Tag: Menopause

  • Weird world of women experiencing menopause

    Weird world of women experiencing menopause

    • How ignorance of symptoms is putting relationships in disarray
    • More women misconstruing condition for mental/spiritual attack

    Menopause is often not well understood. Many people think it just means the end of a woman’s monthly period. But for many Nigerian women, it brings a lot of strange changes, like confusing health problems, mood swings, and a loss of their usual self. Because there is not enough correct information and people hardly talk about it, most women go through this difficult time alone and are misdiagnosed. In this report, Chinyere Okoroafor looks into the hidden pain many women face during menopause and how wrong beliefs and lack of knowledge make it even harder and lonelier.

    I didn’t know what was happening to me,” Mrs. Adeoye, a 55 year-old mother of four (not the real name) said, her voice low as she sat across facing this correspondent. “I was gaining weight so fast, always tired, and I couldn’t sleep at night. My mood was everywhere, I’d cry for no reason, shout at people, then feel guilty right after.”

    She paused, pressing a hand to her chest. “Everyone around me said it was a spiritual attack. Some said maybe someone in my family had cursed me. I got scared.”

    Desperate for help, she travelled all the way to Ilorin to see a herbalist. “The Baba gave me all sorts of concoctions, bitter roots, strange leaves, and I spent money, thousands. Nothing worked.”

    It wasn’t until she joined menopause support community through a friend and spoke to the Founder of the Menopause Support Initiative (MSI) and the convener of Nigeria’s first dedicated menopause support community, Pharmacist Mosunmola Dosunmu, that things started making sense.

    “She explained it to me that it was menopause. Just menopause. Not a curse. Not madness. Just a natural phase of life. I cried. I had suffered so much because I didn’t know.”

    It was a tale of mental disruption when our correspondent encountered Mrs. Ukoh.

    A mother of two in her mid-40s recalled how her period had always been irregular. But what she didn’t realise at the time was that the strange changes she felt in her body, fatigue, mood swings, and hot flashes, were signs of something deeper.

    “I just thought it was stress or maybe something spiritual. It never occurred to me that my body was preparing for menopause. Sometimes when I don’t understand the things I’m feeling in my body, I would think I was going mad. It started slowly, first the mood swings, then the panic attacks, the confusion. Some days I couldn’t remember the simplest things. I’d find myself crying alone in the kitchen and not knowing why.”

    Her voice trembled as she continued. “My family didn’t understand. They said I was losing it. My husband stopped talking to me the way he used to. My children avoided me. I was taken to different hospitals, and they said it was depression, anxiety, even early signs of schizophrenia. So they put me on pills. Antipsychotic pills. I took them for years.”

    She looked away, wiping a tear. “I lost so much, friends, my job, even my sense of self. And all that time, no one ever said the word ‘menopause.’ Not once. It wasn’t until one evening, I was tuning the radio and just stopped on this voice. A woman was talking about menopause. She mentioned everything I’d been going through, mood swings, anxiety, memory lapses. I froze. It was like she was talking directly to me.”

    She paused, then gave a small, sad smile. “That night, I couldn’t sleep. I just kept thinking, ‘What if this has been it all along?’ The next morning, I called the number they gave.

    Like Mrs. Adeoye, Mrs. Ukoh said she spoke to someone, in the person of Pharm Dosunmu who really listened to her for the first time. And for once, I didn’t feel crazy. I felt understood.”

    For Edith Obioma, the mood swings and irritability brought on by menopause took a heavy toll, eventually costing her, her marriage.

    At 35, she noticed that her body changed, but she didn’t recognise the signs. Her periods became irregular, but doctors, focused on her IVF treatments, never mentioned menopause. They only said her eggs were “not great” or “too few.” She clung to hope because she still saw her period sometimes.

    In a low, trembling voice that nearly brought her to tears, she told of how she poured her heart into trying for a baby, enduring failed IVF cycles that left her emotionally broken. “Each failure broke me,” she recalled. “I withdrew, avoiding people, sinking into loneliness.”

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    According to her, seeing mothers with children felt like torture. She resented their joy, questioned her fate. Her marriage suffered. She snapped at her husband at any least irritation, consumed by anger and grief.

    At 40, the IVF finally worked, and she had her daughter, thinking the struggle was over. But that was just the beginning of the real battle.

    Her period stopped completely. Panic attacks, hair loss, and relentless anxiety set in. Doctors dismissed her concerns. Even during COVID, when symptoms worsened, she assumed it was the virus. It wasn’t until her younger sister experienced the same that Edith realized, she was experiencing menopause.

    By then, her marriage was already over. Her husband had tried to be patient, but he didn’t understand her anger, her distance. One day, he left.

    “Looking back, I regret so much,” she says. “I fought so hard, but for what? The women I fought ended up in Lekki with houses. I lost everything.”

    Her family offered no support. Friends took sides. She was alone, except for the church. Healing took years. Then, one day, her husband returned, not to stay, but to say:

    “If this was the woman you were when we moved back to Nigeria, I wouldn’t have followed another woman.”

    The words stung. Not because she wanted him back, but because they confirmed her fear, menopause had changed her, and no one had understood.

    Mrs. Vivian Duru faced a similar battle. At 42, menopause hit suddenly, sleepless nights, mood swings, and a relentless heat coursing through her body. She felt restless, forgetful, and irritable. At first, she blamed stress, then a spiritual attack. She fasted and prayed, but nothing changed.

    One day, convinced she was pregnant, she went for a scan. She had the bloating, dizziness, and hormonal shifts she associated with pregnancy. But when the doctor read the results, he shook his head.

    “There’s no baby.”

    She left the hospital in tears, convinced something had stolen her child. Only after meeting another woman with similar experiences did she understand, this was menopause. No one had told her it could come so early.

    Adeola’s story was even more devastating. At 42, she changed. The warm, loving wife she said she was to her husband Ladi, became irritable and withdrawn. Family gatherings brought no joy. Then, the illnesses started. One hospital visit led to another, draining their finances. Nothing helped.

    For 10 years, she suffered one health crisis after another. Her marriage crumbled. Intimacy faded. Her husband, exhausted from trying to love a woman who had become a stranger, was ready to leave.

    Then, he finally learned the truth. His wife’s suffering had a name, menopause.

    But it was too late. He was drained, past the point of caring. Even knowing her pain wasn’t her fault, he couldn’t bring himself to fight for their marriage anymore.

