Time flies with great content! Renew in to keep enjoying all our premium content.
Prime
Menopause: What many Kenyan women aren’t prepared for
Menopause brings physical and emotional changes for women, often starting in their 40s, including hot flushes, sleep disruption, mood shifts, and weight gain.
I remember watching my mother struggle through sudden waves of heat, bouts of forgetfulness, and excessive sweating even while doing something as simple as washing dishes on a cold day. At the time, it felt confusing, almost inexplicable.
On another visit to the hospital, a doctor advised her to lose weight. She was in her early 90s and had gained significant weight, something he said was common for women at her stage of life. But these changes often begin much earlier.
For many women in their 40s, the body starts shifting in unexpected ways, and few are ever prepared for it. Each day can feel like a new, unfamiliar discovery.
Dr Maina Muriithi, an obstetrician–gynaecologist at Aga Khan University Hospital, describes menopause as a period marked by cessation of menses for 12 consecutive months.
“It is natural if it occurs spontaneously, and unnatural if it is due to other factors like chemotherapy or surgical removal of the ovaries, which produce the major female hormones,” he explains.
The average age of menopause for an African woman is about 51 years, although this is not a definite figure. Menopause can occur earlier in some women and later in some.
These changes, Dr Muriithi notes, do not occur uniformly in all women.
“Some women experience mild symptoms of menopause, while others experience severe menopausal symptoms, and some might even go through the period unknowingly, only noticing that their menses have disappeared.
“These changes could start from the age of 45. Experiencing the symptoms before age 40 is called premature ovarian insufficiency, and is abnormal,” he says.
The earliest and most common symptom of menopause is hot flushes, which come as sudden, intense heat all over your body, particularly in the upper part, such as the face and neck.
“These tend to occur mostly at night, causing sleep disturbance,” Dr Muriithi says, noting that up to 80 percent of women going through menopause experience hot flushes, but they tend to go away within one to two years.
Common hot flushes triggers
Common triggers for hot flushes are caffeine, alcohol, and spicy food.
“Changes in the menstrual cycle include the cycle becoming irregular and less frequent, and having periods of heavy menstrual bleeding," he says.
He cautions, “Persistent heavy or painful menstrual bleeding, however, should prompt a check-up, as it is not normal and could be associated with other conditions like adenomyosis that could present in the perimenopausal period.”
Other changes
Other body changes that occur include breast atrophy, vaginal dryness and thinning of the mucosa, fat redistribution, weight gain and wrinkling of skin.
The appearance of white-greyish hair that comes with ageing occurs when hair cells lose the black pigment-producing cells called melanocytes, typically from the age of 40, and is not reversible.
“Some people experience bone and joint pains due to loss of bone density and the additional weight gain,” says Dr Muriithi.
“Cognitive and emotional changes that one might encounter include forgetfulness and poor concentration, and are commonly termed as brain fog of menopause. Irritability and periods of sadness are also quite common.”
A decrease in libido is also among common symptoms experienced during menopausal transition. These changes, in the extremes, can be quite distressing.
Managing the transition
However, there are general lifestyle strategies that one can employ to transition through the period of menopause seamlessly.
These include eating healthy, maintaining a good weight, exercising, hydrating, maintaining loose clothing at night, avoiding spicy food and caffeinated drinks and practising breathing exercises and mindful meditation.
“Sometimes this is not enough when one is experiencing extreme symptoms, and hormonal replacement therapy (HRT) and other interventions come in,” says Dr Muriithi.
“HRT replaces the hormones oestrogen and progesterone, which fall to low levels as you approach menopause. Prior to initiation of HRT, one has to undergo a checkup to ensure that they are eligible to use it.”
Conditions that would prevent one from using HRT include a history of heart disease, active cancer of the breast, uterus or ovary, history of clots, uncontrolled blood pressure, liver disease or pregnancy.
“For those who do not qualify for hormone replacement therapy, non-hormonal options containing soy isoflavones (plant-based compounds found in legumes like yams), antidepressants and anti-anxiety medication can significantly lessen the symptoms,” Dr Muriithi notes.
Other alternatives include psychotherapy to understand one’s body and self, and behavioural therapy to adjust to the period of menopause.
