For women, going through menopause is inevitable if they live long enough. In Trinidad and Tobago, there’s very little education about the topic, and women often struggle with knowing what they’re going through.
According to WebMD, menopause is the end of a woman’s menstrual cycle and fertility. It happens when the ovaries no longer produce the hormones oestrogen and progesterone, and the person doesn’t have a period for a year.
There are three stages: perimenopause, menopause, and postmenopause. Perimenopause can begin in the 40s, though some people experience it earlier. Menopause happens when the person has their final period, and post-menopause is the period 12 months after the last period.
Menopause happens naturally with age, but can also stem from surgery, treatment of a disease, or an illness. Once it occurs naturally, the first sign of perimenopause is an irregular menstrual cycle. Other symptoms can include hot flashes, night sweats, mood swings, irritability, lower sex drive, sweating, racing heart, headaches, vaginal soreness and dryness, painful sex and trouble sleeping.
To combat this lack of education, a group of women decided to form an NGO, Meno-TT, to support, educate, and advocate for themselves and others.
President Gillian Smith-Trumpet, who worked in the banking sector for over 20 years, said they decided to form Meno-TT after realising many women were going through the first stage of menopause and there wasn’t an existing support organisation they could join. “I’d had a hysterectomy and I had no clue as to what I would have experienced, and I was going crazy with all these symptoms. I said to my best friend, Natasha Nunez, 'Don’t you think we should create something to help other people like ourselves who are going through this but don’t know what’s happening, to do the research and find out what it is going on with our bodies?' We’re all almost the same age and we decided, why not start a menopause group?”
Smith-Trumpet said they realised there were over 120 symptoms of menopause, and doctors often don’t recognise the symptoms.
“You have to literally tell them, 'This is what I’m feeling, do not treat me individually in terms of all the symptoms I’m experiencing. You’re going to treat me for depression, you’re going to treat me for anxiety, you’re going to treat me for this, you’re going to treat me for that. I need one pill that will help me with everything.'”
She said the women’s combined experiences made them appreciate the need for a virtual gathering place.
“We realised there is a need to tell the women of TT, 'Hear what, y’all are not going crazy. This is perimenopause, this is menopause, these are the symptoms you’re experiencing. We created a safe space whereby you can share your experiences, what you’re going through and we all share our experiences, because you and I may have different experiences, and what may work for me may not work for you.'”
Nunez, Meno-TT's secretary, said the group has grown to over 700 members since its inception in March 2023, with more joining daily.
“The response has been frankly astounding. We’ve have been shocked at how many women out there really are either struggling, or want to be a part of a community of like-minded women who have many similar struggles. They find support and encouragement and, importantly, information about what they can do to advocate for themselves in a doctor’s office and to find the relief that they need.
She said the objective in forming the NGO was to enable them to do research, advocacy and education formally.
“We know black women experience menopause a little differently (from) other races, especially for us in the Caribbean. It’s important we find and support this research so we can pass it down to younger women so when they reach our age they won’t be as clueless as we were.
"I think all of us really realised we were coming to this age and experiencing certain symptoms but what is it? The word menopause was floating around, but you never really knew, and then when that light bulb went off, it was like, finally! Finally we know what it is and we can address the issues.
“I think a lot of women are having that lightbulb moment and thankfully we are here to support them in this journey. Getting older is inevitable, and for women especially, it’s not something that is cherished and celebrated."
Registered dietician and Meno-TT vice president Lisa Feveck said she started researching menopause when it happened in her 30s. She specialises in women's health during all stages of menopause.
“When I started, no one said 'menopause.' I got a lot of different medications, anti-anxiety, anti-depression, and nobody had an underlying cause, so I had to figure it out on my own...There’s a lot of strange symptoms, itching, scratching, random smells, tooth pain, heart palpitations; it affects blood sugar, blood pressure, cholesterol.
