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Menopause occurs in women between the ages of forty-five to fifty-five as a result of a decline in the production of female hormones, oestrogen and progesterone. Hormonal changes in menopausal women cause irregular menstrual cycles, hot flashes, mood changes and vaginal dryness. The hormone, oestrogen is responsible for keeping the lining of the vagina thick, elastic and lubricated and decreased levels of this hormone results in vaginal dryness. A lack of vaginal lubrication can have a severe impact on a woman's sex life, causing pain during sexual intercourse.

What is menopause?

Oestrogen controls the development of body shape and breasts and also plays a prominent role in pregnancy and the menstrual cycle. With the approach of menopause, oestrogen levels drop significantly as signs of vaginal atrophy, causing the vaginal lining to become drier, thinner, inelastic as well as light pink and blue in colour start to occur. There exist three phrases in the transition to menopause when a woman's ovaries stop producing eggs, decreasing levels of oestrogen and progesterone in the body when menstruation become less frequent and regular, coming to a complete halt after the peri-menopausal phase.

Why is menopause associated with pelvic pain and infertility?

Pelvic pain following menopause is usually a sign of an underlying condition such as endometriosis, uterine fibroids or ovarian cancer.

Ovaries have a limited number of follicles that produce healthy eggs and hormones during each menstrual cycle, and as women age, the number of follicles depletes. Over time the quantity and quality of eggs decrease as menopause marks the end of fertility, so until you have reached this stage, there remains a chance you can conceive. In vitro fertilisation, egg donors and embryo adoption are a few fertility options for menopausal women.

What are the fertility options for women with menopause?

Ovarian tissue grafting is done at a young age because an immature ovary is increasingly more hormonally active as compared to an aged ovary. During the laparoscopic procedure, a sample of egg-laden tissue is removed, sliced and frozen. The thawed out the egg is transplanted when needed through a laparoscopic procedure. Pregnancy entails grafting the slice close to or on the ovary, which then releases mature, healthy eggs that are picked up by the fallopian tubes for natural sterilisation.

What are the related symptoms?

Women with menopause display the following symptoms:

  • Hot flashes
  • Mood swings
  • Vaginal dryness
  • Reduced sex drive
  • Sleep disturbances

How is menopause treated?

Menopause is a natural biological occurrence that can be managed through hormonal therapy. Oestrogen therapy is effective in reducing hot flashes; our endocrinologists might recommend this type of treatment in low doses within a limited timeframe to relieve menopausal symptoms and prevent bone loss. Oestrogen may be applied to the vagina using a vaginal ring, tablet or cream to relieve vaginal dryness. Dr Benecke will discuss treatment options with you, mentioning the benefits and risks associated with hormone therapy.

How can I outsmart my biological clock and keep menopause at bay?

Ovarian tissue freezing and grafting, which is in no means new as it has been offered to young patients with cancer who have undergone chemotherapy and intend to preserve their fertility can be used to delay menopausal symptoms. The tissue is grafted in the forearm or armpit where there's a good blood supply in the hope of restoring dwindling hormones to stall menopause for a further ten years. Despite the modern take on stalling menopause and prolonging fertility for another ten years, there remains a risk that the procedures of removing ovarian tissue and re-implantations of grafts might be subject to rejection resulting in menstrual bleeding disorders and the relapse of menopausal symptoms.

Why delay menopause?

Going through transitions and challenges is a part of life. It is necessary to undergo physical and emotional changes to learn essential life lessons. Although going through menopause can be an incredibly stressful and emotional time, it can also be positive. Unlike going through puberty, where the woman is inexperienced, confused and nervous, women at this age should be able to navigate through menopause confidently. By delaying menopause, we deny an opportunity for growth.

Our specialists at the Endometriosis Clinic are determined to help you transition into this phase of your life with ease, relieving dreaded symptoms of hot flashes and vaginal dryness.

Specialised Services

While Dr Benecke is a gynaecologist & obstetrician offering the full range of women's health services, his niche lies in the treatment and management of the following gynaecological conditions:


Due to the complexity of the diagnosis, Dr Benecke is meticulous during each consultation and using a multidisciplinary approach he can provide highly specialised treatment and management of this condition as well as the related symptoms such as chronic pelvic pain and the complication of infertility.



Sharing similar symptoms to that of endometriosis, fibroids are growths that develop on the uterus. The size of fibroids can range, growing from the size of a pea to the size of a watermelon, distorting the uterus and causing disabling symptoms.



Polycystic ovary syndrome (PCOS) is a hormonal disorder that disrupts oestrogen production and causes an imbalance of the male hormones, androgens. PCOS causes disruption of the menstrual cycle leading to complications such as severe abnormal uterine bleeding, the development of numerous fluid-filled cysts in the ovaries and infertility.