*Menopause Is Not the End – It is a Critical Transition Hidden Behind Silence and Stigma* 

– *Dr Nelson Aluya MD, MBBS* 

Menopause is universal, inevitable, and often misunderstood.

It is not merely the end of menstruation; it is one of the most consequential biological transitions in a woman’s life. The danger of menopause does not lie in the transition itself, but in how poorly it is understood, recognized, and treated—by societies, healthcare systems, and often by women themselves.

Women constitute approximately 49.6–49.7% of the global population, amounting to over 4 billion women worldwide as of 2024–2025. Although slightly more boys are born than girls—about 106 boys for every 100 girls—higher male mortality means women increasingly outnumber men in older age groups. Globally, the sex ratio evens out to nearly 50/50, with women dominating later decades of life (United Nations; World Bank; INED). And every woman who lives long enough will experience menopause.

Menopause is defined as 12 consecutive months without a menstrual period, typically occurring between ages 45 and 55, with an average age of 51–52. Today, over one billion women globally are experiencing perimenopause, menopause, or postmenopause. In the United States alone, 1.3 to 2 million women enter menopause annually, roughly 6,000 women every day. As populations age and life expectancy increases, this number will continue to rise.

Yet despite affecting nearly half of humanity and 100% of women who reach midlife, menopause remains one of the most neglected and poorly integrated areas of modern meLimitations?

*A Critical Biological Turning Point:*

Menopause represents a sharp decline in estrogen and progesterone—hormones that influence far more than reproduction. Estrogen plays a protective role in cardiovascular health, bone density, brain function, metabolic regulation, and emotional stability. When estrogen levels fall, risk rises.

This is why menopause is increasingly recognized as a critical health inflection point, not a benign milestone.

*Cardiovascular Disease: The Greatest Threat:*

Cardiovascular disease is the leading cause of death in women worldwide, surpassing all cancers combined. Before menopause, estrogen confers relative cardiovascular protection. After menopause, that protection rapidly diminishes.

Research shows that the menopausal transition is associated with: Worsening lipid profiles Increased insulin resistance

Central weight gain

Vascular stiffness and endothelial dysfunction

Collectively, these changes double the risk of heart disease compared with premenopausal women.

Compounding this risk is misdiagnosis. Women experiencing myocardial infarction often do not present with classic symptoms such as crushing chest pain or dramatic shortness of breath. Instead, they may report fatigue, nausea, heartburn, dizziness, jaw or shoulder pain—symptoms frequently dismissed as anxiety, stress, or “menopausal complaints.”

The consequences are stark. Studies show that women aged 45–64 have higher mortality following a first heart attack than men of the same age. One-year mortality rates approach 23% in women versus 18% in men, and within five years, 47% of women die, develop heart failure, or suffer a stroke compared with 36% of men.

“Menopause does not cause heart disease.

Ignorance of menopause does.”

*Mental Health, Depression, and Suicide Risk:*

Menopause is also a period of heightened psychological vulnerability. Fluctuating and declining estrogen affects neurotransmitters such as serotonin and dopamine, increasing susceptibility to major depression, anxiety, irritability, and emotional dysregulation.

*This risk is not theoretical:* Epidemiological data indicate that women are more likely to die by suicide between the ages of 45 and 49, coinciding with the late perimenopausal and early menopausal years. While suicide is multifactorial, menopause represents a biological and psychosocial stressor that intersects with caregiving burdens, career pressures, aging awareness, and sleep deprivation.

“o dismiss these symptoms as “normal” is to trivialize a period of genuine risk.”

*Cognitive Decline and Neurological Vulnerability:*

Emerging evidence suggests that estrogen plays a role in maintaining synaptic health and cerebral blood flow. The menopausal transition has been associated with brain fog, memory lapses, and reduced processing speed, symptoms frequently minimized or ignored.

Women account for nearly two-thirds of Alzheimer’s disease cases worldwide. While causality remains under investigation, declining estrogen during menopause is increasingly viewed as a potential contributor to long-term neurological vulnerability, particularly when combined with cardiovascular risk factors.

*Bone Loss and Physical Frailty:*

Bone density declines precipitously after menopause. Without estrogen, women experience accelerated bone resorption, placing them at high risk for osteoporosis and fractures. Nearly half of a woman’s lifetime bone loss occurs during the menopausal years.

Hip fractures, in particular, are associated with loss of independence, chronic disability, and increased mortality—yet bone health screening and prevention remain underutilized.

*The Burden of Symptoms—and Silence:* Hot flashes, night sweats, sleep disruption, fatigue, vaginal dryness, reduced libido, and cognitive changes are not trivial inconveniences. Moderate-to-severe vasomotor symptoms peak in the first two years after menopause and can persist for a decade or longer.

Despite this, menopause remains dramatically under-treated. Many women are told to endure symptoms without explanation or support. This silence has consequences—not only for individual health, but for families and communities.

