By Rachel Lankester, Editor

Sue Mbaya is leading a movement to raise awareness of menopause in Africa. She’s the founder and director of Menopause Solutions Africa and host of the Pause for Menopause podcast. With a mission to normalize this life stage and empower women, Sue’s work is transforming perceptions and providing vital support. Globally recognized as the voice of menopause in Africa, Sue’s influence is far-reaching. Her efforts have made her a beacon of knowledge and support, guiding many through the complexities of menopause. I was delighted to talk to her on my podcast

menopause in Africa

How Sue became so involved and passionate about menopause

Sue’s journey into menopause advocacy began in a very personal way. Despite being busy and thriving in her career, she was unexpectedly hit by the storm of menopause. Years earlier, she’d undergone a hysterectomy and was assured that as long as her ovaries remained untouched, she’d be fine. However, without any erratic menstrual cycles to warn her, she was blindsided by the onset of menopause.

Sue found herself struggling with severe headaches, anxiety, and an inability to cope with her hectic life. Desperate for answers, she decided to Google “hot flashes,” a term she vaguely remembered. “I googled, and I thought, what do they feel like? That’s what I’m feeling. Why do people get hot flashes? Menopause. And that was my introduction to the world of menopause!” 

The ensuing years were marked by disconcerting, destabilising, and isolating experiences. Sue’s natural inclination to fix things spurred her to action. Determined that other women should not endure the same unpreparedness, she committed to raising awareness about menopause. Her mission was clear: women needed to know what was coming so they could be prepared. This resolve ignited her passion and set her on the path to becoming a leading advocate for menopause awareness in Africa.

The impact of stress and other life events on menopause symptoms

It’s astonishing how little information is available about menopause globally. Many women, unaware of what lies ahead, often mistake menopause symptoms for other serious health issues, such as dementia or severe anxiety. If women were better informed, they could prepare for and manage these changes more effectively, reducing the fear and confusion that often accompanies menopause.

Sue shared her experience of an incredibly busy and challenging time in her life. Professionally, she was thriving, juggling three different career paths and enjoying a dynamic, fulfilling career. However, her personal life was fraught with upheaval. Her mother’s health was failing, and Sue became her primary caregiver. In the same year, she tragically lost her younger sister and took on the responsibility of raising her nephew. Meanwhile, her eldest son, studying in the US, faced a dramatic personal crisis. Amidst all this, Sue also had to move countries and change jobs.

This tumultuous period coincided with Sue entering perimenopause, likely accelerated by the immense stress she was under. She began experiencing debilitating headaches and intense anxiety – uncharacteristic for someone who had always been resilient and self-reliant. Despite never having been anxious before, Sue found herself grappling with severe anxiety, hot flashes, and crushing night sweats. Her sleep was disrupted by frequent trips to the bathroom and relentless night sweats, leading to severe sleep deprivation. This made managing her demanding life even more challenging.

“Once I entered perimenopause, I had some hot flashes, a lot of anxiety, but the night sweats were crushing. I was up all the time, and then, of course, at the same time, I had bladder issues. I was either waking up to go to the toilet several times in the same night, or waking up several times with night sweats, and there was no kindness. It wasn’t like one night it was night sweats, and then next night it was going to the toilet. It was both in the same night! Four or five times I’d be waking up. It was ridiculous.”

During this period, Sue also experienced significant weight loss, which puzzled her and was concerning for those around her. This dramatic weight loss was then followed by an inability to keep weight off, a more common issue, due to insulin resistance and other hormonal changes associated with menopause.

Sue also faced high cholesterol levels and cognitive issues due to sleep deprivation and hormonal fluctuations. Living in Ethiopia, she had very limited access to many suggested remedies and treatments. For instance, while visiting South Africa, her doctor prescribed HRT patches, but Sue was advised to have a mammogram before starting them. Upon returning to Ethiopia, busy with her responsibilities, she delayed the mammogram and found the patches had expired by the time she was ready to use them. This delay turned out to be a blessing in disguise, as a later mammogram revealed lumps in her breast.

Accessing basic treatments for menopause symptoms was also challenging. Sue struggled with vaginal dryness and bladder issues but found that vaginal lubricants were not available in Ethiopia. She had to rely on occasional trips to other countries to get the necessary supplements and treatments.

