Menopaus (menopause), also called putus haid, is when your periods stop for good because your hormone levels fall; you have reached it when you have not had a period for 12 months. It usually happens between 45 and 55, and a study in Kelantan found an average age of 49.4 years. In the years before (perimenopause), periods become irregular and many women get hot flushes, night sweats, poor sleep, mood changes, joint aches and vaginal dryness. Symptoms usually last 7 to 9 years. Lifestyle changes help, and hormone replacement therapy (HRT) is the most effective treatment for most symptoms, yet few Malaysian women seek help. Talk to a doctor if symptoms affect your life, and always get checked if you bleed after menopause.
Apa itu menopaus? Perimenopause, menopause and after
Menopause is a natural stage of life caused by a fall in hormone levels, mainly oestrogen. According to the NHS, there are three stages:
- Perimenopause (pra menopaus): the years when your periods become irregular and symptoms often begin.
- Menopause: the point when you have not had a period for 12 months (and you are not using hormonal contraception).
- Postmenopause: the years after menopause. Some symptoms can continue during this time.
There is no routine test for menopause. A doctor can usually diagnose it from your age and symptoms. Blood tests are sometimes used if you are under 45.
Umur menopaus: at what age does it happen?
Menopause usually happens between the ages of 45 and 55. In a study of 326 women in Kelantan, the average age at menopause was 49.4 years, and 50 was the most common age.
- Early menopause is when periods stop before 45.
- Premature menopause (premature ovarian insufficiency) is when this happens before 40.
Early menopause is more likely if it runs in your family, if you started your periods early, smoke or are underweight, or after surgery to remove the ovaries, chemotherapy or radiotherapy. It is important to see a doctor, because replacing hormones before 45 helps protect your bones and heart.
Tanda menopaus: what are the signs and symptoms?
Menopause is different for everyone. Some women hardly notice it; others find it affects their work, relationships and daily life. According to the NHS, common symptoms include:
| Symptom | What it is like |
|---|---|
| Changes to periods | Usually the first sign: periods come more or less often, and bleeding is heavier or lighter |
| Hot flushes and night sweats | Sudden heat in the face, neck and chest, with sweating, a racing heart or dizziness, lasting several minutes |
| Sleep problems | Trouble falling or staying asleep, often worse with night sweats |
| Mood and memory (emosi) | Mood swings, low mood, anxiety, poor memory or concentration ("brain fog") |
| Joint and muscle aches | Aching joints and muscles, often with tiredness |
| Vaginal and bladder changes | Dryness, burning or itching, painful sex, more UTIs or UTI-like symptoms, needing to pee more often or leaking |
| Weight gain | Often around the stomach and upper body |
| Other changes | Palpitations, headaches or migraines that are worse than usual, hair thinning, dry and itchy skin, lower sex drive, sensitive teeth or sore gums |
What Malaysian women report. In a 2025 survey of 1,825 working women aged 40 to 60 across Malaysia, the most common symptoms were joint pain (34.6%), sleep problems (31.1%), brain fog (26.2%), mood swings (25.8%) and digestive problems (25.5%). Mood swings peaked between 45 and 49; hot flushes, night sweats and sleep problems peaked between 50 and 54; and joint pain and vaginal dryness kept increasing up to 55 to 60. In the Kelantan study, tiredness (79.1%), poor concentration (77.5%) and muscle and joint aches (70.6%) were more common than hot flushes (44.8%).
How long does it last? The NHS says symptoms usually last 7 to 9 years, sometimes longer, and they can change along the way.
Ciri-ciri haid menjelang menopaus: how periods change
During perimenopause, periods may come closer together or further apart, and bleeding may become heavier or lighter, until they stop altogether. A missed or late period in your 40s can be a sign of perimenopause, but it can also have other causes, including pregnancy. Our guide to period lambat explains the common reasons.
You can still get pregnant during perimenopause. The NHS advises using contraception for 2 years after your last period if you are 40 to 49, and for 1 year if you are 50 or over.
See a doctor if your bleeding becomes much heavier than before, and always get checked if you have any bleeding after menopause, even a little spotting or pink or brown discharge. Postmenopausal bleeding is not usually serious, but it can be a sign of cancer, which is easier to treat when found early.
How to cope with menopause symptoms
The NHS suggests these steps:
- Hot flushes and night sweats: wear light clothing, keep your bedroom cool, use a fan, take a cool shower or have a cold drink, and cut down on triggers such as spicy food, caffeine, hot drinks, smoking and alcohol. In Malaysia's hot climate, light cotton clothing and a fan by the bed are easy places to start.
- Sleep: keep regular sleep routines and rest when you can. See our guide to susah tidur for more tips.
- Mood: exercise regularly, make time for relaxing activities such as yoga or meditation, and talk to family, friends or other women going through the same thing. Cognitive behavioural therapy (CBT) can help with low mood, anxiety, sleep and hot flushes.
- Vaginal dryness: vaginal moisturisers and water-based lubricants (pelincir) are available at pharmacies without a prescription. A doctor can also prescribe vaginal oestrogen, which is low-dose and safe for long-term use.
- Bladder: pelvic floor exercises can help with leaking and urgency; see our guide to kerap kencing.
- Weight: eat a balanced diet and stay active to keep a healthy weight.
HRT and other treatments
Hormone replacement therapy (HRT) replaces the oestrogen your body no longer makes. According to the NHS, it relieves most menopause symptoms, including hot flushes, night sweats, sleep problems, anxiety and low mood caused by menopause, and vaginal dryness, usually within a few days or weeks. It also helps prevent osteoporosis.
- Oestrogen can be taken as tablets, patches, gel or spray.
- If you still have your womb, you also need a progestogen to protect it.
