Menopause & Andropause



Menopause is a remarkable milestone in a woman’s life.

In the past, it used to represent a cultural belief when a woman reaches menopause, she was considered old and wise. Menopause marks another beginning of a new era in a woman’s life.

A woman reaches menopause when she has had no menstrual flow for 12 months or more. It usually happens around 50 years of age.’

Basically, there are 2 causes of menopause

1) The ovaries stop releasing eggs and there is a fall in the estrogen and progesterone levels which are secreted from the ovaries.

2) Surgical Menopause

Can happen at any age when a woman has her ovaries surgically removed. Without ovaries, a woman ceases to have menstruation and reproduction abilities.

Menopause not only marks the end of menstruation, it is also a time when major changes begin to take place in a woman’s body.

Some women breeze through these changes, while others suffer disturbing symptoms during the menopausal stage.

Knowing more about menopause and how to manage the accompanying physical, mental and emotional changes will help a woman go through this sometimes difficult phase of life.


The changes in the body after menopause are caused by the decline of ESTROGEN. Estrogen is often referred to as the ‘female hormone’ because it is responsible for the feminine characteristics of a woman.

Estrogen – The follicles in the ovary produce the hormone estrogen. Menopause occurs when all the eggs have been used up in a woman’s life.

With the decline of estradiol after menopause, the body starts undergoing changes, such as:

Brain: Hot flushes, night sweats, sleep disturbances, headaches and mood disorders especially depressive mood.

Emotions: The decline of a protein which regulates certain hormone levels causes sleep deprivation. Lack of rest and a general feeling of stress result in mood swings and irritability.

Skin: Without estrogen, the skin is unable to retain moisture, which leads to dry skin, reduced elasticity and thickness.

Bones: After menopause, you will be losing approximately 20 percent of bone density in the first five to seven years. Effort to increase bone resources is crucial to prevent osteoporotic fractures, which can significantly affect quality of life and lifespan.

Body: Aches and pains in your joints, muscles and spine become more common.

Sexual drive: The ovaries stop producing testosterone, which reduces your sex drive substantially.

Urogenital: The vagina walls become dry, thin and less elastic. There may also be vaginal discharge, itching or bleeding. These make sexual intercourse painful and uncomfortable, further reducing sex drive. Urogenital degeneration could lead to urinary frequency.

The severity of symptoms vary from woman to woman. Some women experience minimal or hardly any negative effects, while others may struggle with more disturbing symptoms. It is important to know that no two women will have exactly the same symptoms or experience. By addressing the symptoms mentioned above, your overall health-related quality of life will improve.’


Menopause is a natural progression of life. It is necessary to adopt an individual approach in managing this period of change These include:

Staying healthy – Exercise regularly, watch your diet, speak to your doctor whether you need nutritional supplements, go for regular health screenings, and seek mental strength.

Being mentally & emotionally strong – It helps to think positive at all times. It will help you seek ways to stay healthier and happier for a longer time. Continue to explore the richness in life and think of menopause as a new phase of life.

Sharing with others – You may not look or feel the way you did at thirty, but you have amassed a wealth of exposure and experience. Leave a legacy by sharing your knowledge with others.

Reaching out – Menopause may coincide with other important events such as retirement, children leaving home, illness, having to take care of elderly parents, grandchildren or a sick spouse. This is the time when major life changes will be happening, so it is important to stay connected to family and friends to avoid feeling isolated and depressed.

Be versatile – During episodes of hot flushes and night sweats, try simple lifestyle changes such as wearing cotton clothes that are Cooler or taking frequent showers.

If your symptoms still persist despite lifestyle changes, consult your doctor to establish if you are suitable for menopause therapy.


HORMONE REPLACEMENT THERAPY (HRT) has been used for the relief of menopausal symptoms since the beginning of the twentieth century. As the name indicates, HRT ‘replaces’ the hormones that the body stops producing after menopause, thus correcting the hormonal imbalance and reducing the distressing symptoms.

There are many kinds of HRT. A woman whose uterus has been surgically removed in a hysterectomy may take estrogen alone, whereas a woman whose uterus is still intact must take a combination of estrogen with progestin, a synthetic progesterone.

HRT comes in many forms. Some women take their HRT daily; whereas others may take it in a cyclical manner to mimic the way the body produces estrogen and progesterone naturally before menopause.

Your doctor will provide the necessary advice on the kind of HRT suitable for you.
HRT reduces the distressing symptoms associated with menopause thus allowing women to have a better quality of life.


STEAR acts on different tissues and organs in the body! It imitates the action of female ovarian hormones and helps relieve menopausal complaints. For further infor consult your doctor on available menopause therapy.


