 Rebo back to Y254, you're welcome. Just in case you're getting to join us, this is wine morning, hashtag WCW, where we get to crash on awkwardness and we do strength over women. And before we had gone on that short break, I had told you that I have wonderful fabulous women who are going to be talking to us about menopause. Do you know what menopause is? Do you know when menopause strikes? Are you prepared enough as a woman to face the, what do I call it? To face the entire, entirety of menopause. They are here to answer that and much more. What happens to your mental health? As a woman when you go through menopause, I have a psychiatrist, Dr. Suma, and I have Amina Farah, the founder of Fabulous Living. They're going to be telling us much more about it. Karibuni Sana. You wanna tell us what monopause is? Because I think it's something, we say menopause, menopause, and then we assume that everyone knows what menopause is. So you probably want to tell us what menopause is. Sure. So menopause is the end of our fertility. It's when our ovaries are no longer producing eggs, okay? So it is when your period ends, and menopause technically is actually just one day. It is the day you have not had your menstrual cycle or your periods for 12 consecutive months. The time leading up to menopause is called perimenopause. And that is when now your periods may start fluctuating. Sometimes you start missing them. And along with this, you also may experience certain changes and symptoms in your body, in your mental health, your mood. So it's just something that as women, we start to feel the transition because what's happening during perimenopause, which means the time leading up to menopause, which can last anywhere from two to 10 years as a woman, our estrogen levels are fluctuating and starting to come down. And then our progesterone is just dropping. So estrogen is our fertility hormone. It's what kind of we need for our ovaries to produce eggs. And during this transition of perimenopause, as we're coming to menopause, those levels are going down. So as a woman, we start to feel certain changes in our body, in our mood, in our brain, you know, in our uterus, in our vaginal health, in our skin, our hair, because estrogen, which is the hormone that makes us women, is starting to decline. And you know, we have estrogen receptors, I'll call them, all over our body. So when this is starting to go down, we feel the change. So perimenopause, two menopause, which is 12 months without your period. And then after that, that period is called postmenopause. Dr. Suma, what happens to a woman psychologically as she gets into perimenopause, menopause, postmenopause? So basically, your body is going through changes. If you're not aware of it, it's very difficult for women to even associate. Like, let's say I have anxiety at around 42, 43, that age. And I don't know that I can have anxiety. I can feel a sense of, I mean, a loss of connection to anything, to enjoy, have pleasure in anything. That is a sign of depression now. So both of these things, if you don't know that it can be related to menopause, you're gonna think, oh, I'm coming up with a psychiatric condition, maybe something is going wrong with my mind. So when you know what to expect mentally and how to deal with it, you can understand that, oh wait, this is part of menopause as well. So commonly what we see is depression happening in a lot of women, anxiety. And along with that, not just that, if you have been diagnosed with a psychiatric illness like schizophrenia or bipolar, that can resurface when you're going through menopause. That shows that hormones that are there in women, they also affect the mental head, the neurotransmitters that are implicated. Not getting too technical, but the neurotransmitters are implicated in schizophrenia and bipolar, right? So it has another peak. Let's say you've got it at the age of 20. Now you're having a flare up in the symptoms. So that also you can be aware of. Why is my mental health worsening? So along with that, we have something called as Alzheimer's dementia. You know, forgetfulness, loss of functioning, lot of, it's a very scary world. Dementia is like a whole scary concept altogether. Now that also, let's say that you've had, what do you say, a very severe PMDD. What is PMDD? It is premenstrual dysphoric disorder, like very severe PMS symptoms basically, just a week before your periods. If you've had that throughout, up until you reach menopause, your symptoms are going to be much worse and you are more prone to catching dementia or something like Alzheimer's, you're more at risk. So all these things, they scare us, but if you're aware, there are preventive measures that can be taken. When should we start talking about menopause? You know how I'm thinking of this. A few years old, I'm thinking, am I ready to talk about menopause? Is a woman out there, she's thinking she's 30? Am I ready to talk about menopause? Good question, Grace. So for you, you know, you're in your, I can say your age, I can say your decade, you're in your 20s, right? I'm in my early 50s, I've already hit menopause, I'm post-menopausal. I just think, you know, this should be part of our education. It's just the way we have education about our periods and our menstrual cycle. We should include