Perimenopause for Nigerian Women: Culture, Health, and Getting the Care You Need

A Transition Without a Name in Many Homes

For many Nigerian women, perimenopause simply does not have a name in the household vocabulary. The end of menstruation may be acknowledged quietly, perhaps with a phrase that places it in a religious frame, such as God's time, but the specific experience of the perimenopausal years, with their irregular cycles, hot flashes, mood shifts, sleep disruption, and cognitive changes, is rarely discussed explicitly.

In the generational transmission of knowledge between mothers and daughters, reproductive health has often been treated as too private, too intimate, or too closely associated with weakness to be spoken about openly. Many Nigerian women describe learning about perimenopause from Western media or online communities, and feeling a kind of retroactive grief that no one had prepared them.

This is beginning to change. Nigerian women's health advocates, particularly diaspora voices in the UK, US, and Canada, have been increasingly vocal about the specific silences and gaps in care that Nigerian and West African women face. This guide is part of that growing conversation.

What Research Shows for Nigerian and West African Women

Research on perimenopause in West African women, both in Nigeria and in diaspora, is growing but remains limited compared to what exists for white Western populations. What does exist is instructive.

The SWAN study in the US included significant numbers of Black American women, many of whom have West African heritage. Black women in that cohort reported longer and more severe vasomotor symptoms than white women on average, and a higher symptom burden overall. They were also significantly less likely to receive HRT despite reporting more severe symptoms, a disparity with clear healthcare equity implications.

Hot flashes and night sweats appear to be common among Nigerian and West African women, though cultural reporting patterns may mean that population data underestimates actual prevalence. Some studies from West Africa itself have found that women attribute perimenopausal symptoms to other causes (spiritual causes, stress, or illness) rather than hormonal change, which means they may not present to healthcare providers with perimenopause as the framing.

Cardiovascular risk is elevated for Black women at baseline and increases significantly during the menopausal transition. This makes the perimenopausal period an important time to monitor blood pressure, cholesterol, and metabolic health.

Cultural and Religious Frameworks

Nigeria is a country of extraordinary diversity, with over 250 ethnic groups and a significant split between Christian and Muslim populations, as well as syncretic traditions that blend either with indigenous spiritual practices. These different cultural and religious frameworks each carry their own relationship to women's bodies, health, and aging.

In many Nigerian cultural contexts, midlife women who have completed childbearing hold significant authority within the family and community structure. This can be a positive framing for the menopausal transition, positioning it as entry into a respected role rather than decline.

But the same framework can work against seeking care. If menopause is understood as a natural, God-ordained process, treating its symptoms can be framed as lack of faith or unnecessary medicalisation. The line between acceptance and delay of needed care is something each woman navigates personally.

Spiritual explanations for symptoms are common. Hot flashes, mood changes, and fatigue may be attributed to spiritual attack, stress, or the evil eye in some cultural contexts. While spiritual care and community support are genuinely important, they should complement rather than replace medical assessment when symptoms are impairing daily life.

Healthcare in Nigeria: What Is Available

Nigeria's healthcare infrastructure is uneven. Urban centres, particularly Lagos, Abuja, Port Harcourt, and Ibadan, have private hospitals and specialist clinics where gynaecological care and perimenopause consultations are available, though at significant out-of-pocket cost for most women. Public hospitals are often under-resourced, and perimenopause is rarely a priority in settings where obstetric and acute care needs are pressing.

HRT is available in Nigeria, though prescribing is not yet widespread and many gynaecologists may not offer it as a first-line discussion. Women who want to explore HRT in Nigeria will often need to ask specifically and may find more knowledgeable providers in large urban private practices.

Traditional and faith-based healers play a significant role in healthcare-seeking for many Nigerian women, and herbal remedies are widely used. Some traditional herbs used in West African women's health have biological plausibility, but the evidence base is limited and some preparations carry risks including heavy metal contamination, adulterants, and drug interactions. If you are using traditional remedies, your biomedical provider should know.

Nigerian Diaspora: Navigating a New System

Nigeria is one of the largest source countries for African diaspora in the UK, US, and Canada. Nigerian women in these countries have formal access to universal or insurance-based healthcare, but access to culturally competent perimenopause care is a different matter.

In the UK NHS, Black women as a group experience measurable disparities in how their symptoms are taken seriously by healthcare providers. Research suggests that Black women's pain and distress are more often minimised or attributed to psychological causes. Awareness of this dynamic is not a reason for fatalism. It is a reason to arrive at appointments prepared, with documented symptoms, clear questions, and a willingness to seek a second opinion if you feel dismissed.

For Nigerian and other West African women in the UK, the Menopause Charity and the Black Women's Health Initiative have been advocating for better representation and care. In the US, organisations including the Black Women's Health Imperative work specifically on health equity for Black women.

Finding a provider who has specific knowledge of menopause and who treats your experience without bias is worth the additional effort. You are entitled to the same quality of care as any other patient.

Diet, Traditional Foods, and Health During Perimenopause

Traditional Nigerian and West African diets include many foods that are relevant to perimenopausal health. Fermented locust beans (iru), used in soups and stews, contain compounds studied for various health properties. Legumes including black-eyed peas and cowpeas provide plant protein and fibre. Leafy greens such as bitter leaf, ugwu (pumpkin leaves), and waterleaf are nutrient-dense. Fish is widely eaten.

The shift from traditional to more processed diets in urban Nigeria and among diaspora communities is worth being mindful of. Diets higher in ultra-processed foods, refined carbohydrates, and sugars increase cardiovascular and metabolic risk, which is already elevated for Black women during perimenopause.

Vitamin D is worth monitoring. Despite living in a high-UV environment in Nigeria, many women have vitamin D deficiency due to high-melanin skin requiring more sun exposure to produce adequate D. In diaspora countries with less sun and more indoor lifestyles, deficiency is even more common and directly affects bone health.

Calcium-rich foods, including dairy if tolerated, canned fish with bones, and calcium-fortified plant milks, are worth prioritising as estrogen-driven bone loss accelerates during perimenopause.

Tracking Your Symptoms and Building Your Case

Arriving at a healthcare appointment with documented evidence of your symptoms is one of the most practical things you can do, especially if your cultural background has trained you to minimise distress in front of others, and especially if you have had previous experiences of your symptoms being dismissed.

PeriPlan lets you log what you are experiencing, how often, and how severely, and it shows patterns over time. A three-month log of your sleep disruption, hot flashes, mood changes, and fatigue is a clearer, more persuasive account than a verbal description in a ten-minute appointment.

Bring this documentation to your appointment. Use it to ground your description of your symptoms in specific, frequent examples. This shifts the conversation from subjective impression to documented experience.

Advocating for Yourself With Confidence

You deserve care that takes your symptoms seriously, that explores the full range of treatment options, and that treats your cultural context as relevant information, not an obstacle.

Do not let a provider dismiss your symptoms as stress, normal aging, or anxiety without a proper assessment. If that happens, ask directly: what would a full perimenopause assessment include? If needed, seek a second opinion.

Ask about HRT explicitly if your symptoms are significant. Black women are prescribed HRT at lower rates than white women despite reporting comparable or greater symptom burdens. This is a documented disparity, and you do not have to accept it.

Connect with community. Nigerian and West African women's health conversations are growing online, including on Nigerian-specific forums, Black women's menopause communities, and diaspora women's health groups. Finding people who share your cultural context and are having this conversation openly is valuable.

Your health matters. The generations of women who came before you did not have the information or access that you do. Using them both is an act of care for yourself and a gift to the women who come after.

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