Menopause: the ignored challenge in sexual and reproductive health

Menopause is the permanent cessation of menses, owing to the gradual termination of ovarian follicular function against a backdrop of other age-related and developmental changes. Apart from heralding the transition from the reproductive to non-reproductive stage of a woman’s life, the menopause also presents a stage of new health challenges. In the short-term, the decline in oestrogen can manifest with debilitating symptoms such as hot flushes, night sweats, mood changes (including depression), loss of libido and sexual dysfunction. Long-term effects notably include an increased risk of osteoporosis and cardiovascular disease. Understanding menopause from a biological perspective alone, however, is reductive. Not all women will experience these symptoms and not all that do will be bothered by them. The menopausal experience is not homogenous because it is influenced by the cultural and socio-economic context in which it occurs.

Despite menopause being a universal experience for women, it is cloaked by a deafening silence. This is all too apparent in the conversations and the initiatives related to improving sexual and reproductive health in low-income and middle-income countries. More or less, the conversation always revolves around maternal health and women of child-bearing age. To address this gap, our research team will be working with the Women’s Health Foundation by focusing on the sexual and reproductive health challenges faced by women in Uganda during the transition to menopause and the post-menopausal period. We will be exploring the associations between socioeconomic status and fertility history of women with early menopause. Our research will then be used to develop and inform an advocacy plan to educate women on these factors.