What about the risks? The NHS says that if you are under 60, have menopause symptoms and are not at high risk of breast cancer or blood clots, the benefits of HRT are likely to outweigh the risks:
- Breast cancer: combined HRT slightly increases the risk, by around 5 extra cases per 1,000 women taking it for 5 years. The risk falls after stopping. Oestrogen-only HRT causes little or no increase. Keep up with your mammograms; see our guide to breast cancer screening.
- Blood clots and stroke: HRT tablets slightly increase the risk, but patches, gels and sprays do not increase the risk of blood clots.
Other options. If you cannot or do not want to take HRT, a doctor may suggest CBT, or medicines such as certain antidepressants or clonidine for hot flushes.
In Malaysia, few women get treatment. In a Klang Valley study, only 24.8% of postmenopausal women had sought treatment for their symptoms. In a survey at klinik kesihatan in four states, 60% of the women had been prescribed vitamins and only 13% had received HRT, and most preferred complementary and alternative medicine. Malaysia has Clinical Practice Guidelines on the Management of Menopause (2022), so you can ask your doctor about all your options.
Supplements and herbal remedies. The NHS says there is very little evidence on how well or how safely herbal remedies such as red clover and black cohosh work, and some can interact with other medicines. Talk to your doctor before taking any supplement, and check that it is registered (see how to verify KKM registration).
Protecting your bones, heart and health after menopause
After menopause, it is important to look after your long-term health:
- Bones: osteoporosis (thinning bones that break more easily) is common after menopause because oestrogen, which is needed for healthy bones, falls. The NHS recommends weight-bearing exercise such as walking or dancing, resistance exercise, calcium-rich foods such as milk, yoghurt and kale, some sunlight on your skin for vitamin D (or a vitamin D supplement), not smoking and limiting alcohol.
- Heart and cholesterol: the NHS lists having been through menopause as a risk factor for high cholesterol. Have it checked regularly; see our guide to kolesterol tinggi.
- Screening: keep up with breast screening and cervical screening (Pap smear or HPV test).
When to see a doctor
See a doctor if:
- menopause symptoms are affecting your daily life, work or relationships;
- you have symptoms of menopause and are under 45;
- your periods are becoming heavier rather than lighter;
- you have any vaginal bleeding after 12 months without a period;
- you have palpitations (a fast or uneven heartbeat);
- you have low mood that does not lift.
Getting advice early can reduce the effect of menopause on your health, relationships and work. You do not have to "just put up with it".
Frequently asked questions (FAQ)
What is menopause (apa itu menopaus)?
Menopause (menopaus or putus haid) is when your periods stop because your hormone levels fall. You have reached menopause when you have not had a period for 12 months. The years before this, when periods become irregular and symptoms often start, are called perimenopause.
At what age does menopause happen in Malaysia?
Menopause usually happens between the ages of 45 and 55. A study of women in Kelantan found an average age at menopause of 49.4 years, with 50 being the most common age. Menopause before 45 is called early menopause, and before 40 is called premature menopause.
What are the signs of menopause (tanda menopaus)?
The first sign is usually a change in your periods: they may come more or less often and be heavier or lighter. Other common signs are hot flushes, night sweats, sleep problems, mood changes, poor memory or concentration, joint and muscle aches, tiredness, vaginal dryness, needing to pee more often, and weight gain around the stomach.
How long do menopause symptoms last?
According to the NHS, symptoms usually last for 7 to 9 years, sometimes longer, and they can change over time. For example, hot flushes may improve and be replaced by other symptoms such as low mood. Some symptoms, such as joint pain and vaginal dryness, can continue after menopause.
Is HRT safe?
For most women under 60 with menopause symptoms who are not at high risk of breast cancer or blood clots, the benefits of HRT are likely to outweigh the risks. Combined HRT slightly increases breast cancer risk, by around 5 extra cases per 1,000 women taking it for 5 years. HRT patches, gels and sprays do not increase the risk of blood clots. Talk to a doctor to decide what suits you.
What supplements help with menopause?
No supplement has been proven to treat menopause symptoms. The NHS says there is very little evidence for herbal remedies such as red clover and black cohosh, and some can interact with other medicines. Calcium-rich foods and vitamin D help protect your bones. Talk to a doctor or pharmacist before taking any supplement.
Can I still get pregnant during perimenopause?
Yes. You can still get pregnant during perimenopause. The NHS advises using contraception for 2 years after your last period if you are aged 40 to 49, and for 1 year after your last period if you are 50 or over. HRT is not a contraceptive.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor or pharmacist. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- What are menopause and perimenopause? — NHS
- Symptoms of menopause and perimenopause — NHS
- Things you can do to help menopause and perimenopause symptoms — NHS
- Treatment for menopause and perimenopause — NHS
- Benefits and risks of hormone replacement therapy (HRT) — NHS
- Early or premature menopause — NHS
- Dhillon HK, et al. Prevalence of menopausal symptoms in women in Kelantan, Malaysia. Maturitas. 2006;54(3):213-221.
- Damodaran P, Ng BK, Azmi AH. Menopausal symptoms among multi-ethnic working women in Malaysia. Climacteric. 2025;28(3):296-303.
- Abdullah B, et al. Prevalence of menopausal symptoms, its effect to quality of life among Malaysian women and their treatment seeking behaviour. Med J Malaysia. 2017;72(2):94-99.
- Manoharan A, et al. Health-seeking behaviors and treatments received for menopause symptoms: a questionnaire survey among midlife women attending primary healthcare clinics in Malaysia. J Menopausal Med. 2023;29(3):119-126.
- Lee WK, Ooi NZM, Goh SL. Clinical Practice Guidelines on the Management of Menopause in Malaysia 2022: a review from a primary care perspective. Malays Fam Physician. 2025;20:50.
