 After the cessation of a woman's menstrual flow, which is referred to as menopause, different women across the world go through this phase of life in different ways. In this special report, our Health Correspondent, Ngozika Ohachisi, takes a look at some of the symptoms experienced during this period and how some women are coping with menopause. Menopause is a natural biological process that ends a woman's menstrual cycle. It is diagnosed after a woman has gone 12 months without her menstrual period. The average age a woman gets into menopause is from 51 and above worldwide. However, about 1% of women go into premature menopause before age 40. And in some rare cases, some women go into that stage at 30. Medical experts usually advise that such a woman should seek medical care immediately. There are physical symptoms menopausal women experience, such as hot flashes, reduced libido, vaginal dryness, hair dryness, anxiety, depression, and sometimes the disruption of sleep. Just as different women experience menopause and its symptoms in different ways, Liliana Dumuzu tells us she got into menopause stage at 47. This got her worried. Menopause is something we may look up to at a certain age, like you rightly said. I think in my own case, I entered my menopause at the age of 47. 47, yeah, I entered menopause at the age of 47. And somehow I didn't know it was the menopause of 18. I just saw that certain changes just came into my lifestyle. I started sweating. I started feeling some kind of pains. And I keep on wondering what was happening though. I have BP. I'm a BP patient then and I thought maybe it was because of the BP of it and that is the high blood pressure, each BP. I went to my doctor and I said, this is what I'm noticing. I started having this hot flash and he said, well, it might be menopause. I said, menopause, but I still look at having kids. Since he loved, I said, if you want to have kids with your condition, you have BP. And he said, it's not advisable. When you just take it, it has come, it has come. But before then, I could remember that at a point in time, I think my period ceased for like three months, then it appeared again. So the thing now got me scared like, what is really happening to me? I don't understand. I saw it. I started menstruating again. And after like six, three, four months again, or six months there about, it stopped. I was worried about the whole thing, but at the time I told myself, why would I be giving myself stress if God has written it this way? Because I believe in God so much, whatever God has written, I believe is it's handwriting and it has come to stay. So you don't force yourself into things that are not, you cannot change rather. You don't force yourself into things you cannot change. So at that point in time, I went to my doctor. He asked me to do some tests and I did some tests. That was just it. I just noticed my period was often on like that. And there was nothing I could do to it. Though he now gave me some drugs. Yes, I was giving some drugs. And at the end I just told myself, I don't need to force myself in any situation of admitting myself. So at that point in time, I just took to faith. Only to peace has a different experience. She discovered her menstrual cessation at age 58. She said she wasn't worried as she was aware she was due for menopause. About six years ago, I was 58 then. And well, I do not have any problem or issue concerning it. I was, my life was just normal. I did not notice anything except that the flow stopped. And I did not go to any hospital to check because I know that I was, I was due for it. So when it stopped, I was not worried in order to start to go to see a doctor for anything I did not. Perception of menopause in Africa varies by culture. For women with multiple births, menopause is likely to be welcomed as an end to childbearing. Liliana Dumosuo had postmenosal bleeding. She says ignorance is a major factor in Africa. The way I was generation reason now, a lot of things have changed. Just like I told you the other time that I had to take to my faith. When I saw things were not, but thank God my doctor was able to tell me then what was happening with me. And when I saw I couldn't do anything to it, there's nothing I could do to it. So I don't need to kill myself. So where they call it witchcraft or whatsoever, it is not it. It is not it. It comes at a particular age. Some might be lucky they will see their menopause at the age of 50 something. Some might be lucky even 60. By 60 some are still menstruating. So it depends on individual. It depends on how your circle runs. Dr. Joy Agbara is a consultant obstetrician and gynecologist with the Lagos State University in Hospital Lasot. She explains the reason some women experience early menopause. You have some women that started the very menopause earlier from 40. If we begin to see that before 40 years, we say that is premature ovarian insufficiency or failure, you understand. But after the age of 40 years, you know can happen. Of course, you may have people going into menopause earlier, not because it was time. Maybe because they had surgery. So we say iatrogenic. A woman who for any reason, maybe she had complex ovarian cysts. She had an endometrioma for which you have to move and goes into menopause earlier than it should be. A woman who is undergoing cancer therapy, you know, maybe radiation for any of the cancers, you know, that you expose the ovaries may go into iatrogenic ovarian failure, you understand. So those ones, you see them earlier. Medically, menopause has no cure, but it can be managed. In her first education, the woman needs to be aware that it's not an abnormality. It's just a continuum of she has moved from one phase of her life into another phase of her life. If she is psychologically prepared, it's one of the ways that you can manage. And so we encourage them, you know, to join groups of women that within that age, they can share experiences and all that. And then non-pharmacologic management, because of the heat you want to encourage the woman, you know, to wear more lighter clothes. Some