    Before Pharmacist Dosunmu discovered that her long struggle with bloating, mood swings, and irritability were symptoms of menopause, her son had endured several unwarranted beatings as a result of her unpredictable temper.

    According to Pharm Dosunmu, her journey with menopause began long before she experienced its symptoms firsthand.

    She recalled how her mother, at 45, was once misdiagnosed with pregnancy, a mistake that created confusion and shame within their family.

    “As a pharmacist, I used to think menopause happened only around age 50. No one educated us about it.” She said.

    Years later, at 42, Dosunmu found herself facing a wave of unfamiliar symptoms, mood swings, depression, memory lapses. A single mother of two boys, she became unexplainably angry, particularly toward one of her sons who resembled her.

    “I didn’t understand why I kept lashing out until one day, my son looked me in the eyes and said, ‘Mommy, you need help.’ That was my wake-up call.”

    Her condition worsened. She began hearing voices, battled suicidal thoughts, and was often locked indoors, crying for days. Her work suffered. Brain fog made it impossible to concentrate or manage her business. She lost weight rapidly and struggled to stay mentally and physically stable.

    “I tried enrolling for a master’s degree in Mass Communication,” she added. “But I couldn’t read or retain anything. Eventually, I dropped out.”

    In hindsight, Dosunmu believes that a support system could have made all the difference.

    “If someone had just told me, ‘It’s menopause, you’re not alone,’ maybe I wouldn’t have felt so lost.”

    Just like Mrs. Adeoye and Mrs. Ukoh, Oscar-winning Hollywood actress Halle Berry also went through a similar ordeal.

    Another woman, who gave her name only as Mrs. Joy, shared her difficult journey. At just 44, she had visited several doctors but received no clear diagnosis. “I was tired all the time, gaining weight fast, my business was falling apart, and my marriage was suffering,” she recalled. “I didn’t know what was happening to me.”

    Overwhelmed and in tears, she eventually met Pharmacist Dosunmu. After carefully listening to her symptoms, he told her she was likely experiencing menopause.

    “She didn’t just give me medicine, she explained what was going on in my body,” Mrs. Joy said. With lifestyle changes and the right supplements, her health improved quickly.

    But when she stopped the routine months later, her symptoms returned. “That was my wake-up call,” she said. “Now I know better. I stay on track, and I tell every woman I know to take menopause seriously.”

    In a recent appearance on Good Morning America, Berry revealed she was misdiagnosed with herpes at the age of 54, only to later discover she was actually in perimenopause.

    “I was 54 years old, 54, I wasn’t aware of it, and none of my doctors had even mentioned this time of life to me. It was as if this would never happen to me. I was probably 10 years into it and had no clue. I thought I was going crazy. I had really bad memory loss. I had a hard time concentrating, I flooded my laundry room three times, and I would leave my keys stuck in doorways.

    “I could never find my phone. I was walking into rooms and not remembering why I was there. These were things that were not a part of my makeup before this time period. I started to think, Oh God, am I starting to have early onset dementia? Is something happening to my brain?

    I got very aggro. I was wanting to argue with everybody about every little thing, and that was so not me. I was always the chill one in the conversation or in the room. I had a hard time sleeping, and I guess sleep deprivation is a form of torture. It felt like I was falling apart at the seams, and nobody seemed to be able to relate. Everybody just said, “Oh, it’s just a time of life. You’re getting old. Just deal with it.” But I didn’t feel old. I didn’t feel like it was time for me just to pack it up and wander off to pasture, but yet that’s kind of what everybody started to tell me. I felt crazy and alone and afraid. I felt ashamed.”

    “When I realized I was in perimenopause and could put a name to it, I started investigating and doing my own research and reconnaissance. I realized, Oh, this is what’s been happening to me for a decade. It was so enlightening.” She said.

    These women’s stories are just a few examples, but countless others face this life-altering transition without the support or information they urgently need. While menopause is a natural stage in every woman’s life, women like Mrs. Adeoye, Mrs. Ukoh, Mrs. Duru, Mrs. Dosunmu, and even Halle Berry should not have had to navigate it without the knowledge that could have helped them seek proper care, avoiding unnecessary health struggles, broken relationships, and a loss of identity.

    Behind these personal stories lies the complex science of menopause

    According to the Mayo Clinic, menopause is the cessation of menstrual periods, specifically after 12 consecutive months without a period, vaginal bleeding, or spotting. It typically occurs between the ages of 45 and 55, when the ovaries stop producing the hormones estrogen and progesterone.

    The drop in these reproductive hormones triggers a host of symptoms, including hot flashes, vaginal dryness, mood swings, sleep disturbances, anxiety, forgetfulness, and reduced sexual desire.

    An obstetrician and gynecologist at Mushin General Hospital, Dr. Solaja Olufemi, described menopause as “a time of emotional and physical upheaval.”

    He explained that the emotional turmoil many menopausal women experience is deeply rooted in hormonal changes that affect brain chemistry and emotional regulation.

    “For many women, menopause brings unexpected health issues. During menopause, there is a significant drop in estrogen and progesterone, hormones that influence mood, memory, and sleep. This shift can trigger intense emotions like anxiety, irritability, sadness, and even depression,” she said.

    “Women often feel like they are losing control of their emotions or sense of self. For some, it feels like they are ‘going crazy,’ especially when symptoms like mood swings, brain fog, and sleep disturbances are not properly explained or managed.”

    Dr. Olufemi added that the lack of awareness and social support makes it worse. “When women don’t understand what’s happening to them or are made to feel ashamed, it adds a layer of emotional isolation. What they need is compassion, open conversations, and access to medical support.”

    Explaining the biological basis of menopause, Dr. Olufemi said it lies in the natural depletion of a woman’s egg supply. “As women age, their egg reserves begin to decline,” he said. “This decline triggers a drop in estrogen and progesterone levels, which gradually leads to irregular periods and, eventually, the complete cessation of menstruation.”

    While menopause is not a disease, it comes with a wide range of symptoms that can significantly affect a woman’s quality of life. “Some women barely notice the transition, but for others, it can be overwhelming,” the gynecologist noted.

    He highlighted the three key phases of menopause: perimenopause, menopause, and postmenopause.

    “The perimenopause stage usually starts in a woman’s 40s,” he said. “During this phase, hormonal fluctuations can lead to irregular periods, hot flashes, night sweats, and mood changes.”

    He explained that menopause is officially diagnosed after a woman has gone 12 consecutive months without menstruation. “After that, she enters the postmenopausal phase, where the symptoms may persist as the body continues to adjust to its new hormonal baseline.”

