A journey through menopause

Are you going through ‘the change’ - and don’t want to talk about it? You are not alone.

Menopause is a subject that is rarely spoken of, leaving women suffering silently - as menopause has its ups and downs. Due to lack of information, many only find out they are at that stage long after it has set in.

But why is this phase in a woman’s life dreaded?

Dr Vindya Pathirana, an obstetrician and gynecologist at Cradle Speciality Health Centre in Dar es Salaam, says women do not want to get to, or talk about, menopause because it is an indication of aging.

It is a period that is characterised by a sagging skin. A time when the radiance and glow of the skin fades. “So, nobody wants to admit that they are getting older. But in some parts of the world life happens after 40 years. Some women start families after 40 years, so I think women should be bold and face aging gracefully,” advises the gynecologist.

To get an insight of what the menopause voyage entails, Woman had a chat with two women going through menopause who share their mid-life tour experiences.

Louisa Kimei, 53

Louisa Kimei has been on the journey for five years now. When Louisa turned 48, she started having irregular periods. Louisa would miss her periods for three months, after which she would get heavy periods that would go for two weeks.”

“Menopause has been such an unhappy phase for me. While other women would say they had less days, I unfortunately started having more days and this even affected my blood count. At some point, I had to be admitted and stayed in hospital for a few days. These periods came along with severe cramps.”

Louisa also started getting pregnancy-like cravings, where she craved eating clay or uncooked rice. She also lost her appetite. This experience was quite new to Louisa because she had never heard about menopause. When her daughter pointed out that it could be menopause, she started speaking to her friends about it and learned they were also facing almost the same symptoms such as hot flashes, body aches and mood swings.

Louisa understands that many reach the stage unawares and advises women to regularly visit the gynecologist. She points out that searching on Google and listening to friends made her believe she had cancer. To clear her doubts, the gynecologist she consulted sent her to a cancer specialist hospital and her results came out negative.

Because Louisa was having heavy periods, her doctor recommended iron supplements among other medications. She now visits the gynecologist once a month. She is grateful that she is coping well.

Emmy Samwel, 45

Emmy’s menopause journey started last year. “Although I was aware that at some point I would reach menopause and probably earlier, given that my mother had experienced the same, I wasn’t prepared for the emotional upheaval. The hot sweats, especially at night were unbearable and in about two weeks I was almost going crazy because of lack of sleep.”

Emmy says she would get very hot and suddenly very cold, and would spend half the night either trying to cool down or warm up. “And since I didn’t know better, at times I would actually get up and shower even twice a night just to cool down because the heat can be unbearable.”

Emmy says although she is exposed and has access to reading materials, she still was ignorant about what to expect when menopause started. She says it is not a subject that women just engage in even if they are the same age.

“After a few weeks of intense emotional and physical hectic-ness, I decided to visit a gynecologist who confirmed that I was already on the way to menopause and prescribed some medicines - which I did not take because I am not a fan of medicines.”

One of Emmy’s friend recommended she speak to her mother (friend’s) since she is very open about the subject. Emmy did so and says it was an eye opener. Her friend’s mother recommended a lot of home remedies including reducing spicy food, coffee and alcohol.

“I did not know that the process takes a lot of years to full completion so I had to prepare mentally for that. My biggest achievement is accepting the fact that it is here, knowing how to manage it when it gets serious, knowing that the condition will be here for a while and that I just have to accept to live with it.”

What the experts say

Dr Pathirana says after the age of 45 hormones decrease and menstruation ceases, which is called menopause. Although very rare menopause can happen as early as in the 30s in some women, while some menstruate till their 50s.

The doctor says the major problem women face is usually with hormonal fluctuations, which gives mood swings and body, muscles, ankle and heel pain, easy irritability and anger. Some develop hair on the chin, breast etc. Other symptoms include bloating, constipation and weight gain.

“The best way to face menopause is through increasing one’s metabolism. So having a good balanced diet, eating on time and not doing crash diets for weight loss is very important. A good amount of exercise, drinking three litres of water, visiting the gynecologist and having hormonal checkups helps.”

The doctor says failure to follow a proper diet and drinking enough water can lead to constipation and mal-absorption, a condition where one fails to absorb nutrients.

In tackling the downs of menopause, Dr Pathirana says there is hormones replacement therapy for those who have severe hormonal imbalances. She cautions that this is a choice that needs close supervision with an endocrinologist (a specialist doctor in diagnosing and treating disorders of the endocrine system, that is, the glands and organs that make hormones.

“There are also some plant medications for easing mood swings but not all work for everyone and that is why when one reaches 40, they should see a gynecologist,” Dr Pathirana says.

Dr Nicholaus Mazuguni, a consultant Gynecologist and Fertility Specialist at Avinta Care in Arusha, says one may also experience vaginal dryness, hot flashes, chills, night sweats, sleep problems, weight gain, thinning hair, dry skin and loss of breasts fullness.

“Despite irregular periods, pregnancy is possible. If one skips a period and they aren’t sure if they have started the menopausal transition, they should consider a pregnancy test,” he says.

Dr Nicholaus adds that menopause requires no medical treatment. Instead, treatments focus on relieving one’s signs and symptoms and preventing or managing chronic conditions that may occur with aging.

Dr Nicholaus says hormone therapy, is considered to be the most effective treatment option for relieving menopausal hot flashes. “Depending on one’s personal and family medical history, one’s doctor may recommend oestrogen in the lowest dose and the shortest time frame needed to provide symptoms relief for you.”

Dr Nicholaus says before one decides on any form of treatment, they should speak to their doctor about their options, risks and benefits involved with each, and review their options yearly, as their treatment options may change.