The psychological impact of menopause and Sue’s decision to use HRT

Sue’s experience with hormone replacement therapy (HRT) is a testament to the complex interplay of personal choice, cultural expectations, and healthcare accessibility. Sue initially resisted HRT despite severe menopause symptoms, turning to food supplements and herbal remedies instead. “I felt as though I had let myself and the side down by ultimately taking HRT,” she admits, highlighting a prevalent cultural narrative that equates natural remedies with stronger faith or willpower.

Sue’s struggle was not just physical but psychological. She had to endure a year of mammograms to monitor small lumps, during which supplements provided some relief but not full control over her symptoms. The decision to start HRT came with a sense of betrayal to her beliefs and a perceived failure to adhere to natural remedies. This psychological burden, combined with menopause symptoms, illustrates the multifaceted challenges women face.

Despite her struggles, Sue acknowledges her privilege in being among the small percentage of African women who can actually access HRT. In many African countries, HRT is not even a consideration due to unavailability. “I still cannot walk into a chemist and get a vaginal lubricant,” Sue notes, highlighting the scarcity of menopause-related products. A country’s economic priorities often overshadow such needs, reserving foreign currency for life-saving medications rather than menopausal health products.

Sue’s work revolves around the theme of thriving through menopause, but she emphasizes the need to address foundational issues first. “In my part of the world, we’re still dealing with the impacts of patriarchy,” she explains. The notion that menopause elevates women to positions of respect within the community is often exaggerated. In reality, few women or men attain such status, and the societal structures that once provided support during menopause are eroding.

The lack of intergenerational dialogue about menopause exacerbates the issue in Africa, as elsewhere. Sue recounts how her mother and sisters never discussed menopause with her, a common experience among her peers. This silence leaves many women unprepared and unsupported as they navigate this life stage. 

Modernization and urbanization have brought new challenges. Urban women may have more access to information and healthcare, but rural women often remain isolated, adhering to persistent myths and misinformation about menopause. Sue highlights the disparity in medical access, pointing out that in Kenya, there is only one gynaecologist for every 100,000 women, and only 10% of women will ever see a gynaecologist in their lifetime.

This lack of access extends to general healthcare as well. Women often do not receive adequate screening for menopause-related health issues such as osteoporosis or insulin resistance. Many rely on nurses or midwives with basic qualifications who may not connect symptoms like cholesterol spikes to menopause.

Despite these challenges, there are signs of progress. Sue mentions exciting developments in Kenya, South Africa, and also India, where efforts to conduct relevant menopause research are gaining traction. However, securing funding for such research remains a significant hurdle.

Sue’s podcast, Pause for Menopause, aims to debunk myths and provide crucial information. In a bootcamp series, she addressed various menopause-related topics, emphasizing the need for accurate information across all contexts, urban and rural.

Differences in menopause awareness and support across Africa

We talked about disparities in menopause care between the UK and Africa, and I emphasized our relatively privileged access to healthcare services in the UK. We talk about divides in information here in the UK, but everybody can access the same services. While the UK may have issues such as a “postcode lottery” affecting hormone therapy access, it pales in comparison to the situation in parts of Africa. It’s important to broaden our understanding of menopause beyond local experiences. White people especially, can tend to assume that their experience is universal. We need a more global perspective that acknowledges the unique challenges faced by women in different parts of the world.

Sue brings invaluable insights into the African context of menopause, particularly the dire state of sexual and reproductive health services in conflict-affected regions. “Sexual reproductive health services are non-existent for so many women,” she explains. This lack of infrastructure exacerbates the difficulties faced by menopausal women, adding another layer of complexity to their health and well-being.

Sue references a Vodafone study that surveyed 5,000 women across five countries – South Africa, Spain, the UK, Italy, and Germany—to highlight the severity of menopause symptoms and their impact on women’s work lives. South African women reported the highest levels of severe symptoms and the greatest need to hide these symptoms at work, despite South Africa being the most progressive African country in terms of women’s healthcare. This paradox underscores persistent challenges in addressing menopause even in relatively advanced healthcare systems.

Reflecting on her personal journey and professional evolution, Sue acknowledges her initial despair during her early menopause experience. “I was like, ‘woe is me, I’m gonna die,'” she recalls. However, she and her colleagues are now transitioning to a more empowered narrative. “We’re not just saying, ‘oh, it’s terrible,’ which it is in many ways. But we’re saying it’s terrible, but there’s something you can do about it.”