    Dr. Olufemi mentioned the long-term health risks associated with menopause, including osteoporosis, cardiovascular disease, weight gain, and a slowed metabolism. “The loss of estrogen makes women more vulnerable to these conditions, which is why regular medical checkups and a healthy lifestyle are crucial,” he advised.

    He also drew attention to premature menopause, which occurs before the age of 40. “This can result from medical treatments like chemotherapy, certain health conditions, or sometimes for no identifiable reason,” he said. “Women who go through premature menopause face unique challenges and often require specialized care.”

    Shockingly, Pharm Dosunmu added that menopause can start earlier than expected, sometimes in women as young as 28. “Many people assume menopause happens later, but early menopause is common,” she said.

    Why menopause information matters

    The women stories underscore a critical gap in awareness and care. According to a 2023 report by the Nigerian Society for Gynecology and Obstetrics, 7 in 10 women lack adequate knowledge about menopause, leaving them vulnerable to stigma, poor health outcomes, and social isolation.

    A 2021 World Health Organization (WHO) report showed that around 26% of the global female population is made up of women aged 50 and older, signifying a growing postmenopausal population, with this percentage increasing from 22% a decade earlier; this indicates that the number of women experiencing menopause is rising globally due to increased life expectancy.

    The global health agency also projected that over 1.2 billion women will be menopausal or post-menopausal by 2030. This projected increase could put pressure on healthcare systems to address the needs of menopausal women.

    According to Pharm Dosunmu, the implication of the WHO projection by 2030 means that a very large number of women worldwide, over 1.2 billion, will be going through or have passed menopause.

    This significant rise means that healthcare systems everywhere may face greater demand to provide proper care, support, and treatment for menopausal women and without adequate preparation, health services might struggle to meet these needs, potentially leading to gaps in care and worsening health outcomes for this growing population.

    Dosunmu emphasized that lack of awareness often leads to misdiagnosis, treating hormonal changes as mental illness, pregnancy, or mysterious ailments. “When women and healthcare providers understand menopause, they can avoid harmful labels and offer the right care, saving lives, relationships, and dignity,

    “In one church where I spoke, a pastor’s wife approached me later, saying she wished she’d met me earlier. Her condition was menopause-related, not a spiritual attack or mysterious illness. Had she known earlier, she might have avoided diabetes or other complications,

    “There was a time when I developed keratinized, ( lizard-like skin), a condition I later discovered was related to menopause. When I realized there was a name for my suffering, I was relieved. Naming the problem gave me the power to manage it.” She said.

    Dr Olufemi added that, “When women don’t have access to accurate information, they’re vulnerable to exploitation. They turn to self-medication, herbal mixtures, or misinformed spiritual solutions that often worsen their condition.”

    Nigerian healthcare providers lack menopause training

    Despite the growing number of menopausal women worldwide, Nigeria’s healthcare system remains largely unprepared to meet their needs.

    A 2019 study conducted at the University of Ilorin Teaching Hospital found that only 16.3 percent of doctors had received any formal training or updates on menopause or menopausal hormone therapy (mHRT) in the preceding five years.

    Shockingly, 83.7 percent of respondents, drawn from departments such as obstetrics and gynaecology, internal medicine, family medicine, and public health, reported receiving no formal education on menopause management.

    The problem extends beyond general physicians. A 2009 national survey of Nigerian gynaecologists revealed that only 7.9 percent had ever prescribed hormone replacement therapy (HRT) for patients with severe menopausal symptoms. The low usage of HRT, a standard treatment in many developed countries, underscores a broader gap in knowledge and confidence among specialists themselves.

    Global data from the World Health Organization (WHO) further supports this concern, noting that menopause “receives limited attention in the training curricula for many healthcare workers,” particularly in developing countries.

    There is currently no nationwide curriculum requirement or Continuing Medical Education (CME) standard that mandates training in menopause care for doctors or nurses.

    Menopause myths

    These misconceptions often stem from cultural beliefs, lack of education, and limited access to accurate health information.

    For Dosunmu, one of the myths, which is shocking to her, is the belief that having intercourse with a menopausal woman causes infection in men. “That is completely false, but unfortunately, it’s still believed in some religious circles. The truth is, due to lower estrogen, there’s reduced vaginal lubrication and thinner vaginal walls, which can cause discomfort or infections related to poor hygiene, not because the woman is ‘contaminated.’

    One of the most harmful myths, Dosunmu said, is the idea that menopause marks the end of a woman’s value. “People assume that once a woman can no longer have children, she becomes irrelevant. This is not only wrong but deeply unfair. Women still have dreams, strength, and purpose after menopause.”

    Another common misconception, according to Dosunmu, is that menopause only affects older women. “Many Nigerians think it only starts at 50 or beyond, but I started experiencing symptoms in my early 40s. Some women begin even earlier due to genetics or medical procedures like chemotherapy. This myth leads to misdiagnosis and silence.”

    She also addressed the widespread belief that menopausal women completely lose interest in sex. “It’s not that women suddenly stop wanting intimacy. The drop in estrogen can affect libido and cause discomfort, yes, but with proper care and understanding, intimacy can still be fulfilling.”

    Dosunmu emphasised that cultural silence makes the transition worse for many women. “In many homes, menopause is a taboo subject. No one wants to talk about it, and so women suffer in silence. They don’t seek help because they think what they’re going through is either spiritual or shameful.

    “There’s a severe lack of understanding and dangerous misconceptions about menopause in Nigeria. For instance, when I started talking about it publicly, a man from the UK called me, shocked that men also experience hormonal changes, what’s known as andropause.” She said.

    Menopause stigma

    Dosunmu noted that menopause is often viewed through a lens of stigma and misunderstanding, which deeply affects how women cope with this natural life stage.

    She said that many perceive menopause as a sign of aging that marks the loss of femininity, fertility, and attractiveness, leading some women to feel diminished in their identity and self-worth.

    “Menopause is not just a biological change; for many women, it comes with an emotional burden because society wrongly associates it with loss. This perception can make women feel less valued or invisible,”

    Adding to this challenge is the culture of silence surrounding menopause, discussions about it are rare within families and communities. Dosunmu emphasized that this lack of open conversation fosters ignorance and misinformation about the symptoms and management options available to women.

    “Because menopause is rarely talked about openly, many women don’t understand what’s happening to their bodies or how to seek help. This silence only deepens confusion and fear,” Dosunmu explained.