The general consensus on HAT in view of the latest data emphasises that every woman should be assessed on an individual basis.

HRT must be used under supervision from your doctor in order to prevent the risk of complications.

For instance, women with an intact uterus must not use estrogen alone as it may cause thickening of the uterus lining and increases the risk of developing uterine cancer.

HRT may sometimes cause side effects such as breast tenderness, spotting or return of the menstrual period.Elderly women have a higher risk of developing dementia if they begin HRT after the age of 65.

HRT is not recommended for women with stroke, heart disease and deep vein thrombosis.



We all know that women go through menopause. In recent years, scientific research has proven that men too, undergo a menopause-like condition as they approach their mid-40s. Androgen deficiency is diagnosed only in men with consistent signs and symptoms, and low serum testosterone levels.9 This condition is termed andropause, or late onset hypogonadism.

Andropause usually takes place around the age of 40 when testosterone levels in men gradually become reduced.The process happens slowly over years or decades. That is why andropause often goes unnoticed in many men.

Another reason why andropause tends to be overlooked is that it tends to happen at mid-life, when most men reshuffle their priorities.Many will attribute the poor memory and concentration, loss of sexual desire and depressed mood to a mid-life crisis, not realizing that they are going through another phase of life, just as women do.

The most common symptoms are changes in attitudes and moods, fatigue, loss of energy, low sexual desire and physical agility. More of a concern is the physical impact such as loss of muscle mass and strength, and increased body fat.

Certain medications, moderate obesity, low thyroid levels and complications related to kidney disease can bring about earlier andropause.


Just as estrogen is responsible for a woman’s feminine characteristics, testosterone is responsible for masculine characteristics.

It is produced in the testes and is responsible for the development of the genitals, body and facial hair and building muscle mass. Testosterone also helps maintain sexual drive and a healthy sperm count for reproduction.

In the past, it was not possible to assess scientifically whether a man has low testosterone levels. Today, doctors can use a simple blood test to know whether your testosterone levels are normal.


After the age of 40, the testosterone level decreases by 2% every year in men. This gradual decline will start to show its effects over the years, causing physical and mental changes to the body.

These changes include:

Brain: Lack of focus, short-term memory loss, indecisiveness, lack of drive and depression.

Body: Muscle mass and muscle strength gradually decline, unless efforts are made to build muscle by exercising or staying physically active. It is also common to feel more tired.

Sexual function: Reducing testosterone levels will affect sexual desire, frequency of nocturnal erections and frequency of sexual intercourse.

Fat levels: Body fat starts to accumulate, especially at the abdomen area.

Hair: Testosterone is responsible for the development and growth of healthy hair. As testosterone levels fall, men will start experiencing hair loss, not just on the head but also on the rest of the body including the armpits, chest, pubic area and face.


Andropause is often likened to menopause because the symptoms are almost similar but it is different in many ways.

In men, the dropping testosterone levels are unlikely to ever stabilize as it will continue to decline gradually over the years, making a man slowly lose his vitality and energy.

Now that men’s lifespan is extended to eighty and above, it is necessary to tackle andropause before it affects your quality of life. Here are some tips:

Exercise – Physical exercise helps increase your metabolic rate, flexibility and control over your weight thus improving your general health.

Take charge – See a doctor for help if you suspect you have low testosterone levels. Remember low testosterone levels do not just make you less energetic or less focused, but it can have more far-reaching effects such as osteoporosis and obesity.

Dietary changes – With age, a reduction in the intake of high dietary fats and low nutrient foods is beneficial. Reduce or abstain from smoking and alcohol.

If despite lifestyle changes your symptoms still persist, consult your doctor for a proper diagnosis of andropause and to establish if you are suitable for testosterone replacement therapy.


The main aim of testosterone replacement therapy (TRT) is to return testosterone levels to a normal range so that patients can have a better quality of life.Your doctor must be consulted to diagnose andropause, and to determine if you are suitable to be put on TRT.

TRT is recommended for symptomatic men with typical shortage of androgens who have low testosterone levels. TRT users report an improvement in sense of wellbeing. Physical strength is also improved, with an increase in muscle mass, strength and bone mineral density.

TRT also improves sexual function. Testosterone works on most aspects of sexual response such as increased sexual desire.

Men with prostate or breast cancer, recent heart problems, untreated obstructive sleep apnea and excess of red blood cells (erythrocytosis) are not recommended to use TRT.

Speak to your doctor to determine if you are a suitable candidate for TRT. As with any medication, testosterone should be taken under a doctor’s care, with appropriate follow-up evaluations (when necessary).

Feel free to make an appointment to speak to Dr Gan and gain an informed choice of your options for managing your menopause. Book your appointment here.

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