SHE sat in my office one afternoon, shifting uneasily in the chair. “Doc,” she said softly, “I don’t feel quite like myself these days…”

She wasn’t sure how to describe it — the tiredness, the mood swings, the restless nights, the sudden flares of heat that left her flushed and sweating. At 44 years old her periods had become unpredictable, her patience shorter, and she couldn’t shake the feeling that her body and her mind were changing in ways she didn’t understand.

This woman is not alone, I see quite a few women weekly with this very complaint.

For many women, this moment marks the beginning of a transition called perimenopause — the stage leading up to the menopause. It can begin in a woman’s 40s, and sometimes even earlier. In Jamaica, as in many parts of the world, this experience touches the lives of half of our population, yet it’s still whispered about rather than openly discussed.

The numbers behind the change

Menopause is defined as the point when a woman has gone 12 consecutive months without a menstrual period. This change is due to decreasing oestrogen levels, signalling the end of her reproductive years. The average age of menopause globally is around 51, though many Jamaican women experience it a few years earlier, often between 48 and 50.

With longer life expectancy and better healthcare, Jamaican women are now spending nearly one-third of their lives post-menopausal. That means managing this transition is about more than just easing symptoms — it’s about protecting long-term health, confidence, and quality of life.

More than hot flashes: What women really feel and what is really happening

When people hear “menopause”, they often think only of the cessation of periods and hot flashes. But it’s so much more than that. Oestrogen is a woman’s master regulator hormone, involved in the function of several organ systems and processes — including temperature control, metabolism, the reproductive organs, skin, hair, bones, brain, heart, and muscles.

The withdrawal or deficiency of oestrogen during perimenopause and menopause triggers a cascade of symptoms – the most bothersome for many women is the hot flash, caused by changes in the brain’s temperature control centre due to oestrogen loss. Hot flashes typically begin as a sudden sensation of intense heat in the upper body and face, often followed by profuse sweating, and may last from a few seconds to several minutes.

Menopausal symptoms vary widely between women. Some women barely notice the change, while 70 per cent of women will have noticeable symptoms and others find it overwhelming and unbearable. Common symptoms include:

•Irregular, light or heavy periods before they stop completely

•Hot flashes and night sweats

•Trouble sleeping

•Palpitations

•Vaginal dryness, discomfort with intimacy and loss of sex drive

•Weight gain, especially around the tummy

•Fatigue, body aches, joint pains

•Dry skin and itchiness.

Then there are the mental and emotional changes — anxiety, depression, mood swings, brain fog, irritability, and loss of concentration or drive. Many women describe feeling as if they’ve “lost themselves”.

The weight gain struggle

One of the most common and frustrating changes women report is weight gain — particularly around the abdomen. This isn’t just about eating habits; it’s largely hormonal. As oestrogen levels drop, the body changes how it stores fat and burns energy resulting in insulin insensitivity and a slower metabolism. Poor sleep, and stress also play a role in weight gain.

Understanding that this is a biological change, not a personal failure, helps women take a kinder, more informed approach to their health.

Simple lifestyle shifts that can help

Many women in Jamaica suffer in silence, brushing it off as “just getting old” or are on the other side of the pendulum being investigated ad nauseum by several specialists looking for a cause for these new mid-life symptoms. But menopause is not an illness — it’s a natural stage of life that deserves understanding and proper care.

Menopause may be inevitable, but suffering through it doesn’t have to be. Simple, consistent lifestyle optimisation changes can make a big difference in how women feel during this transition.

1) Eat wisely – Focus on a balanced diet rich in lean proteins and fibre from fruits, vegetables, whole grains and good fats. Protein should be prioritised to ensure muscle mass maintenance. Include calcium and vitamin D supplements for strong bones. Cut back on excess sugar, salt, and processed foods.

2)Move often – Exercise regularly incorporating weight training. Walking, dancing, swimming, or yoga can lift your mood, improve sleep, and protect your heart and bones.

3)Prioritise rest – Aim for six to eight hours of sleep each day. Turn off screens before bed, keep the bedroom cool, and limit caffeine late in the day.

4) Stop smoking – Smoking can worsen hot flashes and increases the risk of heart disease, stroke, and osteoporosis.

5) Limit alcohol and caffeine – Both can trigger hot flashes and disturb sleep.

6) Nurture relationships – Encourage social relationships, a good group of friends is not just better than pocket money, it’s also vital for longevity. Also, honest conversations with your partner, family, friends and co-workers can help them understand what you’re going through.

7)Build community – Talk about it. Join women’s support groups, church circles, or online communities. Sharing experiences helps ease the loneliness and breaks the stigma.

These steps do more than manage symptoms, they also protect against heart disease, diabetes, osteoporosis and cognitive decline which become more common after menopause.

When to seek medical help

Sometimes, despite your best efforts and lifestyle adjustments, symptoms can still interfere with daily life. That’s when it’s important to speak with a trained medical professional who understands menopause.

Treatment options range from non-hormonal therapies (such as certain supplements, prescription medications and cognitive behavioural therapy) to hormonal treatments.

For many women, Menopausal Hormone Therapy (MHT), also known as Hormone Replacement Therapy (HRT), provides significant relief. It helps reduce hot flashes, improves mood and sleep, and protects heart and bone health. However, MHT/HRT isn’t suitable for everyone, and the right type, dose, and form (pill, patch, gel, or vaginal ring) should be personalised.

That’s why it’s important to seek care from a certified menopause practitioner or a qualified doctor with training in menopause management. Every woman’s story is unique, and her treatment plan should be too.

Mindset matters – A new beginning, not the end

Menopause is not the end of youth or vitality — it’s the start of a new phase of strength, wisdom, and self-awareness. In some cultures, menopause is welcomed and seen as a positive life transition. Studies have shown that this mindset may actually improve the symptoms that these women experience.

If you’re not feeling quite like yourself lately, know that you are not alone, and help is available. With the right support, information, and care, menopause can be more than just a transition — it can be an opportunity to reset, refocus, and truly thrive.

Dr Astrid Batchelor is an obstetrician and gynaecologist and certified menopause specialist. She is passionate about improving women’s health care and awareness in Jamaica, particularly in the areas of menopause, infertility, and reproductive wellness. She practices at the Charis Women’s Wellness Centre.

DR ASTRID BATCHELOR.