    Moreover, menopausal symptoms such as mood swings, forgetfulness, and irritability are frequently misinterpreted as signs of illness or mental instability. This results in unfair labeling of women as “crazy” or “unwell,” which only increases their social isolation.

    “Women experiencing normal symptoms of menopause are sometimes wrongly seen as mentally unstable, which is deeply unfair and harmful,” Dosunmu emphasized.

    This stigma is further compounded when women face blame or judgment in their relationships for emotional or physical changes associated with menopause. They are often unfairly characterized as difficult, which adds to the burden of stigma.

    Dr. Ike urges women hesitant to seek menopause treatment due to societal stigma or misconceptions to understand that menopause is a natural and normal stage of life, not a disease.

    He emphasizes that every woman’s experience is unique, with some facing mild or no symptoms while others experience more intense challenges.

    “Menopause can be a liberating phase, free from menstrual cycles and their associated difficulties,” Dr. Ike said. He advises women to find knowledgeable and empathetic healthcare providers who can offer proper guidance and support.

    Dr. Ike also highlights the importance of connecting with other women experiencing menopause to gain emotional support and empowerment.

    “Society recognizes that menopause is a universal phase for women, and there should be no shame or stigma attached,” he added. Early medical consultation, he notes, enables women to manage symptoms effectively and enjoy this new phase of life with greater comfort and freedom.

    For Dosunmu, “Menopause is not an illness, but a natural transition. Every woman should understand her body, so she can take care of herself and strengthen her relationships.”

    Menopause care

    To manage menopause symptoms and improve well-being, Dosunmu stressed the importance of lifestyle changes, especially regular exercise, a healthy diet, and proper hydration.

    “Menopause isn’t just about hormones; it’s about the whole body,” she said. “Simple things like regular physical activity, eating the right foods, and drinking enough water can make a huge difference in reducing symptoms like mood swings, hot flashes, and insomnia.”

    She explained that regular exercise helps regulate mood and improves sleep, while a balanced diet rich in vegetables, fruits, whole grains, and calcium supports hormonal balance and bone health. Staying hydrated, she added, helps manage hot flashes and fatigue.

    “Many women don’t realize how much control they can have over their symptoms by making small, consistent changes in their daily routine,” Dosunmu noted. “Supplement medication is helpful, but lifestyle plays a powerful role too.”

    A practising pharmacist in Atlanta, Georgia in the United States of America, Dr. Christian Ike, advises avoiding known triggers such as alcohol, caffeine, and spicy foods, which can worsen symptoms like hot flashes.

    Ike notes that some women turn to supplements like soy isoflavones, flaxseed, St. John’s Wort, vitamin E, and evening primrose oil to alleviate symptoms, but stresses that these are not FDA-approved specifically for menopause treatment.

    He stresses the importance of maintaining bone and heart health through adequate calcium intake (about 1200 mg daily) from sources such as dairy products and leafy greens, sufficient vitamin D (600–800 IU daily), balanced protein and fruit consumption, reducing sodium, alcohol, and fatty foods, regular physical activity and smoking cessation and routine medical check-ups to monitor overall health

    Pharmacist Ike outlines the available medication options for symptom relief, including non-hormonal treatments such as low-dose antidepressants like selective serotonin reuptake inhibitors (SSRIs) and neurokinin 3 receptor antagonists, which help regulate body temperature and mood.

    Additionally, over-the-counter remedies like melatonin may assist with sleep difficulties.

    Another treatment option he highlighted is Hormone Therapy (HT), which effectively replaces declining estrogen and progesterone levels.

    “Hormone therapy can relieve hot flashes, reduce vaginal dryness, and help prevent bone loss. HT is available in multiple forms, including pills, patches, creams, and gels.

    While hormone therapy is beneficial, Ike cautions about potential risks.

    “HT is associated with an increased risk of heart attack, stroke, blood clots, breast cancer, gallbladder disease, and dementia,” he warns.

    He advises women to consult their healthcare providers before starting treatment, especially those with a history of cardiovascular disease or women who still have their uterus, as they may require a combination of estrogen and progesterone to protect uterine health.

    Pharmacist Ike encourages women to be proactive about their menopause care. “Menopause is a natural transition and with the right knowledge and care, women can navigate it with minimal discomfort and maintain a healthy, fulfilling life.”

    Global govt support for menopause awareness, care

    Governments in many countries now see menopause as an important health and women’s rights issue. They are creating rules, education programs, and support services to help women going through this stage of life. These efforts, like better healthcare and support at work, show that more attention is being given to reducing the shame and health problems linked to menopause.

    The United Kingdom has taken a leading role by launching a Menopause Taskforce aimed at improving care pathways and reducing societal stigma. Their National Health Service (NHS) offers standardized guidance on menopause, and workplaces are encouraged to adopt policies that support menopausal women. Parliament is also debating ways to make hormone replacement therapy (HRT) more accessible and affordable.

    Australia’s Department of Health has integrated menopause awareness into its Women’s Health Strategy, offering national resources and public health campaigns. The country also boasts specialist menopause clinics and encourages employers to adopt supportive workplace guidelines.

    Health Canada invests in education and research around menopause, including funding studies on midlife women’s health. The Society of Obstetricians and Gynaecologists of Canada (SOGC) plays a key role in training healthcare professionals and developing resource materials for both providers and the public.

    Across Europe, menopause care is commonly embedded within their universal healthcare systems. The European Menopause and Andropause Society (EMAS) leads efforts in professional education, research, and policy development, ensuring best practices are shared across EU member states.

    Although the U.S. lacks a centralized menopause policy, federal agencies such as the National Institute on Aging (NIA) and the Office on Women’s Health (OWH) provide extensive, research-backed educational resources. Menopause is also gaining attention in national conversations around workplace rights, insurance coverage, and women’s long-term health.

    Collective responsibility for government, women, and healthcare personnel

    Taking care of women going through menopause should be something everyone helps with, but the government should take the lead. Menopause is part of women’s health and should be included in health plans and programs.

    Women need to pay attention to their bodies, talk about what they’re feeling, and ask for help when needed. But the government must make sure support is available. This means teaching the public about menopause, training doctors and nurses to help women better, and making sure women, especially those in villages or poor areas, can get care.

    Menopause shouldn’t be something women suffer through in silence. If the government makes clear plans and supports local health centers, then talking about and treating menopause can become normal. This will help women feel stronger, live healthier lives, and show that the country cares about all its people.

