The signs and symptoms of menopause vary from woman to woman, but the most common include:

• Irregular periods: Periods may become less frequent or heavier before stopping altogether.
• Hot flashes: Sudden feelings of heat, sweating, and sometimes chills.
• Night sweats: Sweating during the night that may disturb sleep.
• Mood changes: Feelings of irritability, anxiety, or depression.
• Vaginal dryness: This can lead to discomfort during sexual activity.
• Sleep disturbances: Difficulty falling or staying asleep.
• Urinary changes: Increased need to urinate or difficulty controlling urination.

These symptoms can affect a woman's quality of life, but they are usually temporary and resolve after some years.

Menopause occurs when the ovaries stop producing the hormones oestrogen and progesterone. While aging is the primary cause, factors such as surgery to remove the ovaries, chemotherapy, or radiation can lead to early menopause.

In Sub-Saharan Africa, where traditional medicine and practices are common, many women may seek herbal remedies or advice from community healers. However, it is important to consult healthcare providers for guidance on managing menopause symptoms.

1. Healthy Diet: A balanced diet rich in calcium, iron, and vitamins is essential. Foods like leafy greens, beans, and local fish can help manage symptoms and maintain bone health. Adequate hydration and reducing the intake of spicy foods may help with hot flashes. Some foods that contain soya have been shown to alleviate the symptoms.
2. Physical Activity: Regular physical exercise can reduce hot flashes, improve mood, and support bone health. Activities like walking, dancing, and stretching can be easily done in the community. Manage weight gain, improve cardiovascular health since the risk of cardiovascular disease increases after menopause since the oestrogen protection is lost.
3. Mental Health Support: Menopause can affect a woman’s emotional well-being. Speaking to a healthcare provider or joining support groups can help manage mood changes and reduce feelings of isolation. Empowerment of the woman to own the changes and accept them. Health education of the family members about menopause can aid understanding menopausal changes. 
4. Hormone Replacement Therapy (HRT): In some cases, hormone replacement therapy may be recommended to relieve severe symptoms. However, access to HRT may be limited in rural areas, and it should be discussed with a medical doctor. For close follow up because of the complications associated with HRT. 
5. Cultural Considerations: In many parts of Sub-Saharan Africa, menopause may be viewed as a taboo subject, and women may hesitate to seek help. Community health workers and open discussions in local health centers can help reduce stigma and encourage women to seek appropriate care. Many women may attribute symptoms to aging or spiritual factors rather than hormonal changes, and they may rely on traditional remedies rather than seeking medical help. 

It is important to seek medical help if:

• You experience severe symptoms like excessive bleeding, pain, or mood changes that disrupt daily life. Bleeding after a period of 6 months to a year with no bleeding.
• You notice any unusual symptoms, such as extreme fatigue, weight loss, or changes in your bones-pain and fractures.
• You need advice on how to manage menopausal symptoms with diet, lifestyle, or medication.