What is menopause?

The aging of ovarian follicular function leads to permanent cessation of menstruation, which usually occurs in Taiwanese women between the ages of 48 and 52. Doctors can make a confirmed diagnosis if a woman has had no menstrual period for one year after her last menstruation.

Early menopause symptoms

• The most common symptoms: Hot flashes, night sweats, insomnia, irritability, palpitations (rapid heartbeat), depression, anxiety, joint and muscle pain, and memory decline; all of which are direct effects of decreased estrogen levels in the body.
• Urogenital system: After menopause, the epithelium and connective tissue of the urogenital system may shrink, increasing the risk of urinary tract infections, which can cause frequent urination, urgency, or even urinary incontinence. The vaginal epithelium becomes thinner and drier, which may lead to vaginal inflammation and painful intercourse.

Late menopause issues

• Cardiovascular system: Pre-menopausal women rarely experience myocardial infarction. After menopause, due to the loss of estrogen protection, women are at higher risk of coronary artery diseases, including myocardial infarction and stroke.
• Osteoporosis: The rate of bone loss varies among individuals. Bone density peaks around age 35 and gradually decreases with age. After menopause, bone loss accelerates, increasing the risk of fractures in the spine, wrist, and hip.

Hormone Replacement Therapy

Hormone replacement therapy can be divided into three categories:

• Contains only estrogen: For women who have had a hysterectomy.
• Periodical hormone (antagonist type) replacement therapy: Estrogen is given for 21–25 days each month, with progesterone for 12–14 days per cycle. This allows a regular menstrual period each month.
• Continuous combined hormone replacement therapy: Estrogen and progesterone are taken daily. Continuous progesterone counteracts estrogen to prevent endometrial hyperplasia, avoiding monthly bleeding.

Side effects of hormone replacement therapy

• Breast tenderness
• Irregular bleeding
• Bloating or stomach discomfort
• Weight gain

These side effects usually improve after adjusting the type or dose of hormones, as instructed by your doctor.

Contraindication of hormone replacement therapy

• Unexplained genital tract bleeding
• Known or suspected breast cancer
• Acute thrombophlebitis or thromboembolism
• Severe active liver disease

Conclusion

The average life expectancy of Taiwanese women has reached 84.3 years (Ministry of the Interior data, August 23, 2025), which means that about one third of their lives are spent in menopause. By following correct hormone replacement therapy (HRT), maintaining a regular lifestyle, eating a balanced diet, exercising appropriately, and attending regular check-ups (Pap smear once a year and breast self-examination once a month), women can preserve their vitality and enjoy a healthy, high-quality life.