    According to Dosunmu, her mother’s experience with menopause, and her own confusion due to lack of information, led her to start the Menopause Support Initiative and a radio show called “Menopause Unveiled with Mosunmola” to educate women and guide them toward proper care.

    “Seventy-five percent of Nigerian women, and even men, don’t understand what’s happening when the body starts to change,” she said. “Even many medical professionals miss the signs of perimenopause, the early stage of menopause. My journey into advocacy began with my own experience.”

    For Dosunmu, better education, healthcare access, and a shift in cultural attitudes are crucial to empowering women through this stage of life. “We need to educate both men and women, support women in the workplace, and ensure healthcare providers are trained to offer compassionate care. Imagine if 75% of businesswomen are dealing with this silently, the economic impact alone is immense,” she said. “With the right knowledge, menopause doesn’t have to be a time of isolation and fear, it can be a time of strength.”

    For women in rural communities, however, the situation is even more dire. Limited access to healthcare and economic hardship often leave them suffering in silence. “Some don’t even know what menopause is,” Dosunmu noted. “They mistake it for a spiritual attack or a strange illness. It is very important that they get educated on menopause.”

    Dr. Olufemi also stressed the role of family and community support. “This is a stage in life that requires understanding, not judgment,” he said. “We must make it easier for women to seek help without shame.”

    Marriage counselor, Pastor Reginald Nwabinwe emphasized the importance of male support during menopause.

    “Many husbands don’t truly understand what their wives are experiencing,” he said. “If they were more aware of the symptoms and challenges, they’d offer support rather than pulling away.”

    Despite the importance of these interventions, there remains a gap in national policy. While the National Reproductive Health Policy approved in 2010 addresses sexual and reproductive health, it lacks any specific focus on menopause.

    In the absence of strong government initiatives, NGOs like Marie Stopes International and Menopause Support Initiative have stepped in. However, their reach remains limited, especially in rural areas where awareness is lowest.

    Berry, now 58, has since become a vocal advocate for menopause awareness, education, and research. Standing outside the U.S. Capitol in May last year, she boldly declared,

    “I’m in menopause,” urging other women to speak out and normalize the experience.

    “It’s a normal stage of life. It’s what we’re going through. It’s not a disease. Don’t make it a negative,” she said. “Let’s talk about it, and let’s figure out what we can do.”

    Berry’s call for women to be “fearless” about menopause helps amplify the urgent need for open dialogue and better-informed healthcare systems.

    “When I found out that I was in perimenopause and that none of my doctors had even mentioned this time of life to me, it just got me on fire to get all the information I could about myself, for myself. I realized if I knew so little [about menopause], I’m sure so many other women have the same little information,” she said.

    “Women need more support, we need more therapies, and we need to be studied. More doctors need to understand it. I realized the menopausal body is only a chapter in medical school for doctors. I mean, how can they help us when they know nothing about it? It’s not been made important, and it’s just time for that to change. It really has become my life’s mission.”

  • What to do when you approach Menopause

    As women age stylishly, it is important that they understand the telltale signs and symptoms of menopause and learn how to cope with them. In this interview with Omolara Akintoye, a Consultant Obstetrician/ Gynaecologist and a Chief Research Fellow at the Nigerian Institute of Medical Research, Dr. Gregory Ohihoin, speaks on the challenges women encounter at this period and how to overcome them.

    HAT are the challenges women encounter as they approach menopause?

    When women get to this age they begin to have challenges in every areas of their lives. Generally, mid life is a period women get to and they begin to complain about their jobs, their marriages, children, and virtually everything. This is an indication that they are getting to midlife. Quite often, they even find it difficult to attend old girls association. During this period, they begin to develop change of lifestyle, men and women dye their hair, some even decide to shave their hair. At this period, men and women go the extra mile to look more beautiful and handsome, to do more cosmetics the better for you. But as people do this they should bear in mind that they must adopt a positive attitude to aging. If you desire long life you must definitely age, but it is better for you to age gracefully.

    Menopause is beyond cessation of menstruation. I could remember one of my patients who was about 48 years old, who used to take anti malaria fever every month. She said she normally has fever every month and whenever she goes to the hospital she is treated for malaria. I would tell her that it is not normal. When I took her history and decided to examine her, I realised that she was moving towards the period of menopause. So, for women, when you feel feverish regularly as you move closer to midlife, there is the likelihood that you are moving towards climacteric: this is a period of transition before you get to menopause. As you get to that age, you must bear this in mind: Use light clothing to sleep because at this period you sweat a lot, hence your air conditioner or your fan must be on. If there is no PHCN to support you, then get a generator. Another aspect of the menopause of the woman that this is being affected is her  sexual life. The sexual interest and sexual frequency for every woman decreases due to a drop in the level of estrogens. The woman may have reduced interest in sexual intercourse. At this period, the man begins to complain of his woman’s lack of interest in sex; it is not her fault, it is due to the menopause that makes her lose interest. At this time, a woman’s sex life is associated with lots of pain and soreness rather than normal sensation.  The solutions: The woman can take some drug-assisted hormones referred to as hormone replacement therapy that will help in her urge for sexual intercourse, but this should not be encouraged as it is associated with so many malignancies. The drug it not a kind of medication that woman should purchase over the counter, except of cause if she has had her uterus removed. Even at that, her continual intake of this drug can lead to other complications as well as breast cancer.

    Another challenge at this period is the woman’s inability to control urine. Unlike in the past that she can keep her urine for hours, but as she gets to this age, it is no longer possible. Also when she is involved in things such as laughter or other kind of excitement, she can pass little quantity of urine. This is due to the woman’s inability to practice what is referred to as Kigel Exercise. Early in life, before you get to menopause, when you are passing urine, you stop for a second, hold the urine back, then you continue. When this exercise continues over a period of time the pelvic muscles will become reinforced and reduce your risk of having this disease later on in life.

    At this time, a woman is not expected to keep late nights, rather she needs to manage her sleep hygiene well and ensure she gets adequate sleep.

    Also women who go into menopause before the age of 40 are said to experience what is referred to as ‘Early Menopause’, that is an abnormality and should be investigated. I want to state categorically that during the menopausal transition stage, which is the period of 40-52 years, a woman can still get pregnant. So, if you know that you don’t want to get pregnant, then go for family planning techniques and contraception.

    What are the things women can do to age gracefully?

