Changing the Menopause Narrative

Nobody took me seriously at first when I would mention that I was going through premature menopause. I was normally scolded for joking about the subject, or I would be told that I was too young to be going through it. This further proved how ill-informed we are about everything ‘menopause’ - that we always expect it to look a certain way. What is the face of premature menopause supposed to look like? It is me. It can be you. Even your friend. Or colleague. We need to be informed - not just for ourselves, but also for each other. I went through this transition mostly solo, because we are not informed enough, so even those who saw some symptoms were just as clueless. 

I encourage you to pay attention to your bodies - from physical changes to mental, emotional, and even spiritual changes. These changes are normally gradual, they do not all hit overnight. And the severity of each gets worse with time. So, ignoring this and hoping it will go away is prolonging the unnecessary. Besides, early diagnosis means addressing things as early as possible and making the transition better and smoother. You are informed now, so you can do better than me. Unfortunately, with premature and early menopause, one cannot just look at symptoms and self-diagnose. Some symptoms are similar to other conditions, and the overlap means that mistakes can be made if the necessary tests are not done. These tests are there to minimise the chances of misdiagnosis. I know we have become a generation of Dr Google, but that should just serve as a guide. We need to make time for our health and overall wellness.  

There is no shame in premature menopause or menopause in general. It is a fact that some of us will never know what triggered it, but it becomes our reality and we cannot throw pity parties because it has befallen us. Instead, we need to gear up and be prepared to kick butt. Serious butt! Some days are much easier, some days not so much. The key is being in tune with yourself so that you can kick butt when you need to. After diagnosis, life with premature menopause can be doable. It actually has the potential of being much better - it all depends on your mindset. 

So, pledge now that - at the earliest sign - you will not delay but rather attend to yourself. Our health is in our hands, we owe ourselves and our loved ones that much. To take care of our vessels to the best of our abilities. We cannot allow ourselves to suffer because we are too busy, in denial, uninformed, or too lazy to pay a visit to the doctor. 

I hope that - by sharing my journey - you will be better informed about your own health and that of your loved ones, and you will pay better attention to yourself and be better able to support other women in your life. Lastly, make menopause conversations normal. That is the only way we will remove the shame and stigma surrounding this phase of life. 

To those fortunate enough to breeze through menopause, count your blessings. Importantly, be supportive and empathetic to those who do not breeze through it. The same way we encourage women who do not get period pains to be supportive and empathetic to those who do. We need to stand together so that everyone else can support us. Women for each other is what sisterhood is about. 

Premature menopause, also known as premature ovarian insufficiency (POI), refers to the cessation of menstrual periods before the age of 40. This condition affects approximately 1% of women under 40 and 0.1% under 30. The average age for natural menopause is around 51, making premature menopause a significant deviation from the norm. 

Symptoms of Premature Menopause:

• Menstrual Irregularities: Experiencing irregular or missed periods is often one of the earliest signs.
• Vasomotor Symptoms: Hot flashes and night sweats are common due to hormonal fluctuations.
• Vaginal Changes: Dryness, discomfort during intercourse, and increased susceptibility to infections can occur.
• Emotional and Cognitive Symptoms: Mood swings, irritability, anxiety, depression, and difficulties with concentration or memory are frequently reported.
• Physical Changes: Decreased libido, sleep disturbances, and changes in skin elasticity or hair thinning may be observed.

Health Implications:

Women undergoing premature menopause face heightened risks for several health conditions, including osteoporosis, cardiovascular diseases, and neurological issues. These risks underscore the importance of early diagnosis and appropriate management strategies. 

Causes and Risk Factors:

While the exact cause often remains unidentified, several factors can contribute to premature menopause:

• Genetic Predisposition: Family history can play a role.
• Autoimmune Disorders: Conditions where the immune system attacks ovarian tissue.
• Medical Treatments: Chemotherapy, radiation therapy, or surgical removal of the ovaries can induce early menopause.
• Lifestyle Factors: Smoking has been linked to an earlier onset of menopause.

Diagnosis and Management:

Diagnosis typically involves evaluating symptoms, conducting blood tests to measure hormone levels, and ruling out other potential causes for menstrual irregularities. Management strategies may include hormone replacement therapy (HRT) to alleviate symptoms and mitigate long-term health risks, along with lifestyle modifications such as a balanced diet, regular exercise, and mental health support.

Recognising the symptoms of premature menopause is crucial for timely intervention. Women experiencing signs should consult healthcare professionals to manage symptoms effectively and address potential health risks associated with early estrogen deficiency.

Excerpted from The Perimenopausal Globetrotter by Xoli Kamadlala and available at leading book stores and online.