Menopause and menopausal challenges are generally viewed as issues women should address personally, especially in a country like Nigeria, where maternal health only started getting its deserved attention with increased advocacy for women’s health. This explains why many Nigerian women in their fifties are groping in the dark regarding their physical and emotional health due to a lack of information on how to smoothly navigate their new stage of life.
However, aside from the issue of individual management of challenges, members of the society sometimes complain of having unpleasant experiences in their interactions with menopausal women. Thus, to minimise personal frustrations and interpersonal frictions, there is a need for enlightenment on the proper handling of menopausal issues.
Gynaecologists have defined menopause as a permanent cessation of menstruation, resulting from loss of ovarian follicular activity which happens as a result of depletion of primary follicles. A woman can be said to have reached menopause when she has gone one year without menstruating – and especially when this comes with menopausal symptoms like hot flushes, night sweats, irritation, vaginal dryness, etc.
While there abound other symptoms of menopause like sadness, lack of motivation, aggression, stress, difficulty concentrating, and depression, studies have validated the prominence of mental health issues and low sexual drive among other menopausal challenges.
In a study, titled, “Physical activity and mental health outcomes during menopause: A randomised controlled trial” and published in the Annals of Behavioural Medicine journal, the researchers established a link between the increase in menopausal symptoms and decline in mental health and vice versa. They concluded that physical activity appears to enhance mood and menopause-related QOL during menopause; however, other aspects of mental health may be affected only as a result of the reduction in menopausal symptoms.
The researchers – Steriani Elavsky, PhD and Edward McAuley, PhD, submitted that increasing cardiorespiratory fitness could be one way to reduce menopausal symptoms.
Proper management is key
In an exclusive interview with Pharmanews, a menopause specialist, Pharm. (Mrs) Mosunmola Dosunmu, affirmed the symptoms of menopause earlier mentioned. She, however, noted that menopause is not a mental health condition but it can affect the mental health of any woman, if not properly managed.
She asserted that menopausal changes, whether psychological, emotional or physical, are basically due to hormonal changes which can make mental health worse.
Dosunmu, who joyfully narrated her menopausal journey, surprisingly said that while some women experience low sex drive due to decreased sex hormones (oestrogen and testosterone), which also cause dryness of the vaginal, other women experience increase in libido.
“It can lower desire and make it harder to become aroused. There are some exceptional cases where some women actually experience an increase in libido. Not all women go through a libido decrease.
“These decreased hormones can lead to vaginal dryness, and tightness, which can cause pain during sex.
“If you are experiencing a loss of libido, you can try to increase your sex drive with lifestyle changes sex or sex aids, such as lubricants. The use of supplements is also helpful”, she advised.
Ageing directly link to low sexual drive
In the journal, International Association for Relationship Research, relationship experts – Gurit E. Birnbaum, Ohad Cohen, and Vered Wertheimer – also found an association between ageing and sex drive, especially among women of menopausal age. They stated that the “postmenopausal state was negatively associated with sexual desire, mainly among women who experienced low sexual intimacy.”
As a means of mitigating the negative outcomes of menopause, they urge women to engage in more regular exercise or relaxation, which can reduce depression, seek counselling from experts in order to cope with mood swings, as well as explore hormonal therapy if the need arises.
Personal experience
Recounting how she managed her perimenopausal and post-menopausal transition, Dosunmu said she was initially worried at the onset of menopause, which she had been oblivious of until she observed the tell-tale signs in her body. Fortunately, for her, she was able to rouse herself to handle the situation with the right information, and she has presently become a coach to others.
She narrated: “In 2017, my life changed significantly. I was weary, hurting and depressed, and I was no longer interested in things that excited me. I used to take my nine-year-old son out. During one of the outings, my son told me I needed to seek help. And then I realised I was going through depression, as well as gaining weight despite my strict diet: perimenopause had ensued.
“Two years after, one evening, I noticed a big round thing moving in my stomach. I was scared and overwhelmed, and as a typical Nigerian woman, I went to my knees and prayed to God to help me. I thought it was stomach cancer. The fear gripped me so much that I could not speak to anyone. I decided to pray and watch over my system. I changed my diet; throughout that week, I was feeding on fluids and I exercised each day by walking for an hour.
“By the end of that week, my system had changed. The ball-like thing had disappeared. I had lost weight and all fears were gone. Three months after, I realised I couldn’t eat as I used to. Anytime I took heavy food I felt much pain in my stomach. This led me to pay good attention to my system. I realised my system had changed.”
The menopause specialist continued: “A few months after, I woke up with keratinised skin!
“This gave me a deeper thought that I needed to find out what was going on in my system. Then I started a study on what could be responsible for that keratinised skin. I discovered it’s one of the signs of perimenopause. Just last year I started experiencing night sweats, hot flashes, joint pains and inflammation.
“Very few people prepare for this stage of life.
“It has taken me seven good years of systematic change.
“I changed my diet, incorporated meditation and power of confession (speaking to my body) motivational reading, exercise and the use of specific supplements.
“Over time, I became the go-to source for women and men’s issues in my family and social network.”
Dosunmu, who stressed the need for postmenopausal women to be intentional in their behavioural attitude, noted that though there are tendencies to be aggressive, they must endeavour to curtail the suggestions by engaging in recreational activities which have the capacity to relax their nerves and keep them emotionally balanced.
She said “I’m eager to provide training and raise awareness in corporate settings and our communities about menopause.
“With a lot of awareness creation, we can reach as many men and women in our nation, regardless of their financial situation. We all deserve to get through this time of our life so that it isn’t something we dread or fear but rather something thrilling.”