of them get fans, you know, encourage them not to live sedentary life, the lifestyle they should move around, exercises at that age, you know, those are non-pharmacologic ways of dealing with it. Experts say that menopause is not an abnormality, but a natural phase every woman will go through. Therefore, it's not something to be ashamed or depressed about. They urge menopausal women to always open up and share their experiences or symptoms with their doctors to get help when needed. Oh, we are now joined by Dr. Adiola Falashadia-Falabi, consultant, obstetrician, and gynecologist, Federal Medical Center, Kefi Nassarau State. Good evening. That was a beautiful report by a reporter, Angozika HSC, very detailed, right? You can say that again. All right, so maybe we'll shoot. Yes, let's start with something that I think probably wasn't covered, and that is different stages of menopause. Let's start with that. All right, so talking about menopause simply puts its situation of menstruation for a period of 12 months. Now, it occurs in stages. We have the perimenopausal stage, we have the menopause itself, and we have the postmenopausal stage. Okay, the perimenopausal stage covers the first 12 months when there is cessation of menses. And the menopause starts at that 12 months, and then postmenopause is after the cessation. Though it is difficult to differentiate between when exactly it is menopause and after menopause. Now, the symptoms that you are supposed to experience after menopause, you start to experience some of them before menopause, before the cessation. Now, this cessation is a way of the ovaries, saying bye-bye, I've stopped working. And these ovaries, they are glans located in the female privies. And what they do, they are the major source of the female ovaries. So when they stop working, that is when we make diagnosis of menopause. But before they start, before they stop working, they give you some symptoms to say, I'm stopping, I'm getting old, I don't want to work again. This is what happens. Unlike what obtains in men, in females, all the hegs in our body, unlike men that simply see men all the time, all the hegs in our body, they are what we have gotten from our mother's womb. And then we start to use them up, use them up. By the time they are reduced, maybe like less than 1,000. That is when the ovaries will say, no, bye-bye, I'm old, I don't want to work again. And then when they are saying bye-bye, the way they start to say, these are the symptoms you begin to see, the menses becomes irregular. Remember when menses wants to start, that is at puberty. It starts irregularly. So likewise, when it's about to leave, it becomes irregular. In some people, it's more frequent, in some people, it's lower. In some people, the flow will reduce, while in some, it might become more. That is menorrhagia. Apart from that, the woman might begin to experience some form of vaginal dryness and discomfort. And this one can affect their sexual performances. Because the desire is lower, the drive is lower. But these are symptoms of, this thing can be managed. Because I need to stress it, that is not a disease. It's a normal phenomenon, it's a physiological change. It's a transition from one form of life to another form of life. And another thing that such a person can begin to experience is wrinkled skin. And then there's something we call outflushes. That is sudden experience of itch in the upper part of the body. The trunk, the neck and the face. And then it disappears. So when you start to feel how these symptoms, but you are still menstruating, that's perimenopausal. But after 12 months of no menses, you make diagnosis of menopause. And then afterwards, when the menses are stopped, these symptoms persist for a while. It's also, I mean, encompass sleep deprivation for some people. And then some people will start to urinate more frequently. This is because the hormone called estrogen is now reduced in the body. The body is no longer secreting it as it was before. That is what is causing all these changes. And I must also add that there are mental affectations of these changes, of this period of life too, in which the woman will have mood swings. Some will become depressed, some will become anxious. So you need to really be conscious of what's happening to you. You need to know that it's a physiological change and the way you approach it will affect the quality of life. That is talking about the stages. Those are the three stages. Like you said, it's not a disease. It's a change in the face of a woman's life. But how best can it be managed? Are there medical treatments? Are they, even though it's not a disease, is there a medical way of enhancing some sort of supplement? Yes, we have the ways of managing it. But the first and foremost thing to do is just education first. Once you know what you are expecting and you know what is happening to you, it's not a disease. You know, it's something that you are expecting. Just like when menses comes, some people are knowledgeable about it. They've been trained by their parents and they are expecting it. The way they receive it is different from somebody that just saw blood all of a sudden. So likewise, if we are well educated about it, I like what plus TV Africa is doing now. That's the public enlightenment. It's going to help a lot of people. So kudos to this channel. Now, when we are away, it helps a lot because when they still come to the hospital, before we go to medical aspect, we need to first talk about education. All we do is see to educate them very well. And apart from that, we have other things that should be done. That is non-pharmacological without using drugs now. We need to train them on certain things, like clothing, light clothing. Somebody has mentioned it. And then the practice of deep relaxation, deep breathing and relaxation exercise. Then we need to talk to them about their health, their diet rather. Their diet, especially having a lot of food, vegetable and whole grains. Then they need to limit alcohol. They need to seek counseling for mood changes. If you think you're having mood