Mrs Tina Haruna recalls her transition of going through early menopause at 46. She was suffering from polycystic ovarian syndrome and her ovaries had to be removed. It induced menopause.
Menopause is the final menstrual period, where a woman’s reproductive hormones change and the ovaries no longer release any eggs.
A few women may remain unaffected, whereas some have severe depression, disturbing their routine. In between, there are women who suffer from mild depression, mood swings, irritability or become very sensitive emotionally.
Unfortunately, most women are not prepared for the transition, both physically and mentally. Sadly, nobody talks about menopause and many women are dismissive about menopause because it was just something that happened and would pass.
Family planning services helpful
Alhaji Abdullahi Kabiru, a sociologist and the Kaduna State team leader of Nigerian Urban Reproductive Health Initiative (NURHI), said many women are not aware that even family planning clinics can offer support on menopause.
“In fact, hormonal contraceptives can be prescribed at family planning clinics to help them cope better with some symptoms of menopause such as hot flashes,” he said.
Family planning services is an aspect of reproductive health care. Ideally, a woman should be able to go into a reproductive healthcare centre to access family planning, talk about her sexuality, menopausal symptoms, and so on, said Professor Adetunji Adeniji, a consultant obstetric and gynaecologist, LAUTECH Teaching Hospital Ogbomoso, Oyo State.
Certainly, Nigeria lacks an all encompassing reproductive healthcare centres, but family planning centres, Professor Adeniji stated can still provide some facilities for women to cope better with menopause.
Benefits of contraceptive pills are beyond birth control. For instance, it lowers risk of ovarian and uterine (womb) cancer; reduces hot flashes; and improvements in acne, which can flare up around menopause.
Why hormonal contraceptives are helpful
Professor Adeniji said “Menopause is as a result of the low levels of some hormones in the woman’s body, especially the oestrogen. So, replacing such hormones either in form of pills, hormonal patches, or micro pellets will help to ameliorate the symptoms of menopause.
“We used to think that menopause is not a problem in African setting, but this is not actually so. Now, women actually come to complain; some in fact are uneducated and they do not know the reason behind their symptoms.
“For instance, a woman who has hot flashes just come around saying “I feel hot unduly”. Some also get unduly irritated. Some come down with manifestations of mental health issues like depression and stress.
“Of course, if a good history is taken to know when it all started, a medical doctor that is conversant with the life history of a woman may then be able to relate it to issues of perimenopausal or menopausal problem,” he said.
Menopause not understood by many
Ironically, he said menopausal symptoms in many communities were wrongly linked with economic and spiritual problems. But “when such women come in to the hospital to complain, become educated on menopause, and advised on what to do, they cope better,” he added.
Symptom relief
Nonetheless, Professor Adeniji declared that menopause is a natural process with hormonal and physiological changes that some women might need to have some supplements or hormone replacement therapy to cope with its symptoms.
Also exercise, lifestyle changes and a diet that contains soy are helpful with menopausal symptoms. Soy contains phytoestrogens, substances similar to the oestrogen produced by the human body, but derived from plants.
He declared that although menopause can start any time from the age of 40 years, it usually predates the actual cessation of menstrual flow.
So, for most women, menstruation gradually subsides, rather than stopping at once. The symptoms of menopause may appear slowly, peak, and then decline gradually, as a woman moves out of her fertile years. This may take about three to four years.
The earliest stage of menopause, called perimenopause, causes irregular periods, as a woman moves away from fertility. This stage is usually gradual.
During this process, a woman may experience other changes to her body. For example, changes to skin and hair. These alterations are part of ageing and are due partly to lower levels of hormones. A woman’s genes also affect skin changes, hair thinning and greying.
Most women experience some of the many perimenopause symptoms. Irregular periods and longer cycles that eventually end are not the only symptoms.
Other symptoms of menopause range from changes in mood, period, or sex drive to sleep trouble, anxiety, depression, and the well-known hot flashes.
Myths and secrecy surrounding menopause
Many myths and secrecy surround menopause. Some women believe they will be less attractive, or that sex may become painful. Others might be concerned that they will be less “feminine” or suffer memory loss. In reality, nothing but loss of fertility is inevitable with menopause.
Anecdotally, some women find that menopause improves their self-esteem and increases their interest in sex. After the menopause, there is no risk of pregnancy and, for some women, this may improve sex.
Pregnancy, also possible
Pregnancy may still be possible until menopause is complete. Fertility only ends when menopause is complete. Just as a woman’s periods do not disappear at once, neither does her fertility.
Notably, the beginning of menopause marks the beginning of the end of fertility. A woman may still ovulate, and the eggs may be healthy enough to produce a pregnancy.
Menopause is not a disease
When perimenopause symptoms are experienced, they are often short-lived and mild. Menopause is also not a sign that the body is failing. Some women worry that they have started menopause too early, because of poor health or some other issue.
Most women start menopause around the age of 50. However, variability in either direction is normal, and not something to worry about. Healthy transition into menopause is possible.
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