    There are two key things that people need to do at this period: Take your exercise seriously and dietary adjustment. If you are used to consuming a lot of carbohydrate in the past, you need to readjust that. One sure thing that will happen to women as they get to age 50 is menopause.

    Though frequent exercises haven’t been proved as a means of reducing menopausal symptoms, they can ease the transition by helping to relieve stress and enhance your overall quality of life. Regular exercise is also an excellent way to stave off weight gain and loss of muscle mass, which are two frequent symptoms of menopause. Most healthy women should aim for at least 150 minutes of moderate aerobic activity, or 75 minutes of vigorous aerobic activity a week.

    Women younger than 65 should spend at least 150 minutes a week on moderate-intensity aerobic exercises, like walking. Do strength training at least twice a week, making sure to rest or at least one day between these sessions. She can undergo balance and stability exercises for five minutes every day, along with one to three minutes of stretching twice a day. If she choose to include yoga and meditation in your exercise regimen, do them on an as-desired basis.

  • ‘Coping with menopause’

    First question is answered by fertility, sex and relationship counsellor, Mrs Tola Ajayi; and the second by a monk of St. Benedict Monastery, Ewu/ Founder, Pax Herbal Clinic and Research Laboratories, Rev. Father Anselm Adodo.

    Menopause is defined as  when menstrual cycles  cease due to the depletion of eggs from aging. It is said that a woman has reached menopause after she has missed menses for 12 consecutive months. It marks the end of fertility and the average age of menopause is 51 years.

    The loss of oestrogen and testosterone following menopause can lead to changes in a woman’s body and sexual drive. Menopausal and postmenopausal women may notice that they’re not as easily aroused, and they may be less sensitive to touching and stroking. That can lead to less interest in sex.

    Sex drive decreases gradually with age in both men and women, but women are two to three times more likely to be affected by a decline in sex drive as they age.

    Reduced sex drive becomes much more common in women starting in their late 40s and 50s. The effect of age also differs by individual: some women experience a big decrease in sexual desire beginning in their midlife years, others notice no change, and a few report an increased interest in sex at midlife. Those women whose desire increases may feel liberated by their new freedom from contraception or by newly found privacy if their children have recently left home.

    Also, lower levels of oestrogen can cause a drop in blood supply to the vagina. That can affect vaginal lubrication, causing the vagina to be too dry for comfortable sex.

     

    Tips that can help

     

    Communication is very important at this stage. Talking with your partner about your concerns can strengthen your relationship. Getting older and chronic health problems like heart disease or diabetes can affect your sexual health and how you feel about sex. What feels good and what doesn’t. Times that you may feel more relaxed. Which positions are more comfortable? Whether you need more time to get aroused than before? Concerns you have about the way your appearance may be changing. Ways to enjoy physical connection other than vaginal intercourse, such as oral sex or massage

     

    To improve your sexual life at menopause

     

    Be active. Physical activity can boost your energy levels, lift your mood, and improve your body image. All of these can help increase your interest in sex.

    Don’t smoke. Cigarette smoking can reduce blood flow to the vagina and lower the effects of estrogen. This can make it more difficult to get aroused.

    Avoid drugs and alcohol. They can slow down how your body responds.

    Have sex more often. If you choose to have sex, it can increase blood flow to your vagina and help keep tissues healthy.

    Allow time to become aroused during sex. Moisture from being aroused makes sex more comfortable.

    Practise pelvic floor exercises. These can increase blood flow to the vagina and strengthen the muscles involved in orgasm.  Talk more about sex with your spouse

     

    Conclusion

     

    Sex at menopause can be fun. Whether it’s where you do it, how you do it, when you do it, what you wear, or what sex toys you use. This is because the change is really important. Sex is supposed to be fun, so it helps to approach it with an attitude of playfulness.

  • Do men attain menopause too?

    Penultimate Thursday, I was opportune to attend a religious retreat on the outskirts of the city where I reside with a group of amazing women. Quite an expository event, I must say. In attendance were management staff of various corporate bodies and proprietors of top schools and owners of privately owned businesses. It was a gathering of great women, great minds.

    Day one of the event was more of registration and introduction. On Day 2 of the retreat, most of us, both introverts and extroverts, were beginning to warm up to one another. Well, we had to. We all slept in a very big, fine hostel of a school. We ate and had our baths together.

    A very interesting conversation came up on the eve of Day 3. In the middle of the very interesting conversation, a particular topic drew my interest. A lady started marketing some food supplements. She talked about enhancers; stuff that men could take to boost their libido and further boost their immune system. She further talked about how a particular food supplement could make a man last longer in bed.

    In the middle of her presentation, she dropped what I would later describe as a bomb: “Men also experience menopause.”Seriously? My jaw dropped. Call me ignorant but at that level, I’m totally lost. Believe it or not, I was hearing it for the first time in my life.

    When I recovered from my initial shock, I burst into a hysterical laughter, because I thought to myself that she must be joking. When I was able to pull myself together, I realised that the woman was far from jokes. I was able to deduce that from the stern look on her face. In fact, she stared at me and almost became offended that I had laughed at all.

    Thereafter, I nudged her to continue this very interesting topic. Interesting because I have had the privilege of interacting with some men and it had never come up. Never. Not in my own world, at least. She went on to talk about the male menopause and how it affects men. She talked about the causes, symptoms and possible way out. All my life, I grew up thinking that menopause is strictly for women. Little did I know…

    As soon as I got home from the retreat, trust me, I went surfing. Below are my findings: Male menopause is the more common terms for andropause. It describes age related issues in male hormonal levels.

    The same group of symptoms is also known as testosterone deficiency, androgen deficiency and late on set hypogonadism … (please bear with me; I will soon continue in English)

    If you are a man, testosterone is a hormone produced in your testes. It does more than fuel your sex drive. It also fuel changes during puberty. It fuels your mental and physical energy. It maintains your your muscle mass, regulates your fight to flight response and regulates other key evolutionary features.

    Good news

    Male menopause differs from female menopause in several ways. For one thing, not all men experience it. For another, it doesn’t involve a complete shutdown of your reproductive organs. However, sexual complications may arise as a result of lowered hormone levels.

    Signs of Male menopause

    Male Menopause can cause physical, sexual and psychological problems. They typically worsen as one gets older.

    They can include:

    .Low Energy.

    .Depression or sadness

    .Decreased Motivation

    .Lowered self confidence

    .Difficulty concentrating

    .Insomnia or difficulty in sleeping

    .Increased body fat

    .Reduced muscle mass and feelings of physical weakness

    .Gynecomastia or development if breast.

