KK Women's and Children's Hospital (KKH) launched Singapore's first set of guidelines for managing the menopause transition on Fri (Feb 20), aimed at standardising care for this stage in women's health.
The Guidelines on Management of the Menopause Transition were unveiled at KKH by Sim Ann, Senior Minister of State for Home Affairs and Foreign Affairs, and Adviser to the People's Association Women's Integration Network Council.
Developed by KKH's Maternal and Child Health Research Institute, the framework helps menopausal women manage their symptoms, focusing on diagnosis, treatment and long-term care. It involved a multi-speciality panel of gynaecologists, family physicians, endocrinologists, psychiatrists, oncologists, nurses and patient advocacy groups in Singapore.
Associate Professor Rukshini Puvanendran, Co-Director of KK Menopause Centre and Head and Senior Consultant of the hospital’s Family Medicine Service, said that with Singapore projected to become a super-aged society by 2030, women are expected to spend a third of their lives post-menopause, underscoring the need for timely and standardised care.
“Menopause transition remains one of the most overlooked phases in a woman's life,” she said.
Associate Professor Rukshini Puvanendran, Co-Director of KK Menopause Centre, and Head and Senior Consultant of the hospital’s Family Medicine Service sharing the new guidelines on Feb 20, 2026. (Photo: KK Women’s and Children’s Hospital)
It is under-addressed, not just by women, but also in healthcare settings – two 2025 studies by KKH revealed challenges in menopause care in Singapore.
In the first study, a survey of 1,461 women aged 45 to 65 found that 70 per cent experienced moderate to severe symptoms, yet of these women, 70 per cent did not seek medical help.
In the second study, a survey of 262 healthcare professionals found that 90 per cent were not confident in diagnosing and treating menopausal symptoms, citing reasons such as lack of training, knowledge and time.
Women in Singapore typically reach menopause at age 49. During this phase, declining oestrogen levels trigger changes in the body, with common symptoms including joint and muscle aches, disturbed sleep, hot flushes and night sweats.
The guidelines were developed to address the disconnect in menopause care in Singapore, and cover clinical diagnosis, menopause hormone therapy, early menopause, lifestyle optimisation and intimate health.
Dr Elaine Quah, Senior Research Fellow, Division of Obstetrics and Gynaecology, KKH (left), presenting results from the two surveys. (Photo: KK Women’s and Children’s Hospital)
Clinical diagnosis includes when menopause is defined – 12 consecutive months without a period. The most common symptoms Singapore women experience are new-onset joint and muscle aches, disturbed sleep, sexual health and urinary issues, physical and mental exhaustion, and vasomotor symptoms such as hot flushes and night sweats.
Unlike Western populations, where hot flushes and night sweats are most commonly reported, Singapore women most frequently experience joint and muscle aches and sleep disturbances.
The recommendations reaffirm that menopause hormone therapy (MHT) is safe and effective in treating hot flushes and menopause-related mood issues, and for the prevention and treatment of postmenopausal osteoporosis (bone loss).
They also state that the benefits of MHT significantly outweigh the risks for most women under 60 within 10 years of menopause who are suitable candidates for it.
For women who cannot or prefer not to use MHT, non-hormone treatments, like antidepressants or newer medications, can be considered for hot flushes. However, custom-made hormone preparations are not recommended as there is limited evidence about their effectiveness and safety.
Women who experience early menopause (when menstruation stops permanently before the age of 45), whether naturally, from medical treatments like chemotherapy, or surgical procedures such as ovary removal, will require specialised management as early loss of oestrogen affects long-term cardiovascular, bone and brain health.
Women who are likely to experience early menopause due to medical or surgical treatments will be offered counselling pre-and post- treatment. This includes discussing fertility risks and preservation options with a fertility specialist, as well as consulting with a menopause expert to prepare for sudden symptoms and manage long-term health risks.
Some women may have premature ovarian insufficiency (POI), which is the loss of normal ovary function before the age of 40, leading to irregular or absent menstruation and low oestrogen.
