By Veronica Mrema
Only a small number of women in Tanzania seek medical care specifically for the challenges they experience as they approach menopause.
Menopause is a biological process that, for most women, occurs between the ages of 45 and 55. The transition towards the end of menstruation is accompanied by various changes caused largely by declining levels of the hormone estrogen.
Estrogen is produced by the ovaries as part of the female reproductive system.
As a woman approaches menopause, estrogen levels gradually decline, triggering a range of changes throughout the body.
Some women experience changes affecting the brain and cognitive function. They may become more forgetful, experience dizziness, have difficulty sleeping or suffer from headaches.
Others experience mood changes, including irritability and sudden changes in emotions.
The effects can also be felt throughout the body. Some women experience changes in their skin, joint and muscle pain, weight gain or weight loss and, in some cases, difficulty moving comfortably after waking up until the body becomes more active.
These are among the many changes that can accompany the transition to menopause.
Tanzania has national statistics showing the number of women who reach menopause.
However, there is still a gap in information about what these women actually experience, including the type and severity of symptoms, their effects on work and relationships, women's understanding of menopause and the services they need.
According to the Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022, 10.6% of women aged 30 to 49 had reached menopause.
Among women aged 48 to 49, the proportion was 46.1%.
However, these figures do not provide a complete picture of the challenges women experience during the transition to and after menopause.
Professor Muzdalifat Salim Abeid, a specialist in Obstetrics and Gynaecology and Medical Director at Aga Khan Hospital, says there is a need for closer attention to women going through this stage of life.
“At Aga Khan, we felt it was important to establish a dedicated clinic specifically for these women. I have some women come asking me to start them on hormonal therapy, but that is not how the process works.
“You have to sit down and talk to the person and conduct an assessment. Not every woman, or every age group, should be given these medicines. So you ask the person: do you know that not everyone is suitable for these medicines? Do you know the possible risks?” she says.
She says many women are not aware of these issues and may instead rely on advice from friends they meet in social groups or at work.
“Even among those who come to our clinic, you often find that because of limited awareness, they initially stay at home thinking it is normal.
“Or they talk to women who have already gone through it and are told that it is simply old age and that they will eventually be fine.
"Even when they go to hospital, they may be treated for several other conditions without addressing the underlying issue. They may fail to recognise it early because of limited awareness,” she adds.
However, not every woman experiencing challenges associated with menopause should automatically start using hormonal medicines, commonly known as Hormone Replacement Therapy (HRT).
Professor Muzdalifat says the first step is to assess the woman to determine whether she is suitable for HRT and whether she has any factors that could increase her risk of adverse effects.
“You first need to educate the person and carry out an evaluation to determine whether she is at risk of complications,” Professor Muzdalifat stresses.
The Tanzania Medicines and Medical Devices Authority [TMDA] has also stressed that these medicines should not be used indiscriminately without the advice and supervision of a healthcare professional.
Dr Yonah Mwalwisi, a pharmacist and Director of Human and Veterinary Medicines Regulation at TMDA, says HRT is among the medicines that require a prescription.
TMDA has so far registered eight HRT medicines in Tanzania, available in forms including tablets, capsules and pessaries.
HRT can be beneficial for some women experiencing menopause symptoms, but its use should follow a medical assessment and take place under the supervision of a healthcare professional.
According to TMDA, some of the risks associated with HRT may include blood clots, stroke and an increased risk of breast cancer in some women, as well as cancer of the lining of the uterus in certain circumstances.
Other possible adverse effects may include abnormal vaginal bleeding, breast pain, headaches, fluid retention and interactions with other medicines.
TMDA data show that between 2021 and 2025, a total of 2,624 reports of suspected adverse events or reactions were associated with hormonal medicines used by women.
The figure, however, covers hormonal medicines used by women generally and does not mean that all 2,624 reports were related specifically to HRT.
As Tanzania continues to expand awareness about menopause, health professionals say women need accurate information before deciding to seek treatment, particularly when it comes to hormonal medicines.
The message is not that HRT should be avoided altogether. Rather, women need to understand that hormonal treatment is not a one-size-fits-all solution.
Medical assessment, appropriate prescribing and follow-up by a qualified healthcare professional remain important in determining whether HRT is suitable for an individual woman.
For a deeper look at the experiences of women going through menopause, the gaps in information and the safety concerns surrounding hormonal medicines, do not miss our special in-depth analysis, which will be published on this page on September 25, 2026. Stay tuned.
Chapisha Maoni