Understanding Perimenopause & Menopause

Perimenopause and menopause are normal, natural stages of life.

Women’s understandings of menopause

As women, we will each have our own understanding and experiences of perimenopause and menopause.

For some South African women, menopause means no longer being able to have children and marks the beginning of old age and becoming an elder.

For others, menopause is a time when they no longer have to deal with having a menstrual period. Menopause is seen as freeing them from the discomfort or pain, as well as costs (of pads, tampons, days off work) of their periods.

There are women who feel that menopause means that they are less of a woman (a ‘loss of femininity’) and that there is a stigma attached to menopause.

There are South African women for whom menopause may take on all these meanings.

How each of us experiences perimenopause and menopause depends on many things:

  • whether you smoke
  • your levels (type/intensity) of physical activity/exercise
  • your diet
  • whether you are overweight or obese
  • your existing medical conditions (including HIV)
  • your overall gynaecological health
  • your access to quality health services
  • your ethnicity
  • your access to information.

Page last reviewed: 1 March 2026
Next review due: 1 March 2027

Avis, N., Crawford, S., Greendale, G., Bromberger, J., Everson‐Rose, S., Gold, E., Hess, R., Joffe, H., Kravitz, H., Tepper, P., & Thurston, R. (2015). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Internal Medicine, 175(4), 531-539. https://doi.org/10.1001/jamainternmed.2014.8063

Avis, N., Zhao, X., Johannes, C., Ory, M., Brockwell, S., & Greendale, G. (2005). Correlates of sexual function among multi-ethnic middle-aged women: Results from the Study of Women’s Health Across the Nation (SWAN). Menopause, 12, 385-398. https://doi.org/10.1097/01.gme.0000151656.92317.a9

Blackson, E., McCarthy, C., Bell, C., Ramirez, S., & Bazzano, A. (2024). Experiences of menopausal transition among populations exposed to chronic psychosocial stress in the United States: A scoping review. BMC Women’s Health, 24. https://doi.org/10.1186/s12905-024-03329-z

Davis, S., Pinkerton, J., Santoro, N., & Simoncini, T. (2023). Menopause-Biology, consequences, supportive care, and therapeutic options. Cell. https://doi.org/10.1016/j.cell.2023.08.016

Dixon, S., Bi, S., Toye, F., & McNiven, A. (2023). Perimenopause and/or menopause help-seeking among women from ethnic minorities: A qualitative study of primary care practitioners’ experiences. The British Journal of General Practice, 73. https://doi.org/10.3399/bjgp.2022.0569

Drew, S., Buwu, N., Gregson, C., Micklesfield, L., Ferrand, R., & Gooberman-Hill, R. (2025). Understanding experiences and views of the menopause in Zimbabwe and South Africa: A qualitative study. Climacteric, 28, 337-344. https://doi.org/10.1080/13697137.2025.2499054

Freeman, E., Grisso, J., Berlin, J., Sammel, M., Garcia-Espana, B., & Hollander, L. (2001). Symptom reports from a cohort of African American and white women in the late reproductive years. Menopause, 8, 33-42. https://doi.org/10.1097/00042192-200101000-00007

Gold, E., Colvin, A., Avis, N., Bromberger, J., Greendale, G., Powell, L., Sternfeld, B., & Matthews, K. (2006). Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: Study of women’s health across the nation. American Journal of Public Health, 96(7), 1226-1235. https://doi.org/10.2105/ajph.2005.066936

Hayatbakhsh, M. R., Clavarino, A., Williams, G. M., Sina, M., & Najman, J. M. (2012). Cigarette smoking and age of menopause: A large prospective study. Maturitas, 72(4), 346-352. https://doi.org/10.1016/j.maturitas.2012.05.004

Jaff, N. G., & Crowther, N. J. (2025). Menopause in low and middle-income countries – an untold story. Climacteric, 28(3), 217-219. https://doi.org/10.1080/13697137.2025.2513140

Lee, S., Watson-Singleton, N., Saban, K., & Janusek, L. (2025). 0938 Development of a Culturally Tailored Sleep Intervention for Midlife African American Women: A Scoping Review. SLEEP. https://doi.org/10.1093/sleep/zsaf090.0938

MacLellan, J., Dixon, S., Bi, S., & Toye, F. (2023). Primary care practitioners’ experiences of peri/menopause help-seeking among ethnic minority women. British Journal of General Practice. https://doi.org/10.3399/bjgp.2022.0569

Madanhire, T., Hawley, S., Dauya, E., Bandason, T., Rukuni, R., Ferrand, R., & Gregson, C. (2023). Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: A cross-sectional study. BMC Women’s Health, 23. https://doi.org/10.1186/s12905-023-02466-1

Makara-Studzińska, M., Kryś-Noszczyk, K., & Jakiel, G. (2014). Epidemiology of the symptoms of menopause – an intercontinental review. Przegląd Menopauzalny = Menopause Review, 13, 203-211. https://doi.org/10.5114/pm.2014.43827

Matina, S., Cohen, E., Mokwena, K., & Mendenhall, E. (2025). Menopause and aging in sub-Saharan Africa: A narrative review. Climacteric, 28, 230-241. https://doi.org/10.1080/13697137.2025.2511906

Matina, S., Mendenhall, E., & Cohen, E. (2024). Women´s experiences of menopause: A qualitative study among women in Soweto, South Africa. Global Public Health, 19. https://doi.org/10.1080/17441692.2024.2326013

Prather, C., Fuller, T., Jeffries, W., Marshall, K., Howell, V., Belyue-Umole, A., & King, A. (2018). Racism, African American Women, and Their Sexual and Reproductive Health: A Review of Historical and Contemporary Evidence and Implications for Health Equity. Health Equity, 2, 249-259. https://doi.org/10.1089/heq.2017.0045

Schrager, S., Williams, M., Ward, E., Henningfield, M., Yuroff, A., Johnson, G., Sullivan-Wade, L., Hawkins, J., & Turnquist, A. (2024). African American women’s experiences of menopause: A focus group study. Maturitas, 187, 108043. https://doi.org/10.1016/j.maturitas.2024.108043

Whitcomb, B. W., Purdue-Smithe, A. C., Szegda, K. L., Boutot, M. E., Hankinson, S. E., Manson, J. E., Rosner, B., Willett, W. C., Eliassen, A. H., & Bertone-Johnson, E. R. (2018). Cigarette Smoking and Risk of Early Natural Menopause. American Journal of Epidemiology, 187(4), 696-704. https://doi.org/10.1093/aje/kwx292

Williams, M., Richard-Davis, G., Williams, P., Christensen, L., Ward, E., & Schrager, S. (2022). A review of African American women’s experiences in menopause. Menopause, 29, 1331-1337. https://doi.org/10.1097/gme.0000000000002060

Yisma, E., Eshetu, N., Ly, S., & Dessalegn, B. (2017). Prevalence and severity of menopause symptoms among perimenopausal and postmenopausal women aged 30-49 years in Gulele sub-city of Addis Ababa, Ethiopia. BMC Women’s Health, 17. https://doi.org/10.1186/s12905-017-0484-x