As POI significantly reduces fertility, these women will be offered counselling to manage fertility loss and to discuss fertility preservation where appropriate. The framework recommends that women with POI, start MHT promptly to mitigate menopause symptoms.
Sim Ann, Senior Minister of State for Home Affairs and Foreign Affairs, delivering the opening address at the launch of the Guidelines on Management of the Menopause Transition at KK Women’s and Children’s Hospital, on Feb 20, 2026. (Photo: KK Women’s and Children’s Hospital)
The guidelines emphasise that lifestyle optimisation is the core of menopause care, regardless of treatments.
Women are advised to adopt healthy habits including a balanced diet, regular exercise, maintaining a healthy weight, not smoking, limiting alcohol intake, managing stress and improving sleep.
Such measures can reduce the severity of menopause symptoms and help lower the long-term risk of heart disease and bone loss – the drop in oestrogen levels significantly increases the risk of weak bones and fractures.
Women are also advised to consume adequate calcium and vitamin D through food and supplements for their bone health.
The framework calls on healthcare professionals to proactively screen for bladder and intimate-health issues related to menopause, such as vaginal dryness, painful intercourse, and urinary issues, which women often do not report due to stigma.
Healthcare professionals at clinics and hospitals can first recommend vaginal moisturisers and lubricants.
For women without a history of breast or other hormone-sensitive cancers, vaginal oestrogen may be offered. It works directly on vaginal tissues with minimal absorption into the bloodstream, making it a safe option for treating such symptoms.
Clinicians are advised to assess physical, emotional and relationship factors in women experiencing sexual concerns during menopause.
Counselling may also be offered to women experiencing mood changes, anxiety or low mood due to menopause, in line with Singapore's mental health guidelines.
The Guidelines on Management of the Menopause Transition will be disseminated through partner organisations including the College of Obstetricians and Gynaecologists Singapore.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.
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The Guidelines on Management of the Menopause Transition were unveiled at KKH by Sim Ann, Senior Minister of State for Home Affairs and Foreign Affairs, and Adviser to the People's Association Women's Integration Network Council.
Developed by KKH's Maternal and Child Health Research Institute, the framework helps menopausal women manage their symptoms, focusing on diagnosis, treatment and long-term care. It involved a multi-speciality panel of gynaecologists, family physicians, endocrinologists, psychiatrists, oncologists, nurses and patient advocacy groups in Singapore.
Associate Professor Rukshini Puvanendran, Co-Director of KK Menopause Centre and Head and Senior Consultant of the hospital’s Family Medicine Service, said that with Singapore projected to become a super-aged society by 2030, women are expected to spend a third of their lives post-menopause, underscoring the need for timely and standardised care.
“Menopause transition remains one of the most overlooked phases in a woman's life,” she said.
Associate Professor Rukshini Puvanendran, Co-Director of KK Menopause Centre, and Head and Senior Consultant of the hospital’s Family Medicine Service sharing the new guidelines on Feb 20, 2026. (Photo: KK Women’s and Children’s Hospital)
It is under-addressed, not just by women, but also in healthcare settings – two 2025 studies by KKH revealed challenges in menopause care in Singapore.
In the first study, a survey of 1,461 women aged 45 to 65 found that 70 per cent experienced moderate to severe symptoms, yet of these women, 70 per cent did not seek medical help.
In the second study, a survey of 262 healthcare professionals found that 90 per cent were not confident in diagnosing and treating menopausal symptoms, citing reasons such as lack of training, knowledge and time.
Women in Singapore typically reach menopause at age 49. During this phase, declining oestrogen levels trigger changes in the body, with common symptoms including joint and muscle aches, disturbed sleep, hot flushes and night sweats.
The guidelines were developed to address the disconnect in menopause care in Singapore, and cover clinical diagnosis, menopause hormone therapy, early menopause, lifestyle optimisation and intimate health.
