Menopause care · Singapore
Hot flushes, night sweats, broken sleep or dryness getting in the way? Our female doctors look at your symptoms and your health, then talk you through whether hormone therapy suits you.
A treatment plan built around your symptoms, your health and your stage of life.
Menopause hormone therapy (MHT), also called hormone replacement therapy (HRT), replaces oestrogen, the hormone that falls around menopause. It is effective for hot flushes and night sweats and can help other symptoms, such as vaginal dryness. If you still have a womb, a progestogen is generally added to protect its lining. Whether it suits you depends on your symptoms, age, time since menopause and health.
Before advising you, your doctor looks at the whole picture: your cycle and any bleeding, breast and cervical screening, heart and bone health, migraines, medicines and family history. Not everyone needs hormone blood tests. Treatment is reviewed regularly, and non-hormonal options can be discussed if hormones do not suit you.
How it works
Oestrogen treats the symptoms; the other choices are about safety and fit. Your doctor considers whether you still have a womb, which route suits you, the dose, and whether a vaginal treatment on its own would be enough. The plan is then reviewed once treatment is under way.
Oestrogen for whole-body symptoms
Oestrogen taken as a tablet, or absorbed through the skin from a gel, spray or patch, is effective for hot flushes and night sweats, and may help sleep that they disturb. Patches are less popular in Singapore's heat.
Progestogen to protect the womb
If you still have a womb, a progestogen is generally added to protect its lining (the endometrium). If you have had a hysterectomy, oestrogen alone is usually used. The regimen depends on your history and stage of menopause.
Low-dose vaginal oestrogen
For dryness, discomfort or urinary symptoms on their own, a low-dose vaginal oestrogen, or a non-hormonal moisturiser, may be enough without whole-body treatment. Read about vaginal dryness and bladder leakage.
Reviewed as you go
Breast tenderness, bloating, headache, mood change or irregular bleeding can occur, especially after starting or changing treatment. Your doctor reviews the benefit, your bleeding pattern and any side effects, and whether the dose should change or treatment should stop.
Is it for me?
Hormone therapy is not right or wrong because of age alone. For many healthy women under 60, or within 10 years of menopause, the benefits may outweigh the risks. Starting later, or a history of a hormone-sensitive cancer such as breast cancer, blood clots, stroke, heart or liver disease, needs particular care and may change the options.
On treatment: report unexpected bleeding, or signs of a clot or stroke, urgently.
Heat and sweating that disturb your comfort, sleep or work.
Dryness, discomfort or urinary symptoms may need only a vaginal treatment.
Assessed in context, because not every midlife symptom is caused by hormones.
Non-hormonal options, including a prescription medicine for hot flushes, can be discussed.
Irregular periods and new symptoms can be assessed first, with tests only when they help.
Your care, step by step
Talk through your symptoms, cycle history, health, medicines and goals with one of our female doctors.
An examination or targeted tests are arranged only when they are clinically useful.
Weigh the benefits, limits, risks and alternatives together, then agree the type, route and dose.
Check how you respond, your bleeding pattern and any side effects after starting, then at regular intervals.
From our doctors
Two short explainers from Fusion Medical: what menopause hormone therapy is and the forms it comes in, and who should not take it.
Safety & expectations
Hormone therapy is not right or wrong because of age alone. It is a personal decision, made with a doctor who knows your history.
Tell us about any bleeding, migraines, blood clots, cancer, liver or heart problems, and bring your latest breast and cervical screening results. Report new, heavy, persistent or unexpected bleeding promptly.
Fusion Medical offers menopause hormone therapy at Wheelock Place, 501 Orchard Road. Our female doctors assess your symptoms, history and preferences, explain the benefits and risks, and prescribe treatment only if it suits you, with regular reviews afterwards. If you would like tests first, see our perimenopause and menopause screening.
MHT and HRT are two names for the same menopause treatment. Menopause hormone therapy (MHT) is the current name, and it was previously known as hormone replacement therapy (HRT), a name that is still widely used. Both describe oestrogen treatment for menopause symptoms, with a progestogen added if you still have a womb. The type, dose and route are chosen after an individual review of your symptoms and health.
Menopause hormone therapy can slightly increase breast cancer risk, depending on the type used. Combined oestrogen and progestogen therapy carries a small increase that grows with longer use and falls again after stopping. Oestrogen-only therapy, used by women who have had a hysterectomy, carries little or no increase, and vaginal oestrogen does not increase the risk. Your doctor reviews your personal and family history and your breast screening before and during treatment.
Menopause hormone therapy (MHT or HRT) may not be suitable if you have had breast, womb or ovarian cancer, a blood clot, a stroke or heart disease, untreated high blood pressure, liver disease or unexplained vaginal bleeding, or if you are pregnant. These conditions need careful review and may rule treatment out. Your doctor checks your history before advising, and non-hormonal options can be discussed if MHT is not suitable for you.
Age is only one part of the decision. Starting after age 60, or more than 10 years after menopause, can carry a less favourable benefit–risk balance, so the reason for treatment, the route, the dose and the alternatives need careful individual review. If you are already on treatment, whether to continue is reviewed with you.
There is no good evidence that compounded 'bioidentical' hormones are safer or more effective than standard menopause hormone therapy (HRT). Compounded products are custom-mixed, are not regulated like licensed medicines, and their strength can vary. Some HSA-registered HRT products already contain hormones identical to those the body makes, sometimes called body-identical hormones. Your doctor considers only HSA-registered products, chosen after reviewing your symptoms and health history.
Not everyone needs hormone blood tests. For most women over 45, menopause is diagnosed from age, symptoms and changes in periods. Your doctor may arrange targeted tests when your symptoms, bleeding pattern, medical history or another possible condition make them useful.
There is no single duration for everyone. Ongoing treatment is reviewed periodically according to how much it helps your symptoms, its risks and side effects, and your preferences. Any change of dose, or stopping, is planned with your doctor.
Appointments
Book a consultation at Wheelock Place to talk through your symptoms, your health and whether hormone therapy suits you.