changes, we have behavioural scientists that you can go and see. Then they need to do what we call kajemoso exercise. I told you some people will start to urinate frequently because with the lack of this omen, the muscles controlling urination, some of them becomes weak. So there's this kajemoso exercise who will teach them what to do. Before we go to talking about medication, what we do in the medication is the omen that has gone down, we try to hard back the omen. There are certain things and also because there's loss of bone density, we try to give them a hard back omen. The omen that has gone down, we try to replace it. There are various ways of replacing it, which is not what I would say online now until when they come to us. So we try to replace back the omen. But as we are replacing back the omen, there are other things that we need to do because as we are using the omen, there are some other side effects of the omen. So they should be well aware that there are things that can be given. We have medications that can be given to relieve some of these symptoms that have earlier highlighted. Well, work life, that's a woman's career could possibly be affected somehow with all the changes she's experienced and certain changes and all of that. Is there any kind of policy that you think should be put in place? You know, bearing in mind that the women need to work and then they're going through all of this. Thank you for that question. Now, let me just say that there are policies that should be in place but it's not limited to emails alone. Let me just quickly talk, let me remind, let us know that there's what we call Andropos too. That is men. Okay, we'll chip that in, but let's answer this, yes. There's Andropos, there's Menopos. So as we are educating, first and foremost, as we are educating our women, we need to educate our men too. So that they will be aware that they are women who go through this. Maybe their mother, their sisters are not alike who go through this. So all policy makers too, they need to be aware of this and because the age of retirement is 60, but this happens around 51 years old. So we need to bear this in mind and put it into our policies. Perhaps some people might need to excuse themselves when they feel they are not coping well or the initial phase. So they need to put all this into cognizance when they are making the policy. I quite agree that a policy should be in place to help our women. You understand? But by doing this, as we are educating people, educating both men and women, then they will need to know that this thing, but it's not a thing. It's just the first few years that's really affectable. By the time we adjust, the symptoms will not be as much as they were when it first happened. So the first few years, some women might not be so regular at work and so we need to factor this into it and give them an excuse when necessary. So you need to take that over, I think. With, yes, so that, because the men may not know, the policy makers may not know and so people like you who know should probably push this forward. Well, because of time, we won't be able to talk about that of the men which you talked about. But I'm sure that what you've said, a lot of women listening right now, because before now, just like you rightly noted, before plus TV, we really don't hear much about menopause anywhere. It's like some silent thing that women just run into in the course of their lives. So many women don't seem to know they just don't give it much thought, but then it just creeps up on them and then they realize I'm changing and they're sometimes lost. How do you respond to that? A lot of women are not aware, they're not prepared for it. That is why I gave kudos to plus TV Africa. We really need to item the public enlightenment in this regard. Both women, not just women alone, both women and men. We need to make everybody become aware of these changes that must come to this. It's a normal thing. Just the way we started men's, it will definitely end one day. So we need to let our men and our women become aware of it. I think so gone too might take it off. That's the society of obstetrician and gynecologist in Nigeria. They might also take it off so that we're enlightening people. But there's something I want to mention before we wrap it up is different from what you have asked me. Public enlightenment, I agree. But as we are enlightening them, we need to add that during this period, especially perimenopausally, the menstruation is irregular. But our women need to be aware that they can still get pregnant during this period. So as we are enlightening our men, women about this, we need to enlighten our men too and let them know. And then I also want to, before I leave the stage, I also want to mention the fact that after menopause, nothing stops our women from having sex. Rather is even a form of treatment because it's been found out that when they have sex regularly, it's going to increase blood flow to the vagina. So all of these vagina dryness, thinning of the vagina wall and all the life that we are expecting can get treated by this one. And there are ways that we can manage the reduced libido, the thinning and all the pain and all the other things that they are having. There are ways that it can be managed just that when they are going through this, they should not go through it alone. They should make noise about it. Like I appreciate Madame Lilian and Madame Oluchi for coming out publicly to talk about themselves. So if our women will relate with each other in this kind of way, it will help other people coming so that when they get to this stage, they will know that they are not alone and they will be able to cope better. These are the way it is done in Western worlds. Thank you. Thank you so much, Dr. Adiola Falashadia-Falabi, consultant obstetrician and gynecologist, Federal Medical Center, Kefi Nassaroa State. Thank you so much for your time. Thank you. Hello. Hope you enjoyed the news please do subscribe to our YouTube channel and don't forget to hit the notification button so you get notified about fresh news updates.