At 40, I have noticed how quickly people explain almost anything with four words: “You are getting old.” A stiff back, a forgotten name, poor sleep or a sudden ache becomes a joke about age. We laugh because humour makes change easier to accept. But sometimes the joke closes a conversation that should have […]

At 40, I have noticed how quickly people explain almost anything with four words: “You are getting old.” A stiff back, a forgotten name, poor sleep or a sudden ache becomes a joke about age. We laugh because humour makes change easier to accept. But sometimes the joke closes a conversation that should have remained open.

World Menopause Day falls on 18 October, and this year’s theme is chronic pain at midlife. It is an important choice because menopause is still largely discussed through hot flushes and periods ending. Pain in the joints, muscles or elsewhere in the body may not be recognised as part of the wider midlife picture. Women themselves may not make the connection, and the people around them may simply decide that this is what getting older looks like.

That assumption is especially familiar in cultural homes. Women are expected to keep moving. They work, run businesses, care for children, support ageing parents and often carry the emotional administration of an entire family. When something hurts, the usual response is to rub it, pray about it, take a painkiller and continue. Endurance is admired so much that stopping to investigate pain can feel indulgent.

There is a danger in that. The International Menopause Society says chronic pain affects a significant proportion of women during and after the menopause transition, but remains underestimated in research and care. The World Health Organization also recognises that perimenopause can affect physical, emotional, mental and social wellbeing for several years. Yet neither statement means that every pain in a woman over 40 is caused by hormones.

That distinction matters. Menopause should help us ask better questions, not give us another convenient answer. Back pain may come from an old injury, poor seating or hours spent driving. Joint pain may have inflammatory or mechanical causes. Tiredness and body aches can sit alongside diabetes, thyroid disorders, anaemia, vitamin deficiencies, sleep problems or other conditions. A woman deserves more than being told, “It is your age,” just as she deserves more than being told, “It is probably menopause.”

For women already living with a chronic condition, the picture can become even more confusing. When you manage diabetes, for example, there is a temptation to attach every new symptom to it. Sometimes the connection is real, and sometimes it is not. The body does not organise itself into neat departments simply because healthcare does. Midlife care must look at the whole person, her medical history, her daily demands and what has recently changed.

This is also a workplace issue. The International Labour Organization reported in June that an estimated 657 million working women are navigating menopause. These are not women at the end of their usefulness. Many are at the height of their experience, managing teams, running organisations and holding years of knowledge that cannot be replaced overnight. Yet pain, disrupted sleep and other symptoms can make an ordinary working day much harder than it appears from the outside.

In Zambia, where many organisations are only beginning to take mental health and chronic illness seriously, menopause may sound like one more policy imported from somewhere else. It is not. Our offices, factories, clinics, markets and family businesses are full of women in midlife. The language may be different and the subject may remain private, but the biology does not stop at the border.

Employers do not need to diagnose anyone, and women should not have to disclose intimate details to prove that they are struggling. The practical response is much simpler: create room for honest conversations, allow reasonable flexibility for medical appointments, review seating and physical demands, and train managers not to turn a health concern into a joke about mood or age. These adjustments can support anyone managing pain, not only women going through menopause.

Families also have a role. When a woman who has carried everybody else begins talking about pain, the answer should not immediately be that she needs to lose weight, exercise more or accept that she is ageing. Advice given too quickly can sound like blame. A more useful response is to ask when the pain began, what makes it worse and whether she has spoken to a qualified health professional. Listening is not a treatment, but it can be the first step towards one.

Women, too, may need permission to take their own symptoms seriously. Keeping a simple record of pain, sleep, menstrual changes and other symptoms can make a medical conversation clearer. It is reasonable to ask what else should be ruled out and what treatment or management options are appropriate. Evidence-based care may involve different approaches depending on the cause, medical history and personal preference. There is no single menopause solution that suits every woman.

We should also resist turning midlife into a medical emergency. Menopause is a natural life stage, not a disease, and some women experience few difficulties. Awareness should not make every woman frightened of her forties or suspicious of her body. The aim is not to search for illness in every ache. It is to stop normalising suffering simply because a woman has reached a certain age.

I think the real question this World Menopause Day is not whether midlife is supposed to hurt, but why women are so often expected to carry pain quietly when it does. “You are getting old” may still make us laugh, but it should never be the end of the investigation.

Kaajal Vaghela is a sportswear designer and cultural wellness consultant with over three decades of lived experience managing Type 1 diabetes in Zambia and the diaspora. Having previously served as Chairperson of the Lusaka branch of the Diabetes Association of Zambia, she remains a passionate advocate for breaking down myths and building awareness about diabetes. For more personalised coaching or corporate wellness workshops, visit: www.kaajalvaghela.com and for any feedback: diabetes.by.kc@gmail.com)