Menopause unmasked: What every woman should know

Melody Mutamburi

It was such a beautiful Saturday morning as I walked along the shoreline of Lake Chivero with two of my wonderful girlfriends, the sun bit gently on our faces and the gentle winds from the lake provided a refreshing Saturday morning walk.

Suddenly one of my friends exclaimed that she needed a rest as she felt tired and just feeling overwhelmed. I asked her if everything was ok, she said with a tired voice “its menopause my dear”. I asked her a series of questions to which she could not answer about what menopause entails of. This gave me the desire to bring awareness to as many women as this article can reach!

Menopause is a natural biological process that marks the end of a woman’s reproductive years as articulated by (Barnabei, 2007). However it is also a significant life transition that can have profound effects on the woman’s mental health. It is typically diagnosed after 12 months of amenorrhea (no periods) (Harlow et al, 2012). The stages of menopause include 1. Perimenopause- the transition period leading up to menopause, where hormone level will start to fluctuate and menstrual cycles become irregular 2. Menopause– the point at which a woman hasn’t had a period for 12 consecutive months 3. Post menopause- the stage after menopause, where symptoms may continue but often lessen over time. As a woman navigating the physical and emotional changes associated with menopause, they may experience a range of mental health challenges, from anxiety and depression to mood swings and cognitive impairment. Although women’s experiences are deeply shaped by a range of biological, socio-economic and cultural experiences and circumstances (Nelson, 2008).

Why Menopause Feels Like an Emotional Roller-coaster

1. Hormonal Fluctuations: The decline in estrogen levels during menopause can have a significant impact on a woman’s mental health. Estrogen plays a significant role in regulating mood, and fluctuations in the hormone levels can lead to feelings of anxiety, irritability and depression.
2. Sleep Disturbances: sleep disturbances are very common during menopause, and can exacerbate mental health symptoms. Poor sleep quality can lead to fatigue, mood disturbances and decreased cognitive function.
3. Mood Swings: Mood Swings are a hallmark symptom of menopause and can be intense and unpredictable. One may experience feelings of sadness, anxiety and irritability which might be difficult to manage and challenging
4. Anxiety and Depression: Anxiety and Depression are common mental health concerns during menopause. Woman may experience symptoms such as worry, fear and sadness which can impact daily life and relationships.
5. Cognitive Impairment:  Some women experience cognitive impairment during menopause including difficulties with memory, concentration and decision making

Common symptoms and changes also include hot flashes, irregular menstrual flow and vaginal dryness

“Midlife Shifts”- Unpacking Menopause’s Mindful Impact

The impact of menopause on the mental health of a woman can be significant and can affect various aspects of a woman’s life. Some of the ways in which it affects mental health include:

1. Relationships: Menopause can impact relationships with family and friends particularly if a woman experience mood swings, irritability or withdrawal behavior. In our Zimbabwean context due to lack of knowledge of the condition in the society, such women are deemed as “vanhu vasingagarike navo”. And hence people avoid them in their spaces as they are said to be toxic due to their mood swings and highly irritable behaviors that is a small issue can highly trigger them or upset them. By nature such behaviors are frustrating to family members, friends and even to the spouse especially in cases where people are not aware of the changes and challenges which the women whom they call mother, friend or wife is going through.
2. Work: Menopause can impact work performance, especially if a woman is experiencing cognitive impairment, fatigue or mood disturbances.
3. Self-Esteem: Menopause can affect self-esteem particularly were a woman experiences hair loss or weight gain.Hair loss in our Zimbabwean context is usually attributed or associated to one having HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome). Because of such stigma it most women to lose their confidence and self-esteem.
4. Overall Well-Being: Overall Well-Being if affected were a woman continue to experience persistent mental health symptoms.

Navigating Menopause with Mental Balance

While menopause can be a very challenging time for women’s health, in the Zimbwean setting it is difficult to even start a conversation on menopause as it is deemed shameful. On one of the published paper on 22 March 2022 titled Improving Experiences of the Menopause for women in Zimbabwe and South Africa a Zimbabwean women was quoted during the interview saying it is difficult to talk about menopause because “Zvakafumuka” that is it is not normally accepted to talk about it. Another woman was quoted saying “people are afraid to have intercourse after the menopause because they say all the sperms won’t be washed out after the month….the cycle.  So, you have this “chimimba muteku” (menopausal belly) and people will laugh at you”. A point which was also highlighted was the issue of menopause being attributed to witchcraft, all due to lack of knowledge about the body biological processes. That being said there are many strategies that can help manage symptoms and promote overall well-being. Some of the strategies include:

1. Hormone Replacement Therapy (HRT): this can help alleviate symptoms such as hot flashes and night sweats which can contribute to mental health symptoms.
2. Cognitive Behavioral Therapy (CBT): CBT helps woman to manage symptoms such as anxiety and depression and can promote coping skills and self-esteem.
3. Mindfulness and Relaxation: Mindfulness and Relaxation techniques such as meditation and deep breathing can help reduce stress and promote relaxation.
4. Exercise: Regular exercise can help reduce symptoms of anxiety and depression and can promote overall physical and mental health.
5. Social Support: Social Support from family, friends and support groups can help women feel connected and understood and can promote overall well-being.

Opportunities for Growth and Empowerment

While menopause can negatively impact one’s life and can be a quite challenging time it can also be an opportunity for growth and empowerment. Oprah Winfrey once said “So many women I have talked to see menopause as an ending. But I have discovered it is your moment to reinvent yourself after years of focusing on the needs of everyone else.” The following are some of the ways in which a woman can experience growth and empowerment during menopause period, and these include:

1. Increased Self-Awareness: Menopause can prompt women to reflect on their values, goals and priorities leading to increased self-awareness and personal growth.
2. New Opportunities: Menopause can mark a new chapter in life, providing opportunities for women to pursue new hobbies, interests and relationships.
3. Empowerment: Menopause can be a time of empowerment as women take control of their health and well-being and make informed decisions about their care.

Menopause is a significant life transition that can have a profound effects on a woman’s mental health. While it can be a challenging time there are many strategies that can assist to manage symptoms and promote overall-being. Humor and Reality say that “Menopause is Mother Nature’s way of saying, ‘you are welcome, honey for not having to deal with monthly mood swings and cramps anymore!’ By understanding the mental health challenges of menopause and by promoting opportunities for growth and empowerment women can navigate this transition with confidence and resilience. To this healthcare providers can play a critical role in supporting women’s mental health during menopause. Some recommendations for healthcare providers include:

1. Screening for mental health symptoms for women during menopause and provide referrals to mental health services as needed.
2. Providing education and support: healthcare providers should provide education and support to women about the mental health challenges associated with menopause and promote strategies for managing symptoms
3. Encouraging Self-care: Healthcare providers should encourage women to prioritize self-care including regular exercises, healthy eating and stress management.

For further information and assisted please do visit any of the below healthcare providers

• Parirenyatwa Group of Hospital Mazowe street Harare
• Sally Mugabe Central Hospital Harare
• Chitungwiza General Hospital
• St Anne’s Hospital
• PSMI West End Baines Harare

For more available list of both public and private hospitals and clinics across Zimbabwe please visit On-Mend com site.

Melody Mutamburi is an MSc Neuropsychology student at University of Zimbabwe and an intern at Identity Consultancy, She Writes here on her own capacity.