Adjournment Motion on Enhancing the Well-Being of Women - A Gendered Informed Response to Menopause

SPEECH BY MDM RAHAYU MAHZAM, MINISTER OF STATE, MINISTRY OF HEALTH AND MINISTRY OF DIGITAL DEVELOPMENT AND INFORMATION, ON RESPONSE TO ADJOURNMENT MOTION ON “ENHANCING THE WELL-BEING OF WOMEN: A GENDERED INFORMED RESPONSE TO MENOPAUSE” ON 16 OCTOBER 2024

1.     Sir, Assoc Prof Razwana spoke about enhancing the well-being of women going through perimenopause or menopause, and gave suggestions that the Ministry of Health (MOH), Ministry of Manpower (MOM) and Ministry of Education (MOE) could consider to better support women through this critical phase in their lives. I thank her for her speech and suggestions. I agree with many of the points raised by Assoc Prof Razwana. She shared about the health impact of menopause on women and how we can address this impact with training of healthcare providers, research into contributing factors and management, public education and social support. I will now address her points in my speech.  

Health Impact of Menopause on Women

2.     Every woman’s experience during menopause is different. Some may experience significant impact to their health and well-being, beyond the more common symptoms such as hot flushes, night sweats, and insomnia. For example, cardiovascular health may be affected. This is because as the protective effects of oestrogen on the heart diminish, this can potentially lead to an increased risk of heart disease and stroke. Changes in metabolism during menopause can also result in weight gain, particularly around the abdomen, which may increase the risk of diabetes and other metabolic disorders. Assoc Prof Razwana also highlighted that women undergoing menopause can experience changes in mood, which can impact their mental well-being. 

3.     It is important to note that while these health impacts are of concern, they can be managed. Regular check-ups, a healthy lifestyle, including exercise, eating well, and finding ways to relax can help. Simple things like using moisturisers for dryness and choosing appropriate clothing to manage hot flushes can also make a difference. For significant symptoms impacting quality of life, women should see their doctor to explore suitable interventions to manage the impact on both physical and mental health.

The role of training and research for the healthcare system

4.     We agree that educating our medical students and medical practitioners on menopause is important, and we have been doing so. In our three local medical schools, knowledge of symptoms, diagnosis and management of menstrual disorders, including menopause, is one of the core learning outcomes for the medical students. Postgraduate family medicine programmes such as the Family Medicine residency programme and the Graduate Diploma in Family Medicine include training on common women's health conditions, including menopause, in the curriculum. Professional bodies such as the College of Family Physicians Singapore also run skills courses on a variety of topics relevant to primary care practice. 

5.     These efforts enable our primary care doctors to be a source of support to women in managing the health issues that may arise during this life transition. Under Healthier SG, the relationship between the primary care doctor and enrolee is central. Women who are experiencing menopausal symptoms can inform their primary care doctor, who would be well-placed to assess the symptoms, the patient’s needs and make recommendations on further management. The member also mentioned KK Women’s and Children’s Hospital (KKH) and the KK Menopause Centre. This multi-specialty practice comprising gynaecology, family medicine, dermatology and mental health specialists, has been trained to support a range of needs of women with menopausal-related health issues. Mental health services are also available in various care settings to identify women who may be experiencing psychological symptoms and provide interventions when required.

6.     Research into menopause would provide more insight into how it affects women’s overall health and well-being, and enable better ways to manage menopause symptoms and its impact. The National University Hospital currently conducts the Integrated Women's Health Programme (IWHP) which is a cohort study looking at health issues experienced by Singaporean women. Issues studied include the associations between menopause and age-related health issues such as osteoporosis and sleep disturbances. The research team plans to conduct follow-up studies, and we look forward to further insights that the IWHP and other researchers can provide on women’s health in general, as well as menopause specifically.

Empowering women through better support and awareness 

7.     Women should not feel ashamed, misunderstood or embarrassed to speak openly about menopause. As a society, we should work to remove the stigma surrounding menopause, and we are already taking steps to educate the public. Reliable information on menopause can be found on HealthHub and the websites of our public healthcare institutions (PHIs). KKH has also launched the Women In all Stages Empowered (WISE) Health Guide, which highlights important health advice for women, including advice on menopause. Education about menopause is important to help women understand what to expect and how to manage the changes to their body. We will continue to empower women to approach menopause with confidence and make informed decisions about their health and well-being. 

8.     To truly enhance women's well-being during menopause, we must address not only the physical symptoms but also the psychological and social impacts. This includes combating stigma, promoting open dialogue, and ensuring that women have access to accurate information and supportive resources. Civil society and community organisations are well-placed to participate in this effort. They can play a critical role in providing support for women, and creating platforms for the public in general, to discuss and better understand issues surrounding menopause. MOH is supportive of such efforts.  

9.     In addition, many women who are going through menopause are concurrently taking on caregiving responsibilities. We support caregivers to balance caregiving while pursuing their aspirations and caring for their own health. We are enhancing options to make childcare and eldercare more accessible, affordable and available, for example, by scaling up childcare and eldercare capacity, and providing multiple layers of financial support. These, in tandem with other moves to support women at work, will support women to better balance their responsibilities and their own health and well-being. 

Educating the young and supporting women in the workforce  

10.     Assoc Prof Razwana also spoke about suggestions for MOE and MOM, touching on educating people about menopause in schools, and workplace policies that better support women with menopause. 

11.     In MOE’s Sexuality Education and Science curriculum, students learn about menstrual health in women. Primary 5 students learn about the physiological changes that occur during puberty, such as menstruation. Students are also educated on human reproduction and issues related to menstrual health in Lower Secondary Science and Upper Secondary Biology. In Upper Secondary Biology, students will also learn about changes to the menstrual cycle as a female ages, leading to menopause.

12.     On workplace policies, women who experience severe menopausal symptoms can already seek subsidised medical treatment at PHIs, and take sick leave to rest and recover, just like any other medical need. There have been calls for menopause leave or reproductive leave in other countries. Most recently in the UK, the Government rejected a call by the Women and Equalities Committee to conduct a trial of menopause leave last year. Like the UK, our preferred approach is to support women to remain in the workforce and be well-supported at work. Introducing specific menopause leave may inadvertently negatively impact the employability of women in this age group rather than helping them, which we should be careful to avoid. 

13.     In addition, flexible work arrangements (FWAs) can help employees with other medical conditions to balance the care needs for their condition with work responsibilities, including women experiencing perimenopause or menopause. The upcoming Tripartite Guidelines on FWA Requests, which will take effect on 1 December this year, aim to cultivate a norm where employees feel it is acceptable to request for and use FWAs. We encourage employers to use these Guidelines to engage their employees in conversations and find mutually beneficial arrangements.

14.     The government will continue to work with Tripartite Partners to foster supportive workplaces so that all employees can participate fully at work while managing their own personal needs such as family responsibilities and medical conditions.

Conclusion

15.     In conclusion, supporting women through menopause is not just a medical issue, it is also about awareness and empowerment. The Government is committed to building a society where all Singaporeans have full and equal opportunities to flourish and achieve their aspirations. Civil society and community organisations have an important part to play as well. Together, by providing education and support, we hope to take a whole of society approach to enable women to navigate this transition with confidence, maintaining their well-being and full participation in all aspects of life. 

16.     Thank you.