education about menopause, perimenopause and menopause, because I could ask you the question, has your mother spoken to you about menopause? Not really. Yeah, your mother's spoken to you about it? And for you, Dr. Suck? Not really. Exactly, so what I realized, excuse me, is that even when I went through the journey and I went through premature menopause, so the average age, actually let me give you the age, the average age of menopause is 51 years old. So I should be going through menopause now, right? But I went through it earlier, like a decade early. So my late 30s into my early 40s. And at the time that it happened, I had no idea, right? Because nobody's talking about menopause, nobody's talking about perimenopause. And I didn't think twice, you know, what it was. In fact, I was at that point trying to get pregnant, seeking fertility, and that was a problem, right? And I'll be honest, not even any doctor that I saw just, nobody said, hey, you're hitting menopause, because they didn't expect based on my age, okay? So when I kind of got towards the end of my 40s, actually doing COVID, this is like my COVID gift, I used to be, it's true. I used to be in the restaurant business, you know, I'm a lawyer also, and I was busy. And then when COVID came and we shut down, I sat down and I started just reading more. And then I was like, oh my God, I went through menopause and nobody told me. So I was like, this is a... So let me just ask you. Sorry I got you, sorry I got you short. It's okay. Thank you. In between 30, the age of 30 something, late that is to 40s. Early 40s. Let's just say early 40s. No, but I was actually put on birth control because I had problems for a while. No, I had my period for a while, I was on birth control to regulate my period, which is something that is done for people who don't have, who have problems with regularity in periods, yeah. And then, but you see, even the knowledge about periods and regularity and any issues is not really even discussed, right? So if you have problems with your period, then that could even be like for you to look and say, hey, I may be one of those women who will go through premature menopause, I need to look at it. And that's important for young women, right? That's why I think young women should know at this point, like about your fertility, are you tracking your periods on your, like on an app period tracker, do you know your cycle? Because if you start to notice changes, it could be that you're going into perimenopause, it could be that you're losing your fertility, so it's time to look. And unfortunately, at the time that I was going through this, there was no real language saying this. So when I kind of around 49 actually, I said no, no, we need to have more conversation about this. So my platform, I have a platform called Fabulous Living, which is really a knowledge and awareness platform around the transition of perimenopause and menopause. I want to educate women, I want us to have conversations about this, I want women to understand. And some of the things that women say they feel when they're going through perimenopause, they don't feel like themselves, they feel like they're going crazy, they may have anxiety, depression, changes in their mood. Mood changes, people kind of just say, maybe even, you may look at your mother, I don't know if she's going through it, but like when women are starting to get older, this is just associated with women getting angry and having mood changes. Well, it's because our hormones are changing and we don't think of the link. The link is menopause, right? And then I think if women understood that they're going through the changes, then they would not feel like they've just kind of been, I'll use the word gobsmacked, like something has just happened and you have no idea, which is what I felt. Like in my mid-40s, I was not feeling great, anxiety, little bit of depression here, I was withdrawing socially, I didn't really want to hang out with people as much as I used to. That's a mental health kind of effect of perimenopause and menopause. That is the question I wanted to ask you. In your view, what are some of the stigma and misconceptions surrounding the mental health of a woman when she goes through menopause? So basically, we like when something talks about strengths as opposed to the weakness. Menopause is seen as something, your body going down, your body is slowly losing its functioning. So what does it indicate? It shows weakness. So no one really wants to talk about someone's health deteriorating, right? So there is a lot of shame. I don't want to talk about if I am gonna hit menopause, will I even tell my friends, hey look, I'm actually going through menopause, I have these serious rage symptoms, my mood is going crazy, am I gonna let them know? No, I would rather hide. You're told that as a woman, everybody goes through it, it's normal physiology. So why should you make a big fuss? Why should you even complain? So that's what you're told as a woman. Do not complain, don't talk about anything. You're shamed. If you say, I'm going through all of this, my body's going through all of this, what are you told? You're mentally weak and you're mocked at. How many jokes do we get that, oh it's that time of the month for you or you must be on your period kind