Sue’s advocacy emphasizes preparation and proactive health management. She shares her own realization about the importance of fitness and nutrition, which she neglected before menopause. “I was poorly positioned to deal with the food and weight issues,” she admits, noting the impact on her bone density and overall health.

Sue speaks to young women about the importance of early preparation, encouraging them to “get ready, prepare, you can do something about it.” Studies like the Vodafone survey provide crucial insights that can guide these efforts, highlighting what needs to be done to improve menopause care and support.

Progress and initiatives in menopause awareness in Africa

Sue works with policymakers and health professionals across Africa to address menopause. She recalls a significant moment in Ghana, where a parliamentarian brought the issue of menopause to the floor of parliament. “Our male counterparts were squirming in their seats, but she powered through,” Sue recounts. This bold move sparked a conversation about including menopause in health insurance coverage, as women frequently max out their benefits due to repeated doctor visits for menopause-related issues.

In Namibia, health professionals acknowledged their inadequate training on menopause, having received only two hours of instruction with no ongoing education. Sue’s advocacy has prompted discussions on improving training and resources for health professionals.

Various African countries are taking steps to address menopause more effectively. In Botswana, a private sector company has begun discussing menopause with its predominantly young workforce. South Africa has established a menopause society, and similar initiatives are underway in Uganda, Zimbabwe, and Ghana.

Sue has also engaged with educators in Ethiopia to combat stigma. “We’re just talking to educators and saying, you’re the most influential people in your communities. If you get comfortable talking about menopause, let’s normalise it,” Sue explains. The Ethiopian health ministry has agreed to translate and interpret the Pause for Menopause podcast, further spreading awareness.

In Kenya, Sue collaborates with a UN agency to educate staff about menopause, setting a precedent for supporting employees before reaching out to their broader constituencies. Sue proudly notes, “Africa is moving. We are at the beginning of our menopause revolution, and I’m really, really proud to be associated with it.”

Sue highlights the global support she has received, which has been crucial in her advocacy. “I’ve had a lot of support from friends and counterparts, both on the continent and beyond,” she says, appreciating the solidarity from the UK, Australia, and other regions. This global community has helped normalize the menopause conversation and provided valuable mentorship.

Sue’s policy background has enabled her to engage effectively with policymakers and challenge health ministers, particularly women, to prioritize menopause in their health policies. “I’ve challenged them that in your lifetime as a minister, you must surely impact health policy to make sure it doesn’t continue to be menopause blind,” Sue states.

She calls for a celebration of midlife and the many beautiful aspects of this stage in a woman’s life. “Let’s celebrate them. Let’s celebrate each other,” she urges, advocating for platforms that elevate these positive experiences. At the same time, Sue calls for collective indignation against the indignities women face during menopause, particularly in marginalized regions. “I want us to be collectively indignant that we still have parts of the world where women continue to be marginalized and suffer unnecessarily,” she declares.

She emphasizes the importance of asking for help and the strength it demonstrates. She acknowledges the resilience of African women who persevere despite limited resources. “There is a word in my language, shingirira or bekezela, which means to persevere. You never hear those words being said to young men, but they’re applied to young women,” she notes. Sue challenges this notion, advocating for a culture that encourages women to seek help.

She honors women who endure without access to common treatments like HRT or calcium supplements, and vows to improve their lives. “If in my lifetime, I can do anything to improve the life of a proud woman on this continent so that they can thrive through menopause, I will do it,” Sue pledges.

Sue Mbaya’s initiatives are spearheading a menopause revolution in Africa. With support from global allies and a commitment to education and policy change, she is making significant strides in improving the lives of menopausal women across the continent.

If you’ve enjoyed this post, please check out the podcast interview with Sue.

Why not explore more…

Is HRT For Menopause The Miracle Cure Women Need?

There’s a lot of talk about HRT being something all women should be on and long-term too. Here’s an alternative view.

How To Deal With Hot Flushes (Flashes)

Burning up? Here’s all you need to know to deal with hot flashes/flushes and night sweats.

What To Do If You Can’t Get HRT

There are so many natural remedies for menopause. Diet, exercise, and lifestyle changes can all have an enormous impact.

Last Updated on June 6, 2024 by Editorial Staff

If you liked this post, please share it!

Similar Posts