*Menopause and the Social Fabric:*

Menopause often coincides with peak life stress: caring for aging parents, supporting adolescent or adult children, managing career demands, and confronting aging itself. The cumulative effect can strain relationships.

Surveys suggest that up to 70% of women report menopause as a contributing factor to marital breakdown, citing increased conflict, reduced intimacy, and emotional distress. Divorce rates among adults over 50—so-called “gray divorce”—have risen dramatically in recent decades, with menopause frequently acting as an unrecognized catalyst.

When menopause is misunderstood, women are blamed for biological changes they cannot control.

A Shift Toward Evidence and Empowerment

Menopause is not a disease, but it demands medical respect.

Lifestyle interventions—regular physical activity, balanced nutrition, smoking cessation, reduced alcohol use—remain foundational. Medical care is equally vital: cardiovascular screening, bone density assessment, mental health support, and treatment of genitourinary symptoms.

Hormone therapy, long stigmatized, is undergoing reevaluation. In November 2025, the U.S. Food and Drug Administration initiated the removal of outdated “black box” warnings from most hormone replacement therapies, acknowledging that prior risk assessments were based on misinterpreted data. Current evidence indicates that for women under 60 or within 10 years of menopause, hormone therapy can reduce cardiovascular risk, fractures, and possibly dementia when appropriately prescribed.

Legislative efforts, such as the New Jersey Menopause Coverage Act, reflect growing recognition that menopause care is not optional—it is essential healthcare.

Beyond Survival: The Postmenopausal Years

For many women, life after menopause brings increased confidence, clarity, and freedom—a phase sometimes described as postmenopausal zest. But reaching that stage safely requires awareness, education, and systemic change.

Conclusion

Menopause is not a footnote in women’s health.

It is a defining chapter.

Ignoring it places billions of women at unnecessary risk—of heart disease, depression, cognitive decline, fractured families, and preventable death.

“Menopause does not weaken women.

Silence does.”

Recognizing menopause as a critical health transition is not only a medical obligation—it is a moral one.

NSCDC Busts Syndicate Vandalizing Railway Tracks, NNPC Pipelines; 12 Suspects Arrested

The Nigeria Security and Civil Defence Corps (NSCDC) has dismantled a syndicate involved in the vandalism, theft and recycling of critical national infrastructure, including railway tracks, NNPC pipelines and water board installations, with no fewer than 12 suspects arrested. The National Public Relations Officer of the corps, ACC Babawale Afolabi, disclosed this during a briefing on Wednesday in Kaduna. Afolabi, represented by the Deputy Public Relations Officer, SC Terzungwe Orndiir, said the operation followed a viral video showing massive vandalisation of newly laid Kaduna-Kano rail tracks and existing railway infrastructure in the northern part of the country. He said the Commandant General of the corps, Ahmed Abubakar Audi, directed the CG’s Special Intelligence Squad (SIS) and the Kaduna State Command to identify and apprehend those behind the act.

According to Afolabi, the breakthrough was achieved through intelligence-led operations supervised by the Commander of the CG’s SIS, Commandant Apollos Dandaura, in collaboration with the Kaduna State Command. He said operatives on May 12 dismantled what he described as an international and local syndicate operating under a sophisticated criminal cover. The suspects allegedly used the premises of Inner Galaxy Steel Company at Birnin Yero in Igabi Local Government Area of Kaduna State as a front for their activities. According to the NSCDC spokesperson, the company allegedly compressed vandalised railway materials into scrap at its Kaduna facility before transporting them to Aba, Abia State, where they were melted and recycled into nails and iron rods. Afolabi said this criminal cycle had caused the Federal Government monumental economic losses, adding that the suspects allegedly conspired with vandals to purchase stolen railway tracks, slippers, NNPC pipes and water board infrastructure.

The NSCDC spokesman said seven suspects had been arrested in connection with the case, identifying them as Usman Hassan, company manager; Bilyaminu Usman, weighbridge operator; Choji Pam, weighbridge officer; Jamilu Jaafar, scrap collector; Chukwuemeka Udonwoke, supervisor; Chikwodilli Ezema, company manager; and Isaac Etim, scrap leader. According to him, the suspects are being processed for criminal conspiracy, unlawful possession of vandalised property and receiving stolen property. He listed items recovered from the scene to include large quantities of vandalised railway tracks and slippers, suspected NNPC and water board pipes, as well as specialised machinery allegedly used for compressing and concealing stolen infrastructure.

