Perimenopause for Filipino Women: Cultural Context, Healthcare, and Navigating Midlife

You Are Probably Carrying More Than Anyone Realizes

Filipino women are often described as the backbone of their families, and it is usually true. You manage, you organize, you support, you hold things together. You are used to prioritizing everyone else.

So when perimenopause arrives, with its unpredictable moods, disrupted sleep, and physical changes, the natural instinct can be to push through without acknowledging the weight of what is happening. You are busy. People need you. This is not the time to slow down.

But perimenopause is a multi-year hormonal transition with real effects on your health, your relationships, and your energy. It deserves more than white-knuckling through it. This guide is for you.

How Filipino Culture Approaches Menopause

In Filipino culture, menopause is sometimes referred to informally as 'change of life' or discussed in terms of becoming a lola (grandmother), framing it primarily in relational terms rather than as a health event in its own right.

There is often silence around the specifics. Hot flashes, mood swings, sleep disruption, and sexual changes are not topics that come up at family gatherings or are discussed openly between mothers and daughters. This silence means many Filipino women reach perimenopause without any frame for what to expect.

At the same time, Filipino culture has a deep tradition of herbal remedies (halamang gamot) and folk medicine, particularly in rural areas. Some of these have not been studied for efficacy or safety. Others may interact with modern medications. Your healthcare provider should know about any herbal or traditional remedies you use regularly.

Healthcare in the Philippines and Access Challenges

Healthcare access in the Philippines varies significantly between urban and rural areas. In major cities like Manila, Cebu, and Davao, private hospitals and clinics have gynecologists and some menopause specialists. The public healthcare system, operated through the Philippine Health Insurance Corporation (PhilHealth), provides some coverage but often with limited access to specialists outside major cities.

Women in rural areas may rely primarily on community health centers (barangay health centers) where knowledge of perimenopause management may be limited and hormonal treatments may not be routinely available.

Cost is also a real barrier. Hormone therapy, whether oral, transdermal, or local, may not be fully covered under PhilHealth, and out-of-pocket costs can be prohibitive for many families.

For Filipino women abroad, particularly the large communities in the United States, Canada, the United Kingdom, and Australia, the healthcare systems in those countries provide better access to menopause specialists. Knowing how to navigate those systems and advocate clearly is essential.

Traditional Remedies and What You Should Know

Filipino folk medicine includes a variety of plant-based treatments used for women's health. Luyang dilaw (turmeric), lagundi, and other herbs are part of a tradition of botanical healing that has been passed down through generations.

Turmeric has been studied for its anti-inflammatory properties and may offer general health support. However, in high supplemental doses, it can affect iron absorption and blood clotting, which matters if you are having heavy periods during perimenopause or are on certain medications.

Before using any traditional herbal preparation specifically for perimenopause symptoms, discuss it with a healthcare provider who knows your full medical picture. The interaction risk between herbal compounds and prescription medications is real, and your safety depends on your provider having complete information.

This is not about dismissing traditional knowledge. It is about combining it safely with whatever else you may be taking.

Diet and the Filipino Food Culture

Traditional Filipino cuisine is rich in rice, vegetables, fish, and root crops. It also includes significant amounts of refined carbohydrates and, in many households, fried or processed foods.

During perimenopause, blood sugar regulation becomes more relevant. Declining estrogen is associated with increased insulin resistance, making stable blood sugar more important for weight management, energy, and mood. A shift toward more vegetables, legumes, protein, and whole grains, while reducing refined starches and sugar, can support metabolic health during this period.

Fish is a strength in Filipino diet. Fatty fish like bangus (milkfish), sardines, and tuna provide omega-3 fatty acids that support cardiovascular and joint health, both of which are affected during perimenopause.

Calcium is worth attention. Dairy intake is lower in many Filipino households compared to Western diets. Calcium can come from tofu, leafy greens like malunggay (moringa), small fish with edible bones, and fortified foods. Vitamin D, needed for calcium absorption, should also be considered, especially for Filipino women living in less sunny climates.

Navigating Family Expectations

Filipino family culture is warm, communal, and often multigenerational. These are genuine strengths. But the expectation that the woman in the family will remain the emotional and physical anchor, regardless of what she is personally going through, can make it very hard to ask for accommodation or support.

If your sleep is broken, your patience is shorter than usual, or your energy is unpredictable, those are symptoms of a physiological process. They are not character flaws. Naming them to your family as health-related, rather than carrying them as a private failure, allows the people around you to be useful instead of confused.

You can say: 'I am going through a hormonal transition that is affecting my sleep and my energy. I might need a little more support for a while.' That is not dramatic. That is honest.

Self-Advocacy in Healthcare Settings

Whether you are seeking care in the Philippines or abroad, come prepared with a clear description of your symptoms. Filipino women can have a tendency to minimize discomfort in front of healthcare providers, not wanting to seem like they are complaining. But minimizing leads to undertreatment.

Be direct and specific. 'I have been waking up multiple times a night from hot flashes. My periods have become irregular and sometimes very heavy. My mood has been significantly lower than usual.' That kind of description gives your provider something concrete to work with.

Ask about all your options. Hormone therapy, non-hormonal medications, lifestyle-based approaches, and local estrogen for vaginal symptoms each have different profiles and one or more may be appropriate for you. A provider who dismisses your symptoms without exploring options is not giving you full care.

Using an app like PeriPlan to log your symptoms daily and track patterns over time gives you real data to bring to appointments instead of estimates from memory.

You Have Held Everyone Else Up Long Enough

This is your time to receive some of the care you have given so freely to everyone else. Perimenopause managed well, with good information, appropriate treatment, and daily attention to your health, means you will have more of yourself to give in the years ahead.

You are not being selfish by making your health a priority. You are being practical.

You deserve to navigate this transition with the same warmth and resourcefulness you bring to everything else in your life. Give yourself permission to take it seriously.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.