    .Decreased bone density

    .Erectile dysfunction

    .Reduced libido

    .Infertility

    .Decreased testicle size.

    Suggested ways out

    It has been reported that living a healthy lifestyle can get one out with the above. You are encouraged to:

    Eat healthy diet.

    Get regular exercise

    Get enough sleep

    Reduce your stress.

    Compared to women, men can still avoid or prevent menopause by contacting a medical practitioner when they sense some changes in their hormones. On a lighter mode, do not worry, you are not all going to enter menopause. Leave that part for us (lol).

  • How menopause can affect digestion

    Constipation is common in menopause. It is typically defined as being unable to have more than three complete bowel movements within a week. Constipation is considered chronic if it lasts for three months or longer.

    When you are constipated, it can be difficult to completely void your bowels. You may feel the need for extra support to remove stool. Other symptoms of constipation include straining to void and having stools that are hard, small, and lumpy. You may be uncomfortable or have an overall sluggish feeling.

    Occasional constipation is not unusual and has a wide range of causes in addition to menopause. You can even have multiple causes simultaneously.

    What’s the link?

     

    Menopause happens when your menstrual cycles have ended for at least a year. It’s earmarked by a drop in female hormones such as estrogen and progesterone. These hormones affect many areas of the body, including the digestive tract. As a result of this hormone drop, some postmenopausal women experience constipation. However, changes in bowel routine can begin even before menopause, during perimenopause.

    Estrogen is responsible for many things including keeping cortisol levels low. Cortisol is a hormone associated with stress. When estrogen declines, cortisol levels rise. This can slow down the digestive process, lengthening the amount of time it takes for food to break down. This can make stool more difficult to pass.

    Too little progesterone can cause your colon to slow down. The longer food waste remains in your colon, the dryer it gets. Stool also tends to be dryer when estrogen and progesterone levels are low.

    Some postmenopausal women also have weakened pelvic floor muscles. This can make it difficult to eliminate stool, especially when it is hard and dry.

    As women age, they may also need medications which have constipation listed as a possible complication. These medications include:

    • some blood pressure medications
    • iron supplements
    • thyroid medication
    • antidepressants
    • calcium channel blockers
  • Menopause: eight in10 women get mood swings, says expert

    A Consultant Gynecologist and Obstetrician at the University College Hospital (UCH), Ibadan, Oyo State, Dr Buki Adewole, has said eight out of 10 women suffer sudden mood swings at menopause.
    Adewole told the News Agency of Nigeria (NAN) on Sunday that the mood swings and menopausal hot flashes were common to all women particularly from ages 40 and above.
    Experts including Longman Dictionary of Contemporary English define mood swings as extreme or abrupt fluctuations in emotional state; it can also be a sign of mental illness precedent to the end of menstrual cycle in women.
    Wikipedia states that mood swing is an extreme or rapid change in mood. Such mood swings can play a positive part in promoting problem solving and in producing flexible forward planning. However, when mood swings are so strong that they are disruptive, they may be the main part of a bipolar disorder.
    Dr Adewole said: “The mood swings are of one the most common symptoms of menopause which could be very frustrating for women. Menopausal age varies from women to women, but it generally starts between ages 40 to 55 in women and that it is at this period that the fertility of the woman diminishes.
    “During mood swings women often experience drastic shifts in emotional state and exhibit inappropriate emotional reaction.
    “Fortunately, it is widely known that mood swings are caused by fluctuating estrogen and progesterone levels as soon the woman enters the pre-menopausal age.
    “Mood swings during menopause are caused largely by the hormonal transitions women go through during this time.
    “Hormones, such as estrogen, influence the production of serotonin, which is a mood-regulating neurotransmitter.
    “Mood swings can leave a woman laughing hysterically one moment and weeping the next moment and understanding why they occur is the key to getting solutions.”
    The gynecologist, who described it as troublesome and traumatic, however, pointed out that the experience differs among women.
    Adewole said the condition was usually worsened by stress and anxiety and that in order to mitigate the effects of mood swings it was better for women to avoid putting themselves under stress and anxiety.
    “Of course, medications to regulate the hormonal imbalance are also one of the ways to treat mood swings. I will advise spouses and children to understand this stage in a woman’s life so that she can be helped to lessen the discomfort,” she said.

  • ‘Menopause: Eight in10 women get mood swings’

    Consultant gynaecologist and obstetrician at the University College Hospital (UCH), Ibadan, Oyo State, Dr. Buki Adewole, has said eight of 10 women suffer sudden mood swings at menopause.

    She told News Agency of Nigeria (NAN) yesterday the mood swings and menopausal hot flashes were common to women, particularly from ages 40 and above.

    Experts, including Longman Dictionary of Contemporary English, define mood swings as extreme or abrupt fluctuations in emotional state; it can also be a sign of mental illness precedent to the end of menstrual cycle.

    Wikipedia said mood swing is an extreme or rapid change in mood. Such mood swings can play a positive part in promoting problem solving and in producing flexible forward planning. However, when mood swings are so strong that they are disruptive, they may be the main part of a bipolar disorder.

    “The mood swings are one of the most common symptoms of menopause, which can be very frustrating for women.

    “Menopausal age varies from women to women, but it generally starts between ages 40 to 55. It is at this period that the fertility of the woman diminishes.

    “During mood swings, women often experience drastic shifts in emotional state and exhibit inappropriate emotional reaction.

    “Fortunately, it is widely known that mood swings are caused by fluctuating estrogen and progesterone levels as soon as the woman enters the pre-menopausal age,” Adewole said.

  • Menopause: Why women swing from laughing to weeping

    Menopause: Why women swing from laughing to weeping

    Dr Buki Adewole, a Consultant Gynecologist and Obstetrician at the University College Hospital (UCH), Ibadan, says eight out of 10 women suffer sudden mood swings at menopause.

    Adewole told the News Agency of Nigeria (NAN) on Sunday that the mood swings and menopausal hot flashes were common to all women particularly from ages 40 and above.

    Experts including Longman Dictionary of Contemporary English define mood swings as extreme or abrupt fluctuations in emotional state; it can also be a sign of mental illness precedent to the end of menstrual cycle in women.

    Wikipedia states that mood swing is an extreme or rapid change in mood. Such mood swings can play a positive part in promoting problem solving and in producing flexible forward planning. However, when mood swings are so strong that they are disruptive, they may be the main part of a bipolar disorder.

