Across much of West Africa, including Nigeria and Ghana, discussions around women’s health are often robust when it comes to milestones like menstruation or pregnancy. Yet, there is a curious silence when it comes to one transformative stage: perimenopause. While it’s a natural part of every woman’s life, perimenopause remains shadowed by myths, cultural taboos, and limited awareness—even as medical professionals stress its importance for long-term wellbeing. As Dr. Juanri Jonck, a general practitioner at LifeLab in Pretoria, recently noted, “Perimenopause is a tipping point that can shape a woman’s long-term health and quality of life.” For many Nigerian women navigating changing bodies and uncertain symptoms, understanding this phase—and accessing the right resources—can make a world of difference. Below, we break down what perimenopause really means, which symptoms to watch for, and why it matters so much in an African context.
What Exactly Is Perimenopause?
Before a woman officially reaches menopause—when the ovaries stop producing oestrogen completely—there’s a transitional stage known as perimenopause. During this period, the ovaries gradually release fewer eggs, and hormone production becomes less predictable. As Dr. Jonck explains, “Perimenopause occurs when the communication between the brain’s pituitary gland and the ovaries becomes disrupted due to the declining release of follicles.” This disruption can spark sudden rises and falls in hormone levels, including oestrogen, progesterone, and testosterone, leading to a wide range of symptoms. Each woman’s experience may be unique, with perimenopause lasting anywhere from four to ten years, influenced by genetics, lifestyle, stress, and overall health.
In Nigeria, it’s not uncommon to see knowledge gaps within families and communities regarding perimenopause and its effects. According to Dr. Nafisat Usman, a Lagos-based gynaecologist, “Many locals still attribute some of the symptoms to spiritual causes, age, or even dietary changes, overlooking the real biological transition at work.” While some elders or traditional healers may offer herbal remedies, there’s growing consensus among local medical professionals that modern awareness is key for better outcomes.
Recognising the Symptoms: What Does Perimenopause Feel Like?
Hormones do much more than regulate reproduction—they act as messengers that influence nearly every system in the body. As a result, when a woman enters perimenopause, every organ system could potentially be affected. According to Dr. Jonck, early symptoms can be vague, which is why women may not immediately make the connection. “You may notice difficulty sleeping, a creeping sense of tiredness that’s hard to shake, forgetfulness, mood swings, anxiety, itchy ears or scalp, loss of sexual desire, joint pains, or even palpitations.”
Researchers also point out that the experience may be shaped by ethnicity, genetics, and environmental stressors. For example, findings published in a short report indicate that Black women report more intense or frequent symptoms—especially hot flashes and night sweats—compared to peers from other backgrounds. Locally, such symptoms are sometimes dismissed as “just stress,” but experts warn against ignoring them.
Common Signs to Watch For During Perimenopause
- Irregular or unpredictable menstrual cycles, which could mean periods become heavier, lighter, longer, or shorter than before
- Frequent hot flashes and night sweats, sometimes severe enough to disrupt sleep
- Significant mood swings, anxiety, irritability, or feelings of depression
- Persistent fatigue and difficulty sleeping
- Short-term memory lapses or episodes of “brain fog”
- Lowered sexual desire (libido)
- Vaginal dryness, which can be accompanied by more frequent urinary tract infections
- Aches and pains in the joints and muscles, sometimes mistaken for arthritis or aging
- Noticeable weight gain or shifts in body shape, especially around the waist
It’s important to note that these symptoms frequently overlap with the effects of everyday stressors common across Nigerian cities—long commutes, economic uncertainty, and inconsistent access to health resources. This can make it even more challenging for women, their families, and even some healthcare providers to spot perimenopause early, often leading to misdiagnosis or an overreliance on unrelated medications.
At What Age Does Perimenopause Begin for African Women?