“Menopause puts us at risk for heart disease, high blood pressure, diabetes – it affects every major organ in our bodies. So it’s important that women know and understand what symptoms they have. They have to go to their doctors and say it’s not that they’re depressed, it’s menopause, so it has to be a different treatment.”
Feveck said she concentrates on women’s diets, because the recommended treatment for menopause symptoms, hormone replacement therapy (HRT), doesn’t work for everyone.
“What I bring to the table is, I try to give dietary advice, some fitness advice, some mindset advice as well, because it’s all a holistic approach, but yeah, I’m here to support and serve where I can.”
Lisa Leander-Yeates, brokerage manager and Meno-TT treasurer, said she would like to see doctors becoming more educated about perimenopause, menopause, the symptoms and the treatments.
“You would think since menopause is an age-old part of life, women in generations before us would have experienced it, and the doctors would know people who experienced it."
Smith-Trumpet said her suggestion of menopause as a cause of her symptoms had been rejected by doctors at both hospitals and health centres.
“They prefer to treat you for each symptom individually, and give you all of these medications that have all of these side effects, which can cause another set of issues, whereas all those different types of HRT they have available abroad could work for the women.
“This is what Meno-TT is about. We are going to educate, we are going to do the research, and we are also going to advocate that the women of TT have a voice, and the doctors and the professionals all need to listen to us. Not because you’re a doctor and you think you know what’s best – listen, because y’all are not listening to us when we go to y’all.”
Nunez shared the story of a young woman in her 20s who had had a hysterectomy, which sent her straight into menopause.
“She was not advised as to what was happening to her, and she is in a mess...As a young woman who has her whole life ahead of her, she has no clue what’s happening with her body, and that is a frightening place to be. Unfortunately she’s not alone in that.
“It’s one of the things that we would like to address. A lot of women who have had hysterectomies are not made aware they’re going to be thrust into menopause, and to me that is a dereliction of duty by the medical fraternity.
"How could you not explain that she has no ovaries now so that means she’s not producing any oestrogen, which means you’re going into full-blown menopause?
"This is a condition that every woman will go through, some worse than others, and it is your responsibility as a physician to let your patients know this. That young woman’s case was so touching and so poignant for everybody who heard her story – and that shouldn’t happen to anybody.”
Nunez said since women make up half the population, it stood to reason treating menopause should be more of a priority.
“Society doesn’t care about women in general, right? So I think this is an extension of that, how the medical profession and just people in general treat with older women and women who are going through menopause.
"We need to turn that on its head, and reframe the conversation in a way that we are not old and dried up. We are in fact in the prime of our lives, and we should be able to contribute to society.”
According to the Health Minister and the Central Statistical Office, TT has an aging population. Along with the push for the retirement age to be raised to 65, this means there will be more menopausal women in the workplace.
Nunez said she knew several women, including Smith-Trumpet, who had had to leave their jobs because their workplaces were not treating with their menopause symptoms.
“That is another point we want to advocate for, for workplaces to acknowledge the fact that some of your best workers are in fact women of this age and they need to be treated with the compassion and dignity and respect that they deserve when they’re going through this transition, because you don’t want to lose them."
Smith-Trumpet said managers needed to empathise with their employees and provide proper accommodation for those going through the transition.
“They have sick leave, maternity leave – what do you have in place for somebody who is going through perimenopause and then transitioning to menopause?
Dance and aerobics instructor and Meno-TT PRO Joella Corneille agrees.
“We need the support of the powers that be. It could be from the Ministry of Health to support this discussion, or from corporate (entities), to understand that this is what is happening to your older female women, or from the public sector, since they’re the largest employer in TT.
"Yes, you’re happy they’re no longer in childbearing age, which is something employers seriously consider, but they also have the mental and physical effects of menopause they’re going through.”
Smith-Trumpet called on the Health Ministry to help the group create awareness among health care workers and the general public.
Meno-TT can be found on Facebook. Applicants must answer the security questions to join the group.