The Silent Phase: Why Menopause Remains Unspoken In Kashmir

(MENAFN- Kashmir Observer) Srinagar- In a modest home in south Kashmir, 52-year-old Rafiqa Begum wakes up long before dawn. Sleep, she says, has become unpredictable. Some nights she lies awake for hours, her body restless, her mind racing without reason. Other days, a dull ache settles in her joints, making routine chores feel unusually heavy.

She has never spoken about these changes to anyone outside her immediate family. Even there, the conversation is brief, almost apologetic.

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“I thought something was wrong with me,” she says quietly.“But then someone told me this happens with age. So I kept quiet.”

Rafiqa's experience is not isolated. Studies suggest that over 80% of women report menopausal symptoms, many of them severe. Yet, in Kashmir, these experiences remain largely unspoken.

Across Kashmir, thousands of women move through menopause in silence, experiencing a complex mix of physical and emotional changes without language, support, or recognition.

A Phase Without Vocabulary

In many Kashmiri households, reproductive health discussions remain narrowly framed around menstruation, pregnancy, and childbirth. Once a woman crosses her reproductive years, the discourse fades.

Menopause, despite being a universal biological transition, rarely finds mention in everyday conversation. There is no commonly used, comfortable vocabulary around it. Instead, it is referred to indirectly, often reduced to“umar ka asar” or simply ageing.

This linguistic absence reflects a deeper cultural discomfort.

“Women are expected to endure,” says a Srinagar-based gynaecologist.“If they speak about hot flashes, anxiety, or mood swings, it is often dismissed as weakness or overthinking.”

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The result is a generation of women who normalize distress.

“Women tend to endure menopausal symptoms without recognising them as a health issue. They treat its symptoms as something to quietly endure,” says Dr Berkheez.

She added that there are certain symptoms like Postmenopausal bleeding and increased endometrial thickness, if overlooked, have the potential to worsen if left unaddressed.

Living Through It, Alone
Medical literature identifies menopause as a phase marked by hormonal shifts that can trigger insomnia, irritability, depression, and musculoskeletal pain. But in Kashmir, these symptoms are frequently unrecognized or misattributed.

Women often interpret anxiety as personal failure, fatigue as laziness, and emotional volatility as something to suppress.

A mental health practitioner in Srinagar notes a pattern:“We see women in their late forties and fifties reporting anxiety or depressive symptoms. When you probe further, many are in the menopausal transition, but they have no awareness of it.”

Without awareness, there is no help-seeking behaviour.

Instead, coping mechanisms remain private and often inadequate.

Mental health experts warn that menopause is often a hidden psychological phase. Global data shows that nearly 35% of menopausal women experience depression.

According to a study titled, Bio-psycho-socio-cultural perspectives on menopause, cultural beliefs profoundly shape the experience, perception, and reporting of menopause, influencing whether it is viewed as a medical crisis, a social taboo, or a liberating life stage. While vasomotor symptoms (hot flashes/sweats) are universal, their frequency and distress levels vary significantly by region.

Menopause is not defined by a single symptom but by a wide range of physical and psychological changes that vary across individuals, says the World Health Organization. While hot flashes and night sweats are the most recognised, experts say women frequently report persistent insomnia, fatigue, joint and muscle pain, weight gain, and fluctuations in blood pressure. Hormonal shifts can also affect mood, leading to irritability, anxiety, and depression, alongside cognitive changes such as forgetfulness or difficulty concentrating.

The Weight of Silence

The silence surrounding menopause is not accidental. It is shaped by intersecting factors: modesty norms, lack of sex education, and a healthcare system that prioritizes maternal health over midlife care.

For many women, speaking about bodily changes linked to reproductive organs is seen as inappropriate, especially after a certain age.

“There is a sense that this phase is not important,” says an ASHA worker from Budgam.“Pregnancy is treated seriously. But when periods stop, people think the need for care also stops.”

Read Also The Cost of Being a“Strong Woman” in Kashmir No Day Off for Kashmiri Mothers

This perception carries consequences.

Unaddressed menopausal symptoms can affect not only physical health but also family dynamics, productivity, and mental well-being. Yet, because these struggles remain invisible, they rarely enter public discourse.

Gaps in the Healthcare System
Kashmir's public health infrastructure has made significant strides in maternal and child health. However, menopausal care remains largely absent from policy focus.

Dedicated counselling services, awareness campaigns, or routine screening protocols for menopausal women are limited or non-existent in most government facilities.

“We do see menopausal patients, but they usually come with specific complaints like joint pain or bleeding issues. There is no structured approach to menopausal health as a category.”

Hormone replacement therapy, lifestyle counselling, and mental health support are available in theory but remain inaccessible for many due to cost, awareness, or social hesitation.

The silence deepens in rural areas, where cultural barriers are stronger.

Women rely heavily on informal networks or local health workers, who themselves may not have adequate training on menopausal health.

“Sometimes we don't know what to tell them,” admits Shaheena, an ASHA worker.“We can guide them during pregnancy, but for menopause, there is no clear training.”

For many, the experience extends far beyond the commonly cited symptoms.

Humaira Nabi, a Ganderbal resident, recalls noticing changes in her mother long before she understood what they meant.“It was not just hot flashes,” she says.“She gained a lot of weight, her blood pressure went high, and she would feel unusually uncomfortable even in winter. She could not wear a sweater sometimes.”

What stayed with her more was the silence around it.

“She never spoke about it. I only realised later, when my aunt reached menopause and they started discussing it among themselves. I overheard them. That is when it made sense.”

Humaira points to a pattern that many families quietly reproduce.“Women do talk, but mostly to each other, not to their children or even their partners. And rarely to doctors unless something becomes serious.”

She also highlights a growing concern that often goes unaddressed.“Early menopause is becoming more common, and from what I have seen, it seems harder to deal with.”

Breaking the Quiet

Experts argue that addressing menopause requires both cultural and institutional shifts.

At the societal level, normalizing conversations is critical. This includes intergenerational dialogue, community awareness, and media representation that frames menopause as a natural phase rather than a hidden burden.

At the policy level, integrating menopausal care into primary healthcare services could make a significant difference.

Simple interventions such as awareness sessions, routine check-ups, and mental health screening can help women better understand and manage the transition.

A Story Still Untold
For now, menopause in Kashmir remains a silent phase, lived but rarely spoken.

Back in her kitchen, Rafiqa pauses between chores, reflecting on the past few years.

“If someone had told me earlier what this is,” she says,“maybe I would not have been so worried.”

Her words capture the core of the issue, not just lack of treatment, but lack of knowledge, language, and acknowledgement.

Until that changes, menopause will continue to be experienced in isolation, one quiet story at a time.

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