Menopause is a universal transition, but its impact is not uniform. For women in Singapore and across Asia, it often shows up differently than the Western textbook version. While hot flushes dominate the narrative in Western studies, local research highlights something else: joint pain, fatigue, and insomnia are far more common. These symptoms are not minor inconveniences—they interfere with careers, intimacy, and mental health.

Despite this, menopause remains under-discussed in Singapore. Too many women are left to endure symptoms silently, or they hear dismissive comments like “this is normal, just live with it.” The truth is: menopause deserves attention, and women deserve care. This is where self-advocacy becomes essential.

What the Evidence Shows in Singapore

A growing body of Singapore-based research paints a clear picture.

• A 2023 study of over 1,000 women found that 62.6% reported at least one moderate to severe menopausal symptom. The top complaints were joint and muscle discomfort (47%), sleep problems (42%), vaginal dryness (36%), and exhaustion (34%) (Logan et al., 2023).
• Earlier research set the average age of menopause in Singapore at 49.1 years—slightly earlier than in the West. In that study, 51.4% of women reported musculoskeletal pain, while only 17.6% experienced hot flushes (Loh et al., 2005).
• The Integrated Women’s Health Programme (IWHP)—a landmark 10-year study at NUH and NUS tracking 1,201 women—is uncovering how menopause interacts with bone density, urinary function, cardiovascular health, and anxiety (NUS Medicine, 2025).
• NUH’s 2025 newsletter noted that 30–40% of midlife women experience muscle and joint pain, often overlooked because local medicine focuses more on hot flushes than somatic symptoms (NUHS, 2025).

These studies confirm what many women already know from lived experience: menopause is more than hot flushes. It is a complex health transition with wide-ranging effects.

The Regional Context

Across Asia, the picture looks similar.

• In a large Chinese survey, insomnia affected 44.7%, fatigue 40.4%, and mood swings 37.2% of midlife women. Only a minority reported hot flushes as their main complaint (Wang et al., 2021).
• The Asia-Pacific Menopause Federation (APMF) issued a consensus statement in 2025 affirming that Asian women frequently present with somatic and psychological symptoms rather than vasomotor ones. They called for culturally tailored care that reflects this reality (Ang et al., 2025).

This matters. If healthcare systems continue to focus only on Western symptom profiles, Asian women risk being underdiagnosed or undertreated.

Why Self-Advocacy Is Non-Negotiable

Even with this evidence, many women in Singapore do not seek help. Research suggests about half of women never consult a professional about their menopause symptoms (Logan et al., 2023). The reasons are complex:

• Cultural silence—menopause is still taboo in many families.
• Systemic barriers—short consultation times, limited menopause training for GPs.
• Internalised beliefs—that suffering is “part of being a woman.”

The result? Women lose sleep, struggle at work, and withdraw from intimacy—without support.

Self-advocacy is the bridge. It is not about confrontation or demanding special treatment. It is about recognising your symptoms as valid, preparing your case, and making sure your story is heard.

How to Practise Self-Advocacy

Self-advocacy is both practical and emotional. Here are ways it shows up in daily life:

• Tracking symptoms: Keep a log of when insomnia strikes, how joint pain limits mobility, or how fatigue affects focus. Written records make your experience harder to dismiss.
• Defining consultation goals: Before seeing a doctor, ask yourself: What would make this appointment successful? Maybe it’s clarity on whether symptoms are menopause-related, or a referral for bone health testing.
• Asking about options: Every approach—whether lifestyle, supplements, or hormone therapy—has pros and cons. Asking about all options ensures your care aligns with your values.
• Using respectful firmness: If minimised, you might say: “I understand this may not seem urgent, but these symptoms are affecting my daily life. Could we explore alternatives?”
• Bringing support: A trusted friend or partner can help reinforce your concerns and reduce the overwhelm of consultations.

These are not small steps—they are acts of reclaiming power in systems that too often silence women.

Counselling as a Self-Advocacy Ally

Medical professionals handle treatment, but counselling supports the person. At Underneath the Moon, we work with women to:

• Prepare for medical conversations: Clarify symptoms, define priorities, and rehearse what to say.
• Process emotions: Dismissal, frustration, or shame can take a toll—we create space to work through it.
• Build self-compassion: Shift from self-blame to self-understanding, reducing stigma.
• Navigate relational impacts: Menopause affects intimacy, self-image, and family dynamics—we help women address these with honesty and courage.

This is the psychosocial side of self-advocacy—supporting women to use their voice confidently and sustain themselves emotionally along the way.

Moving Forward

Menopause is not decline—it is transition. But it should not be endured in silence. The science is clear: in Singapore and Asia, symptoms are widespread, diverse, and significant. Women deserve to be heard, believed, and supported.

Self-advocacy is not about asking for favours. It is about dignity. It is about ensuring women in Singapore get the care and respect they deserve during this life stage.

✨ At Underneath the Moon, we provide counselling to help women strengthen their self-advocacy, build resilience, and navigate the emotional and relational impacts of menopause. If you are ready to reclaim your voice and feel supported through this transition, reach out to us today.

References

1. Ang, S. B., et al. (2025). Asia-Pacific Menopause Federation consensus statement on menopause management. Journal of Menopausal Medicine. Advance online publication. https://pubmed.ncbi.nlm.nih.gov/40347161/
2. Logan, S., et al. (2023). Menopausal symptoms in midlife Singaporean women: Prevalence and associated factors. Climacteric. Advance online publication. https://doi.org/10.1080/13697137.2023.2287626
3. Loh, F. H., Khin, L.-W., Saw, S.-M., Lee, J. J. M., & Gu, K. (2005). Age at menopause, symptom prevalence, and correlative factors in Singaporean women. Maturitas, 51(2), 139–149. https://doi.org/10.1016/j.maturitas.2004.11.004
4. National University Health System (NUHS). (2025). Unmasking the overlooked symptom of menopause. NUH Envisioning Health Newsletter. https://www.nuh.com.sg/health-resources/newsletter/envisioninghealth—changing-lives-one-idea-at-a-time/unmasking-the-overlooked-symptom-of-menopause
5. NUS Medicine. (2025). Integrated Women’s Health Programme (IWHP). Department of Obstetrics & Gynaecology. https://medicine.nus.edu.sg/obgyn/research/reproductive-development-biology-research-program/iwhp.html
6. Wang, X., Wang, L., Di, J., & Zhao, G. (2021). Prevalence and risk factors for menopausal symptoms in middle-aged Chinese women. Menopause, 28(11), 1312–1320. https://doi.org/10.1097/GME.0000000000001839