of jokes, right? You're shamed literally. True, people are shamed women a lot. You're shamed literally for something that you have no control over. All these behaviors, they're a result of the physiology. Like your mind is literally, it's not able to have a stable way of functioning, right? The unstable hormonal fluctuations that happen month in, month out, especially during menopause, it gets really, really worse. All the support that you have through the hormones, it's lacking. So a lot of, what do you say? Shame about, no, do not talk about it. Possibly even, it's not a dinner table conversation, like if I were to sit and tell you, would you want to listen? How my body is failing you, would you want to listen? Would you want to, I mean if I told you, I have sexual dysfunction, would you want to listen? No one even wants to talk about how it affects even your sexual health, right? And that affects relationships. If I'm difficult, I'm irritable, will you want to be around me? I'm going to lose my friends. At work there might be problems. Right? And it's at that age, where you're possibly at the peak of your career, like in early forties, you're possibly the CEO, the director, and that's when you have the stress building up of menopause, and then you also have your parents getting older. Amina mentioned this, how even your children possibly are, you know, going to college, it's called emptiness syndrome or something. So a lot of changes happening, plus your body is giving up on you, and women are told, don't talk about it. Why? Yeah, and I think, you know, the stigma or the shame I find with my platform, I even have women who don't want to admit. They're like, oh, I'm not there, maybe it's Jeffika, but you know, it's like, let me just say, they're like, I'm not there yet, but they're going through, they don't want to admit, but they're going through perimenopause, because they're like, I still have my period. Yes, your period might still be there. It's the last thing that usually goes at the end. So before that, during the transition, perimenopause, you may still have your period, but you would be feeling some of these effects. So when we know what these changes are, and we call them symptoms or changes, then people start to say, oh, so I'll say, okay, your period is still there, but are you forgetful? You know, do you feel brain fog? Are you finding it hard to focus at work? You know, are you having mood changes, like where you just go from zero to 100 instantly rage? You know, so when you start to talk in that way, then they're like, oh, yeah, you're right. I've been having some problems with focus, brain fog. You know. You're already describing someone I know. Who's that? That's a good question. Don't go into a mental hospital. Oh, so not admit. You know someone, it's crazy. I'm like, we have tested that. This is so weird. So you see, because, and I think there's an additional layer to why women don't also want to talk about it. It's because you also have to admit you're aging. Okay. So there's that thing of like, we're aging. We're losing our youth. Our fertility has ended. And I think sometimes there's this whole thing about our fertility in African culture, fertility is a big thing. Women are really expected to have children. So maybe now you're like, okay, my fertility has ended. I can't have kids. I'm drying up because you do dry up. You can even get vaginal dryness. You can get, you know, things happening in your uterus and, what we call them genital urinary. Urogenital symptoms. Yes. It's either urogenital or genital urinary. They're the same word, depending whether it's American or UK. So there's symptoms in your, you know, you can have more UTIs, you know, incontinence, vaginal dryness, your libido going down. Because again, our wonder hormone, as I call it, estrogen is going down. And so when women start to realize this, so I think there's that layer, like, you know, I don't want to say I'm aging. And then, hey, I'm losing my fertility. And then all these things are happening. And then am I becoming irrelevant? Am I just drying up? When we want to change the narrative and say, let's embrace our midlife. You know, I'm all about embracing midlife. You know, and that's why it's fabulous living. And because there's things you can do to feel good and start transitioning. And you know what Grace? It's never too early for you guys to know. Women in your 20s, women in your 30s, before you hit your 40s, so that you're not caught by surprise. I was caught by surprise. Right. I'm afraid of these. No. It's actually to do with a very, I mean, this is a psychological concept. We don't like change. We're so used to how things are. And we like the sense of control. Oh, I know what's happening with me. I know what, if this goes wrong, this ABC is what I'll do. And something is changing and I have no control. Let's say I'm experiencing hot flushes and they're getting worse and worse. The fear is, what if it gets worse? And there is hypochondriac symptoms that are there in women because we are meant to, I mean, we're meant to nurture. So along with that comes this sensitivity to care. So we are much more anxious. And we're also ashamed for that. Sorry, all of it is coming out today. I think you're ashamed for even showing that amount of care. Like you...