    “The mood swings are of one the most common symptoms of menopause which could be very frustrating for women.

    “Menopausal age varies from women to women, but it generally starts between ages 40 to 55 in women and that it is at this period that the fertility of the woman diminishes.

    “During mood swings women often experience drastic shifts in emotional state and exhibit inappropriate emotional reaction.

    “Fortunately, it is widely known that mood swings are caused by fluctuating estrogen and progesterone levels as soon the woman enters the pre-menopausal age,” Adewole told NAN.

    She added:“Mood swings during menopause are caused largely by the hormonal transitions women go through during this time.

    “Hormones, such as estrogen, influence the production of serotonin, which is a mood-regulating neurotransmitter.

    “Mood swings can leave a woman laughing hysterically one moment and weeping the next moment and understanding why they occur is the key to getting solutions.”

    The gynecologist, who described it as troublesome and traumatic, however, pointed out that the experience differ among women.

    Adewole said the condition was usually worsened by stress and anxiety and that in order to mitigate the effects of mood swings it was better for women to avoid putting themselves under stress and anxiety.

    “Of course, medications to regulate the hormonal imbalance are also one of the ways to treat mood swings.

    “I will advise spouses and children to understand this stage in a woman’s life so that she can be helped to lessen the discomfort,” she said. (NAN)

  • Smoking hastens menopause, says medical practitioner

    An Ilorin-based medical doctor, Dr Tajudeen Olawepo, has said that cigarette smoking hastens the commencement of menopause in women.

    of Safe Kids Hospital, Ilorin,

    He told the News Agency of Nigeria (NAN) in Ilorin on Friday that studies had shown that smoking hastened menopause by approximately one to two years, regardless of race or genetic background.

    He said that in the case of heavy smokers, this could be up to nine years earlier than for average women with certain genetic variations.

    He added that menopause occurred when the female reproductive organs, the ovaries, stopped producing the hormones estrogen and progesterone.

    Olawepo explained that the symptoms of menopause include hot flashes, night sweats, depression, forgetfulness, vaginal dryness, pain during intercourse.

    Menopause was recognised when a woman had not had a monthly period for 12 months, as long as there was no other reason, he added.

    He said menopause happened between the ages of 45 and 55.

    He noted that “it is not always easy to confirm that menopause has actually happened , of course, irregular periods and occasional hot flash is a sign that changes are taking place, but timing the actual menopause is not so simple.

    “And it’s important to know, not just preventing symptoms in the most appropriate way, but also for contraception.

    “However, most doctors advise menopausal women under 50 to continue with their contraception for two years after their last period and for one year if they are over 50.’’

    Menopause is the time in a woman’s life when her period stops. It usually occurs naturally,
    often after age 45.  (NAN)

  • Menopause in women/men: Solutions to the disquiet of middle age (4)

    This article will deal with treatment of menopause in women and tough upon male “menopause”.

    The main symptom of menopause in women is hot flushes (see earlier articles). This symptom of hot flushes can be corrected with the hormone that is so deficient in women at their mid-ages. Doctors, based upon clinical assessment, may prescribe hormone replacement therapy (HRT), which comes indifferent formulations. Some can be taken by mouth as a daily pill similar to contraceptive pill. A note of warning is warranted here.

    HRT is not a contraception or an anti-pregnancy pill. Women should still take precaution so as not to get pregnant. Please note that this statement does not mean that a woman’s fertility has returned with us of HRT. It’s not so. HRT can also be taken as a patch or vagina cream.

    While on HRT, women that have not had hysterectomy (removal of the womb), may resume having regular menstrual periods. Again, this is not an indication that fertility has been restored. The menstrual period is just the consequence of the way the HRT works. HRT may be continued for up to five years.

    HRT is not without risk. Anyone with the history of breast cancer, blood clotting, severe liver disease, undiagnosed vaginal bleeding and pregnancy should not take HRT. The HRT here is a combined hormones of estrogen and progesterone.

    For women who have had their womb removed, they may use a different form of HRT: estrogen. In all, because of the risks, women intending on using HRT should consult their doctor for guidance before commencing usage.

    Vaginal dryness leading to difficult sex may be relieved with either a lubricating cream, such as KY jelly or estrogen cream. Urinary symptoms may also be relieved by HRT. Low sexual drive that is not helped by HRT may respond to male hormone testosterone.

    Risk of bone fractures, which occurs in one in 20 women undergoing menopause, can also benefit from HRT or a non-hormone treatment. However, good nutrition rich in vitamins, vitamin D and calcium, cautiously taken, may reduce fractures.

    For those that HRT is not suitable for, there are alternatives. If mental health deteriorates during perimenopuase and menopause,  doctors will take appropriate measures to solve the problem. The woman should receive counselling and education of the changes in her body. This is cheaper.

    The key issue is not to deny one’s suffering nor refuse to see a doctor. Distress and disquiet brought about by perimenopause or menopause is not just a “woman’s thing” and neither should women suffer in silence!

     

    ‘Menopause’ in men

    True, men do not have menstrual periods. Therefore, the term ‘male menopause’ is controversial. The claim of male menopause is still been researched on.

    Yet, there are some features in men who are in their mid-ages, which lead to the suspicion that they may also be experiencing what women do. These include: tiredness, weakness, depression and sexual problems, such as loss of libido, erectile dysfunction; impotence or ejaculatory problems – called mid-life crises which may come with career changes.

    Essentially, it has been observed that in their mid-ages, men do have low testosterone and, like women, a boost in their hormone levels may actually improve these symptoms.

    Notably, unlike in women, who may experience failure in their ovaries to produce follicles and estrogen, men’s testes do not stop producing sperms and testosterone. Rather, men may continue to produce sperms well into their late 80s, though subtle changes do occur in the testes in some men who are 50.

    Men experiencing fatigue, depression, erectile dysfunction, low sex drive should, therefore, seek medical help. Investigations in the laboratory may not yield much as the changes in men are not as dramatic as in women. The doctor may, nonetheless, undertake an examination to exclude any faults.

     

    Treatment

    While controversial is not without its benefits, what I call male HRT may also help. This may  consist of giving a measure of testosterone. It should be noted that giving artificial testosterone carries its risk; therefore caution should be exercised.

    In summary, women experience menopause and I will urge those suffering from fluctuations in their hormone levels from 40 in some and 45 – 52 years in others should seek help and not be subdued by cultural considerations. Discomfort and disquiet should not be accepted. Similar advice is applicable to men.