Kuala lumpur: Lim Ai Jing is feeling a bit guilty. Her 54-year-old mother had been calling her to complain that she had not been sleeping well, but Lim dismissed her concerns, thinking they were normal gripes.
According to BERNAMA News Agency, the 'everything' Lim referred to is her research on perimenopause, the transition phase when estrogen levels in women start declining, and menopause, characterized by the end of the menstrual cycle for good, and their long-term effects on women's health. Long considered a natural process that did not require any intervention, experts are now calling for a paradigm shift: recognizing early menopause care not just as a matter of individual well-being but as a crucial strategy to prevent non-communicable diseases (NCDs) and save Malaysia and its people significant money and misery.
Malaysian Menopause Society president Dr. Ho Choon Moy highlighted a widespread lack of awareness in the country about the severity of untreated menopause, often only addressed after issues like diabetes develop. She pointed out the absence of a dedicated budget for menopause, contrasting it with the substantial funding for conditions like diabetes, and criticized the focus on treating symptoms rather than underlying causes.
Menopause increases a woman's vulnerability to various diseases. The average age of menopause in Malaysia is 50.7 years, but perimenopause can start a decade earlier. Former Health Minister Khairy Jamaluddin emphasized in the Ministry of Health's Clinical Practice Guidelines that menopause affects every woman and can lead to numerous health issues due to estrogen deficiency.
Dr. Ho advocated for early menopause care, such as Menopausal Hormone Therapy (MHT), to prevent diseases like diabetes, heart disease, and osteoporosis, asserting its long-term benefits, including cardiac protection.
The 2013-2019 National Diabetes Registry reported that women constitute 57.1 percent of diabetic cases in Malaysia, though age and menopausal treatment details were unspecified. Studies on hip fractures in Malaysian hospitals showed a predominance of female patients due to lower bone density from osteoporosis.
Dr. Ho suggested providing free menopause hormone therapy in government clinics to reduce long-term healthcare expenses, noting its potential to significantly cut costs.
Experts also argue that early menopausal treatment can boost economic growth by helping women remain in the workforce. International studies have identified menopause as a significant factor in middle-aged women leaving jobs. Despite various strategies to retain women in the workforce, menopausal symptoms lack mainstream recognition.
Dr. Premitha Damodaran's study highlighted common menopausal symptoms like joint pain, sleep disturbances, brain fog, and mood swings among Malaysian working women. Lim, a clinical psychologist, noted the debilitating impact of these symptoms on working and non-working women alike.
Menopausal symptoms can reduce productivity, leading women to decline promotions, reduce hours, or resign early, resulting in a loss of experienced talent. Dr. Ho emphasized the waste of resources when experienced women leave the workforce and the potential economic boost from treating menopause symptoms.
Malaysia's female labor participation rate was 56.4 percent as of May 2025, compared to Singapore's 62.6 percent and Thailand's 60.6 percent in 2023. Limited data in the Asia-Pacific region addresses menopause-related workforce exits.
Menopause also increases mental health issues like anxiety and depression, with physical symptoms exacerbating these conditions and affecting relationships. Prof. Dr. Nik Hazlina Nik Hussain stressed the importance of open communication between spouses to support women in seeking help for menopausal symptoms.
Despite the benefits of MHT, its uptake is low in the Asia-Pacific region due to cultural stigma, misinformation, and fear. Dr. Nik Hazlina noted that even healthcare providers lack awareness, often viewing menopause as a natural part of aging.
Some women, like Nadirah, encounter conflicting medical advice on hormonal replacement therapy, reflecting a need for better education among doctors. Dr. Ho attributed this to a lack of focus on menopause in medical education and called for improved training.
Lim agreed, noting that her psychology curriculum overlooked menopause as a cause of mental health issues. She plans to address her mother's complaints with her newfound understanding of menopause.