SPOTLIGHT: Menopausal women want answers, not ‘old granny’ labels

Across South Africa, women are challenging centuries-old silence surrounding menopause and demanding answers, rather than being labeled as "old grannies." In a 2017 study of 450 black women near Pretoria, more than three-quarters had never sought medical help for their symptoms, possibly due to a cultural perception of menopause as a natural, positive process.

Menopause marks the end of a woman's reproductive years, typically occurring between ages 45 and 55 when ovaries cease releasing eggs and estrogen levels fall. Symptoms can range from joint and muscle pain, exhaustion, memory issues, to hot flushes, with up to 72 possible symptoms in total.

South African Menopause Society guidance suggests hormone replacement therapy as the most effective treatment for hot flushes, but the suitability of this treatment depends on each individual's medical history and preferences. Despite this, research indicates that public healthcare clinics in South Africa have limited use of menopause treatments, which many women attribute to their lack of awareness about available options.

Xoli Madlala, who experienced menopause earlier than average, now travels across the country to promote open discussions about menopause, aiming to break down the cultural silence that has previously persisted.

While treatment guidelines for clinics and hospitals include hormone therapy options, including pills and patches, these are often not readily accessible to patients. Public sector doctors occasionally write prescriptions for hormone therapy to allow patients to purchase it at private pharmacies, but private sector shortages persist.

Moreover, dismissing menopause as a mere natural process can lead to underestimating potential health risks associated with this phase of a woman's life, such as bone loss, which may be heightened for women with HIV.