Dr Elaine Quah, Senior Research Fellow, Division of Obstetrics and Gynaecology, KKH (left), presenting results from the two surveys. (Photo: KK Women’s and Children’s Hospital)
HOW MENOPAUSE IS DIAGNOSED
Clinical diagnosis includes when menopause is defined – 12 consecutive months without a period. The most common symptoms Singapore women experience are new-onset joint and muscle aches, disturbed sleep, sexual health and urinary issues, physical and mental exhaustion, and vasomotor symptoms such as hot flushes and night sweats.
Unlike Western populations, where hot flushes and night sweats are most commonly reported, Singapore women most frequently experience joint and muscle aches and sleep disturbances.
MENOPAUSE HORMONE THERAPY IS SAFE AND EFFECTIVE
The recommendations reaffirm that menopause hormone therapy (MHT) is safe and effective in treating hot flushes and menopause-related mood issues, and for the prevention and treatment of postmenopausal osteoporosis (bone loss).
They also state that the benefits of MHT significantly outweigh the risks for most women under 60 within 10 years of menopause who are suitable candidates for it.
For women who cannot or prefer not to use MHT, non-hormone treatments, like antidepressants or newer medications, can be considered for hot flushes. However, custom-made hormone preparations are not recommended as there is limited evidence about their effectiveness and safety.
HELPING WOMEN WITH EARLY MENOPAUSE
Women who experience early menopause (when menstruation stops permanently before the age of 45), whether naturally, from medical treatments like chemotherapy, or surgical procedures such as ovary removal, will require specialised management as early loss of oestrogen affects long-term cardiovascular, bone and brain health.
Women who are likely to experience early menopause due to medical or surgical treatments will be offered counselling pre-and post- treatment. This includes discussing fertility risks and preservation options with a fertility specialist, as well as consulting with a menopause expert to prepare for sudden symptoms and manage long-term health risks.
Some women may have premature ovarian insufficiency (POI), which is the loss of normal ovary function before the age of 40, leading to irregular or absent menstruation and low oestrogen.
As POI significantly reduces fertility, these women will be offered counselling to manage fertility loss and to discuss fertility preservation where appropriate. The framework recommends that women with POI, start MHT promptly to mitigate menopause symptoms.
Sim Ann, Senior Minister of State for Home Affairs and Foreign Affairs, delivering the opening address at the launch of the Guidelines on Management of the Menopause Transition at KK Women’s and Children’s Hospital, on Feb 20, 2026. (Photo: KK Women’s and Children’s Hospital)
LIFESTYLE OPTIMISATION DURING MENOPAUSE
The guidelines emphasise that lifestyle optimisation is the core of menopause care, regardless of treatments.
Women are advised to adopt healthy habits including a balanced diet, regular exercise, maintaining a healthy weight, not smoking, limiting alcohol intake, managing stress and improving sleep.
Such measures can reduce the severity of menopause symptoms and help lower the long-term risk of heart disease and bone loss – the drop in oestrogen levels significantly increases the risk of weak bones and fractures.
Women are also advised to consume adequate calcium and vitamin D through food and supplements for their bone health.
BEING OPEN ABOUT INTIMATE HEALTH
The framework calls on healthcare professionals to proactively screen for bladder and intimate-health issues related to menopause, such as vaginal dryness, painful intercourse, and urinary issues, which women often do not report due to stigma.
Healthcare professionals at clinics and hospitals can first recommend vaginal moisturisers and lubricants.
For women without a history of breast or other hormone-sensitive cancers, vaginal oestrogen may be offered. It works directly on vaginal tissues with minimal absorption into the bloodstream, making it a safe option for treating such symptoms.
Clinicians are advised to assess physical, emotional and relationship factors in women experiencing sexual concerns during menopause.
Counselling may also be offered to women experiencing mood changes, anxiety or low mood due to menopause, in line with Singapore's mental health guidelines.
The Guidelines on Management of the Menopause Transition will be disseminated through partner organisations including the College of Obstetricians and Gynaecologists Singapore.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.
Continue reading...