Paused by menopause: Closer look at middle-aged African women

LILIAN CHUDEY PRIDE

Lilian Chudey Pride, “The Childless Woman’s Coach”, is author of “Life Beyond Motherhood”; “Dignity of Womanhood”, and the publisher of iwriteafrica.com, an online magazine. Her books can be found on amazon.com and she can be reached on email: liliancpride@gmail.com; and lilian@iwriteafrica.com

The activities of many middle-aged African women are paused suddenly by something they do not know or hear of, and many of them would encounter it sooner or later because it is going to be a part of them for quite some time. Call it an unannounced stranger, unwanted guest, or unpleasant occupant, rude and domineering, all  descriptions fit, but certainly, it is not a disease. It is Menopause.

A woman reaches Menopause right at the time she stops having her monthly menstrual period. This is a challenging time as navigating this journey can be quite overwhelming for many women across the world. This period in the woman’s life remains significant as it is a milestone which heralds a completely new phase of life. In Africa, many middle-aged women are not aware of it, many African women have no prior knowledge and no education whatsoever about the subject of Menopause. Many have not heard the name and do not know about its many baggage. Therefore, it becomes imperative that middle-aged African women should be educated about Menopause. They need to know that it ushers in numerous physical, emotional, cognitive, mental and social changes that call for closer appraisal.

Christiane Northrup, international bestselling author, in her book: “The Wisdom of Menopause”, identified  three types of Menopause. These  are:

Natural Menopause (the sloping, winding path): This occurs gradually, usually between the ages of forty-five and fifty-five, in a woman who has at least one of her ovaries. Duration in most cases is five to ten years, though the entire process sometimes takes up to thirteen years.

Premature Menopause (the short path): This occurs somewhat faster as well as earlier, in women in their thirties or early forties who have at least one ovary. Approximately one in a hundred women complete the menopausal transition by the age of forty or younger.

Artificial Menopause (the helicopter ride) can occur quite abruptly, induced by surgical removal or disruption of the reproductive tract (including removal of ovaries or surgical disruption of the blood supply to the ovaries), by radiation or chemotherapy, or by administration of certain drugs that induce or mimic menopause for medical reasons (such as to shrink uterine fibroid).

At the onset or during Menopause, many African women have been misdiagnosed and have been treated for something else. This scenario can create a whole different situation entirely and may cause more damage. Many menopausal women experience low mood/mood swings, fatigue, depression, hot flashes and night sweats as symptoms of menopause, but according to experts, there are more than 30 symptoms to look out for that may manifest due to hormonal imbalances and fluctuations, brain fog, anxiety, joint pain, loss of libido, vaginal dryness and bloating among others, are common symptoms. Cognitive and mental symptoms are less known, but they are there, and can have significant impact on the woman’s daily life.

In 2019, I welcomed this enormous emotional rollercoaster which sought to take my peace away. Difficult to diagnose, none of the  doctors I consulted seemed to know exactly what it was and Africa being what it is, neighbours who were perplexed began looking at it as a wicked act coming from an unknown enemy, but behold, it was menopause and it is indeed a time of high and low and many other annoying symptoms, mood swings and overwhelming experiences that leave one feeling angry, baffled, tensed and depressed, these experiences are so hard to comprehend.

An article in “The Menopause Charity” indicates that a survey of 5,000 women conducted by Newson Health Research and Education found that a third of women wait at least three years for their symptoms to be correctly diagnosed as menopause related, and a further 18 percent visited their doctor six times before they got the help they needed.

In the American Journal of Managed Care (AJMC), 2022, Bruce Dorr, MD,FPMRS,FACOG, wrote: “Consider also that in the United States, 80% of medical residents reported feeling “barely comfortable” discussing or treating menopause, and only 20% of Obstetrics and Gynaecology (OB/GYN) residency programmes provide menopause training, mostly through elective courses. This year, (2022), a survey conducted by Biote found that 25% of women aged 50 to 65 years have never been told by their doctor (primary care physician or OB/GYN) that they were in perimenopause or menopause, even though 92% of the respondents had experienced one or more menopause symptoms in the past year.” Bruce Dorr said that countless patients have asked him how it is possible that so little is known about menopause, a condition that will eventually have an impact on every woman. “The truth is that there has always been a lack of research into women’s health, and we are just now starting to realise how much we don’t know”.   

It may be true that not all women go through the hard path of Menopause and its many symptoms, those who feel its pangs could live with the pain for decades. Nevertheless, there is no one size fits all method of treating or tackling the impact of Menopause. It is obvious, therefore, that research, education and advocacy are needed to adequately explain and alleviate the trauma and confusion of menopausal women.

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