or family responsibilities
• Not knowing where to seek help
• Feeling that the symptoms are “not serious enough”

In addition, menopause care is still evolving, and not all healthcare providers focus heavily on this area.

This can make it difficult for women to feel confident about where to get reliable advice and treatment.

As a result, many women silently endure symptoms for years without realising that help is available.

How Menopause Symptoms Can Be Managed

The good news is that menopause symptoms can often be managed effectively.

Treatment approaches are highly individual and depend on the symptoms each woman experiences.

Some options may include:

Hormone Replacement Therapy (HRT)

Hormone therapy replaces estrogen levels that decline during menopause.

It may be prescribed as:

• Tablets
• Skin patches or gels
• Local cream for specific symptoms

HRT has been widely studied, and modern evidence suggests that many women can safely benefit from it when appropriately prescribed.

Non-Hormonal Treatments

For women who prefer not to use hormones, other options may help relieve symptoms, such as:

• Medications for hot flashes
• Treatments for sleep disturbances
• Management of joint or muscle pain

Lifestyle and Supportive Care

Hormonal changes can also affect:

• Bone health
• Muscle mass
• Metabolism
• Energy levels

Addressing these areas through lifestyle changes, exercise, and appropriate medical guidance can make a meaningful difference.

Tracking Symptoms with the Menopause Rating Scale

One helpful tool is the Menopause Rating Scale (MRS).

This internationally recognised questionnaire allows women to:

• Track menopause symptoms
• Understand symptom severity
• Monitor improvements after treatment

Self-assessment tools can help women recognise patterns in their health and start conversations with healthcare professionals.

How Telemedicine is Changing Menopause Care

Menopause care often requires ongoing conversations and follow-up rather than a single consultation

Digital healthcare platforms now make this easier and more accessible.

Through telemedicine, women can:

• Discuss symptoms from the comfort of home
• Follow up regularly with a doctor
• Adjust treatments based on progress
• Receive personalised guidance

For many women, the ability to have a private consultation from their own space can make sensitive conversations about hormonal health much more comfortable.

Clinics like Dame aim to provide accessible women’s healthcare through secure online consultations.

When Should You Speak to a Doctor?

If you are in your 40s or early 50s and experiencing symptoms such as:

• Persistent fatigue
• Sleep problems
• Mood swings
• Joint pain
• Irregular periods
• Hot flashes

It may be worth discussing these changes with a doctor.

Early support can help you better understand what your body is going through and explore treatment options if needed.

The Importance of Talking About Menopause

Menopause is a natural stage of life, but it should not be something women feel they must endure in silence.

Greater awareness can help women recognise symptoms earlier and access the support they need.

By starting more open conversations about menopause, healthcare providers and patients alike can work toward a future where women feel informed, supported, and empowered throughout this transition.

FAQs About Perimenopause

What is the difference between menopause and perimenopause?

Perimenopause is the transitional phase before menopause when hormone levels fluctuate. Menopause is diagnosed after 12 months without a menstrual period.

What are the first signs of perimenopause?

Early signs may include irregular periods, mood changes, sleep disturbances, fatigue, and joint pain.

Is joint pain a symptom of perimenopause?

Yes. Some women experience muscle or joint pain during perimenopause due to hormonal fluctuations, particularly declining estrogen levels. In Asian populations, joint pain may be one of the more common symptoms reported.

At what age does menopause start in Singapore?

Most women experience menopause between ages 45 and 55, with the average age around 50.

Can menopause symptoms be treated online?

Many menopause symptoms can be discussed and managed through telemedicine consultations, depending on the individual case.