As Thai society rapidly ages, understanding menopause and its effects on women’s health and wellbeing is more critical than ever. Recent research from the Mayo Clinic, highlighted in its podcast “Aging Forward,” sheds new light on the complexities of perimenopause, menopause, and post-menopausal life—areas increasingly relevant to millions of Thai women aged 45 and above and their families. Experts stress that recognizing, discussing, and effectively treating physical, emotional, and sexual health changes can lead to a thriving, empowered midlife for women.
Menopause typically occurs between ages 45 and 55, marking the end of a woman’s reproductive years. This transition brings a significant drop in estrogen and progesterone, resulting in wide-ranging symptoms that affect the body and mind. According to the Mayo Clinic’s Dr. Carol Kuhle, a leading menopause and sexual health expert, “eighty percent of women experience vasomotor symptoms such as hot flashes and night sweats, which can last months or even years.” These symptoms often begin in the perimenopausal phase, starting as early as the late 30s or 40s, and can be confused with other everyday ailments—a frequent source of confusion for both women and their doctors (Mayo Clinic Press).
Hot flashes, sleep disturbances, sudden weight gain, and emotional changes such as brain fog, mood swings, and insomnia are all common in this period. Dr. Kuhle emphasizes, “aging collides with menopause—you’re having to do more, eat less just to stay the same, but the weight that appears around the tummy is more related to estrogen loss than aging itself.” Complicating matters, some women never experience hot flashes, while others suffer persistent symptoms. Thai physicians, public health nurses, and midwives (such as those staffing community health units in Bangkok, Chiang Mai, or Ubon Ratchathani) are seeing these same patterns among their patients, although menopause is still a less openly discussed topic in Thai society, particularly outside major urban centers.
A crucial point from Mayo’s experts is that menopause’s impacts extend beyond symptoms—serious long-term risks include loss of bone density and increased cardiovascular risk. Dr. Kuhle notes, “Women will precipitously lose bone during menopause due to lack of estrogen, leading to greater risk of osteoporosis and fractures later in life.” She highlights that a single hip fracture in the elderly can lead to significant loss of independence—an issue well-known in Thailand, where elderly women are a growing demographic and fall-related injuries are a major public health challenge (World Health Organization).
On sexual health, the discussion is transformative. The Mayo Clinic’s research highlights that understanding and treating the thinning and drying of vaginal tissues—direct effects of lower estrogen—can prevent discomfort, urinary tract infections, and reduced libido, all frequently overlooked in clinical practice. Topical estrogen, pelvic floor physiotherapy, and even the use of vibrators (to increase blood flow and maintain vaginal health) are cited as effective interventions. Dr. Kuhle shares, “I just had a patient today who, by the time she left, was comfortable with the idea of buying a vibrator—not just for sex, but for overall vaginal health.”
In Thai society, discussions of sexual health, especially among older women, remain taboo. Most women in midlife and beyond, particularly in rural areas and traditional households, are reluctant to mention their sexual concerns to healthcare providers. The Mayo Clinic’s approach is instructive for Thailand: normalize sexual health as part of routine checkups. “How’s your heart? How’s your bones? How’s your sex life?”—simple questions that acknowledge sexual wellbeing as a fundamental part of healthy aging.
Addressing the psychological and cultural context is equally important. The Mayo experts note that women’s beliefs about sexuality—often shaped by upbringing and cultural taboos—can directly affect their willingness to speak up and seek help. This rings especially true in Thailand, where modesty and family honor may lead women to suppress questions about menopause, sexuality, or intimate discomforts. Practitioners are encouraged to “neutralize” these conversations and assure patients that normal variations in libido, desire, and sexual function are expected as women age.
Medical recommendations are shifting, too. The long-debated use of hormone therapy has evolved with new research clarifying risks and benefits. For women under 45 with early menopause or under 40 with primary ovarian failure, hormone therapy is seen as essential to prevent cognitive, cardiovascular, and bone health complications. But for others, the decision should be individualized, weighing cancer and heart disease risks. New non-hormonal treatments are emerging, such as fezolinetant (Veozah), a medication that targets brain mechanisms of hot flashes. Though promising, costs and insurance coverage remain barriers in many countries, Thailand included (U.S. FDA - Fezolinetant Approval).
Supplements, a popular self-treatment route in Thailand, are not strongly supported by evidence, the Mayo team warns. Lubricants and vaginal moisturizers can provide symptomatic relief, but dietary supplements for menopause—such as those based on soy—lack robust scientific backing. Interestingly, Dr. Kuhle acknowledges Asian women, including Thais, may metabolize soy-derived phytoestrogens differently, potentially experiencing more benefit, but she adds, “we haven’t seen any harm, but we don’t know long term.” This caution matches Thailand’s own Ministry of Public Health advice regarding health supplements for menopause (Thai FDA).
Dr. Kuhle and her team also encourage women to view menopause not solely as an ending, but as a bridge to an enriched stage of life. She stresses the importance of lifestyle interventions—regular exercise, strength training, proper nutrition, and preventive healthcare screenings—to maintain muscle and bone health and reduce cardiovascular risk. In Thailand, where family structure is evolving and the number of older women living independently is rising, targeted health promotion becomes all the more vital.
Access to correct information and trained specialists is a growing challenge in both the U.S. and Thailand. The Mayo Clinic recommends resources such as The Menopause Society’s online guidelines and provider directories, which could serve as a model for the Thai Women’s Health Association and Ministry of Public Health to develop similar local platforms for Thai women seeking expert advice.
Looking forward, the research consensus is clear: open dialogue, accessible care, and destigmatizing menopause and female sexuality will be essential to improving outcomes for Thailand’s women—and, by extension, families and communities. For health professionals, the message is to be proactive, ask the right questions, and assure women there is support at every step. For Thai women, especially those heading into midlife, the take-home advice is to seek knowledge, advocate for your health, and discuss menopause openly with your healthcare providers.
In practical terms, Thai readers are encouraged to:
- Speak openly with healthcare professionals about menopause and its symptoms, including changes in sexual health.
- Prioritize regular exercise and proper nutrition to maintain bone and cardiovascular health.
- Discuss the risks and benefits of hormone therapy or new medications with a trained physician, and report any distressing symptoms early.
- Use only reputable supplements, and be wary of unproven herbal remedies widely promoted online or in markets.
- Encourage mothers, aunties, sisters, and friends to share their experiences and break the taboo around women’s health in midlife.
- Leverage community health resources, such as clinics and women’s health groups, to access reliable education and support.
By reframing menopause as a journey—not a barrier—Thai women can better prepare for a healthy, fulfilling next stage of life.
For more information, readers can see the full Mayo Clinic podcast transcript (Mayo Clinic Press), consult Ministry of Public Health resources (FDA Thailand), and stay informed on emerging treatments.