It was a time when my work involved long, intellectually and emotionally demanding days. I was distracted by tasks and conversations that required my full attention, but eventually acknowledged the episodes of headaches, anxiety and irritating lapses in concentration. Like an epiphany, the word “menopause” flashed across my mind. A panicked Google search confirmed the high prospects of my candidacy.
I asked myself how it was possible for a modern, well-educated woman to be so uninformed about a certainty with potential to significantly affect my life. That question compelled me to create platforms for candid conversations about menopause in pursuit of a future where African women receive the information and support they deserve.
Calling attention to the implications of menopause carries the risk of fuelling the counter-narrative of debilitated, temperamental women past their sell-by date. In fact, on a few occasions I have been asked, by women, why I would risk my standing as a respected professional by publicly addressing such a private and embarrassing issue.
I nevertheless accepted that risk and recorded the Pause for Menopause podcast. My conviction was that women can be vulnerable and powerful at the same time. Demanding consideration as we deal with menopause symptoms does not, in any way, diminish our contribution at home and at work. What I had intended as a one-off podcast is now anticipating its fifth series, in response to demand from women across Africa.
Negative cultural beliefs about menopause drive the public stigma around it. Women affected are deemed unattractive, incapable, even problematic, while women who are not in menopause are seen as capable and valuable. This false distinction sustains stigma, isolating and marginalising women. Countering this requires a relentless, multi-pronged effort to reposition menopause as a normal developmental stage.
Unfortunately, sub-Saharan Africa, the region of my life experience, is relatively untouched by the awakening to menopause currently sweeping western countries. Low levels of development, competing needs confronting governments and lower investment in research are a few of the gaps responsible for poor awareness.
As recently as 2022, the predominant response by women interviewed as part of a study in Zimbabwe and South Africa was that they had not received or accessed much information about menopause and that they thought the physical and psychological issues associated with it had to be “endured”. This is worrying because by the late 2020s, 76% of postmenopausal women globally will be living in developing countries, a significant number in sub-Saharan Africa.
However, winds of change are blowing. Emboldened by the brave efforts of women in a few countries where menopause organisations exist, such as South Africa and Uganda, women around the continent are making efforts to normalise menopause in their everyday lives and offer each other support.
In Zimbabwe, Primrose Hove initiated Let’s Talk Menopause, a group that brings together more than 4,000 women and includes support for women affected by menopause and HIV. More than 500 women exercise daily as part of its “meno-fitness” sub-group. My organisation, Menopause Solutions Africa offers workplace training to raise awareness of menopause among managers and support groups for employees.
In Ghana, the politician Abla Dzifa Gomashie has initiated a public conversation about menopause by doing the seemingly unthinkable – bringing the subject to the floor of the national parliament.
In Kenya, a pan-African feminist organisation, Femnet, is pioneering recognition of menopause as part of its female empowerment agenda. In Botswana there are early steps to establish menopause societies.
These hotspots (pun most definitely intended), will undoubtedly become a groundswell of women daring to dream of an Africa which accepts women having hot flushes in public, including boardrooms. I believe these are the beginnings of a menopause revolution in Africa. The revolution embodies actions to challenge societal norms, advocate for policy changes and foster supportive communities.
Platforms such as my podcast are important but much more is needed. Context-specific research is urgently required since it is now well established that black and brown women tend to have more challenging experiences with menopause. We also need more champions to spark conversations in all spaces, and policymakers willing to sponsor laws and allocate resources to address menopause.
It is unacceptable that so many women across Africa find themselves unprepared for the complicated mix of symptoms associated with menopause. Not talking harms women. It is incumbent upon each of us to do what we can to propel Africa through the menopause revolution.
Sue Mbaya is founder and director of Menopause Solutions Africa and host of Pause for Menopause podcast