Afolabi further disclosed that the CG’s SIS and Kaduna State Command also arrested five suspects over alleged vandalism of rail tracks along the Kaduna-Abuja corridor at Gwagwada community in Chikun Local Government Area. He said exhibits recovered from them included railway tracks, slippers and gas cylinders allegedly used in destroying the infrastructure. The NSCDC spokesman quoted the Commandant General as commending the CG’s SIS and Kaduna State Command for their gallantry and professionalism. He said the corps was concerned that registered companies were allegedly acting as saboteurs, adding, “Under this leadership, the NSCDC will not treat economic sabotage with kid gloves. We are going after the sponsors. This operation marks the beginning of a new phase in our crackdown on syndicates supporting vandalism under any disguise.” Afolabi thanked members of the public for providing intelligence through social media and urged continued collaboration with security agencies.

Also speaking, the Managing Director of the Nigerian Railway Corporation (NRC), Dr Kayode Opeifa, commended the NSCDC for recovering large quantities of railway materials allegedly vandalised and concealed in Kaduna State. Opeifa, represented by the Chief Technical Officer (Track), Zaria, Mr Paul Doche, said the NRC team was invited by the NSCDC to identify railway materials recovered during the intelligence-led operation. He said the recovered items included heaps of railway sleepers and rail tracks allegedly hidden beneath scrap metal debris, adding, “We have gone round and identified some of our materials there. These are national assets.” Doche praised the NSCDC for what he described as a successful intelligence-driven operation. He noted, however, that it would be difficult to immediately quantify the recovered materials because many of the railway components were buried under heaps of metal scraps. “Before we can quantify, we have to remove all the debris and count the materials one after the other,” he said. Doche reiterated that the Nigerian Railway Corporation had zero tolerance for vandalism and destruction of railway infrastructure. According to him, the matter would be handed back to the NSCDC for further investigation and prosecution of those involved in accordance with the law.

‎Video: Ondo Community Rejects Imposition of Sepeluwa As Oba in Oroto 

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‎Concerned citizens and indigenes of Oroto Community, Ugbo Kingdom, Ilaje Local Government of Ondo State have rejected the imposition of Sepeluwa as the title of Oba in Oroto.

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‎The community in a statement by Oluwafemi Awenebi,said Oroto belongs to all the people of the community, and decisions concerning leadership and traditional institutions must reflect fairness, equity, and justice for everyone.

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‎It said: “We, the residents and indigenes of Oroto, are the rightful owners and occupants of this community. The entire community stands united in rejecting any attempt to force Sepeluwa on the people against their collective will as their domain is obenla.

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‎”We call on the Olubo family to stop using the instrument of the state to oppress and silence the voices of Oroto people, Egharegbemi is the Eldest, Leadership should be based on consultation, inclusiveness, and respect for the wishes of the people. For peace and unity to prevail, everybody must be carried along in matters affecting the community.

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‎”Oroto is for all of us, and the collective interest of the people must always come first. The governor should not impose a Sepuluwa on us, protest letters have been written to the governor and the chieftaincy and local government commissioner yet they want to still go ahead to present a staff of office.

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‎”We, the concerned people and indigenes of Oroto Community in Ugbo Kingdom, write this public correspondence with deep pain, concern, and dissatisfaction over the ongoing attempts to impose the title of “SEPELUWA” within our land and traditional structure without due consultation, lawful process, or historical legitimacy.

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‎”It has come to our attention that plans are underway by the Government to install a person under the title of “SEPELUWA” in Oroto Community.

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‎”This development has generated widespread tension, outrage, and serious concern among the peace-loving people of Oroto and the entire Ugbo Kingdom.

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‎”For months, our people have written several letters through the Ministry of Chieftaincy Affairs and Obas, as well as through the Office of the Executive Chairman of Ilaje Local Government, seeking clarification, dialogue, and peaceful resolution on this sensitive issue.

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‎”We have made repeated appeals, consultations, peaceful protests, and historical presentations to relevant authorities, yet our concerns have received little or no meaningful response.

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‎”We therefore find it necessary to state clearly and publicly that the people of Oroto reject the imposition of the so-called SEPELUWA title in our community.

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‎”Our position is based on historical facts, ancestral tradition, and the established customary structure of the Ugbo Kingdom. To the best of our historical knowledge and ancestral records, there has never existed a recognized traditional title known as “SEPELUWA” within the traditional institution of the Ugbo Kingdom.

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‎”Furthermore, we strongly maintain that no authority outside the recognized traditional stool of the Olugbo of Ugbo Kingdom possesses the customary right to install traditional leaders or create chieftaincy structures within Ugbo Kingdom.

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‎”Any attempt to bypass established customs and impose unfamiliar titles upon our people amounts to an abuse of traditional processes and a disregard for the historical identity of our kingdom.

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‎”The people of Oroto are law-abiding citizens who believe in peace, justice, and democratic engagement. However, peace can only thrive where there is fairness, consultation, and respect for the rule of law.

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‎”A government that truly serves the people must listen to the voices of the people and not force decisions upon them against their collective will and historical heritage.

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‎”The people of Oroto will continue to defend their ancestral rights, cultural identity, and historical truth through lawful and legitimate means. We refuse to remain silent while our traditions, history, and collective heritage are disregarded.”