What Are The Treatment Options?

Treatment would depend on..

1. Uterus or No Uterus

  • First thing that needs to be establish is if the woman still has a uterus intact. Some women would have had their uterus removed due to surgery.

2. Patient Age

  • Which phase is she in – premature menopause, perimenopause or post menopause?

3. Number of symptoms

  • Take a look at the symptom score sheet for menopause (in Part I)

4. Location of symptoms

Just to refresh, menopausal symptoms come in four main groups:

  • Vasomotor

  • Locomotor

  • Genitourinary

  • Psychological

So if a woman has a couple of symptoms from some of these groups, then, to target all of the issues she will need a treatment that gives her a blanket cover and that would be Menopausal Hormone Therapy, MHT, previously known as HRT (Hormone replacement Therapy).

However, if she has only genitourinary symptoms like vaginal dryness, pain during sex or a little urine incontinence, then, she should go for a more localised targeted treatment. Perhaps not MHT straight up. She could try the vaginal estrogens in the form of creams or vaginal tablets and even Laser vaginal therapy to improve her urinary incontinence and the elastic tissue and amount of collagen in the vaginal walls reducing dryness.

Women without Uterus
USE DAILY CONTINUOUS ESTROGEN TREATMENT only
Women with a Uterus
Premature Menopause Perimenopause Postmenopause
Continue MHT until 50 yrs of age. Higher doses
required
Use lowest effective MHT dose Use lowest effective MHT dose

Options:

  1. Continuous Estrogen (high dose) PLUS progesterone (cyclical or continuous)
  2. Combined oral contraceptive pills (COCP)
  3. Livial – Tibolone

Options:

  1. Continuous Estrogen (low dose) + progesterone (cyclical or continuous)
  2. Low dose COCP
Last period >1-2 years ago

Options:

  1. Livial – tibolone
  2. Continuous estrogen + continuous progesterone
Last period < 1 years ago

Options:

  1. Continuous estrogen + cyclical/continuous progesterone

Continuous Estrogen – Refers To

  • Daily oral consumption of estrogen tablets. Some brands available in Singapore include Progynova, Estrofem

  • Estrogen patches like Estraderm available in Singapore

Continuous Progesterone – Refers To IUD Mirena

  • Cyclical Progesterone – refers to progesterone tablets taken only on certain days of the cycle

  • Continuous Estrogen and Progesterone combinations – Daily pills that contain both hormone like Angeliq available in Singapore


We have modern medical science to thank for the longevity we enjoy today. But without estrogen, a woman’s health and quality of life will suffer. MHT can be used to optimise your estrogen levels. You can age better and safely with the new treatment guidelines.

Our Female Doctors are ready to listen to your issues. Visit us at InSync Medical Located along East Coast Road in the heart of Katong, Singapore. We also open on Sundays to Serve you.

Book an appointment now.

Take charge of your sexual health today