Globally, perimenopause tends to begin in a woman’s late 30s to mid-40s, but African data tells a similar story with some unique nuances. In Nigeria, health clinics in Lagos, Abuja, and Port Harcourt report women often experiencing their first perimenopausal symptoms between age 37 and 45. Recent studies suggest that up to 14 percent of South African women begin to notice symptoms by their mid-30s, with this number jumping to more than 50 percent by their 40s (Statista). In local communities, older women often recall their mothers describing “changes of life” at similar ages.
According to Dr. Otobong Ekong, an obstetrician at the University of Calabar Teaching Hospital, “It’s important we educate both women and men, because early recognition can reduce stigma and improve support systems at home.” He notes that factors like diet, stress, exposure to toxins, and genetics might contribute to when and how severely women experience perimenopause in West Africa, but further research is needed to draw definitive links. For Nigerian women with a family history of early menopause or chronic health conditions such as diabetes or hypertension, tracking symptoms can be particularly important.
Diagnosis: How Is Perimenopause Confirmed?
In a clinical setting, one early indicator of perimenopause is a noticeable shift in the menstrual cycle—especially if a woman’s period becomes seven days longer or shorter without other clear causes. However, many women do not exhibit this “textbook” sign. As Dr. Jonck suggests, health professionals should maintain a high index of suspicion whenever women aged 35 and above present with unexpected symptoms or changes in menstruation. “Often, by the time patients come to us, they might already be taking a mix of sleeping pills, antidepressants, lubricants, and pain relievers, when what’s really needed is hormone support,” she reveals.
Diagnosing perimenopause isn’t always fast or simple. The symptoms often resemble those of other conditions—thyroid dysfunction, depression, or chronic fatigue—leading to delays in appropriate care. Recent local interviews with Nigerian women suggest it may take months or even years for them to seek help and get a formal diagnosis, partly due to stigma and poor awareness within the wider community. This highlights the need for more open conversation and easily accessible information on women’s health transitions in Nigeria and across the region. Health practitioners may use physical exams, medical history reviews, hormone level blood tests, or symptom diaries as part of the assessment process—while keeping in mind that the diagnosis is primarily clinical.
Managing Perimenopause: What Are the Options?
Relieving distressing symptoms and supporting optimal quality of life are central goals for treating perimenopause. Where medically appropriate, hormone therapy (HT) remains one of the most effective tools for reducing severe symptoms like troublesome hot flashes or sleep disruption. Dr. Usman, based in Yaba, Lagos, says, “We urge women not to self-medicate or rely solely on hearsay. If symptoms disrupt your life, see a qualified practitioner. Solutions exist, including hormone therapy, but careful screening is important.” For those unable to take hormones—perhaps due to a family history of breast cancer or cardiovascular disease—non-hormonal medications and lifestyle adjustments such as diet modification, mindfulness, regular exercise, and pelvic floor physiotherapy may also offer relief.
Sadly, in some West African communities, easy access to prescription treatments for perimenopause is still limited. Health NGOs like the Women’s Health Initiative Nigeria are now working to expand community-based education, debunk myths, and train healthcare workers to recognise and support women facing hormonal transitions. There’s also growing interest in integrating traditional remedies with evidence-based care, but experts caution that herbal solutions must be scrutinised for safety and efficacy first, rather than adopted blindly.
Researchers and healthcare providers alike recommend keeping a journal to track symptoms, finding trustworthy sources of information (such as official Ministry of Health publications), and joining local support groups—some of which now operate on WhatsApp or Facebook to reach more women, even in rural areas. Greater dialogue, both within families and at a policy level, is essential for improving access to care and de-stigmatising women’s health issues across Africa.
Perimenopause remains a journey that no African woman should walk alone. With new research, cultural openness, and better medical support, Nigerian women can approach this life stage with confidence and dignity. Have you or someone you know experienced perimenopause? What steps did you find helpful—or challenging—in managing symptoms? Share your thoughts in the comments, and follow us for more health insights tailored for Nigerians and West Africans.
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