News
Call to include menopause in National Health Policy
View(s):- Silver jubilee of Menopause Society of Sri Lanka
By Kumudini Hettiarachchi
A vital group they are – multi-tasking, holding down jobs, running their homes and nurturing their children. Then strikes menopause, when their reproductive years wane and their world collapses.
MSSL Founder President Dr. M.D.P. Gooneratne
This was the ‘abandoned and neglected’ group towards whom several Consultant Obstetricians and Gynaecologists of the Castle Street Hospital for Women turned their attention 25 years ago.
……And on March 2000 was born the Menopause Society of Sri Lanka (MSSL) to infuse new life and vigour to this group which had fallen between the cracks.
On July 12, MSSL celebrated its Silver Jubilee (25 years) with the inauguration of the Academic Sessions on the theme ‘25 Years beyond menopause – an essential investment’.
Before delivering the MENOSOC Oration on ‘Menopause: A bi-directional perspective’, MSSL’s Founder President Dr. M.D.P. Gooneratne peered into world history, to showcase the travails faced by women who pass midlife. Thereafter, he looked at the present and the need to do more on their behalf.
He pointed out how during the Middle Ages, menopausal women were considered evil and tortured or killed on suspicion of witchcraft. During the ‘witch-hunt’, aged women with ‘A Wrinkled Face, a Furr’d Brow, a Hairy Lip [and] a Gobber Tooth’ were targeted.
It was only in the last century that the view that menopause was related to hormones was accepted, he said, explaining that menopausal symptoms are related to estrogen deficiency following depletion of ovarian follicles.
Looking inward at Sri Lanka, he said that although there was no prejudice against menopausal women, menopause was taken for granted as part of ageing and these women’s health and social problems were neglected. Hence, in early 2000, he proposed to the Sri Lanka College of Obstetricians and Gynaecologists (SLCOG) that a menopause society should be established and the MSSL came into being.
MSSL President Dr. Harsha Atapattu
As Convener, he had inserted a newspaper advertisement and the inaugural meeting was held on June 19, 2000 at 8 p.m. in the library of the Castle Street Hospital for Women, Colombo.
The MSSL’s journey has been successful with some of the highlights including – educational activities such as a “memorable” meeting at the Public Library auditorium on July 8, 2001; the inaugural scientific session on June 30, 2002 at the Sri Lanka Medical Association (SLMA) auditorium; and in 2012, a collaboration with the World Bank and the Plantation Human Development Trust to educate midwives and volunteers to detect problems and manage menopause.
First MSSL Secretary Dr. Hemantha Perera
Dr. Gooneratne recalls how for the public meeting in July 2001, they sent letters to principals of all leading girls’ schools in Colombo, inviting students in higher classes to attend as the topics would be beneficial at the Advanced Level examination. In fact, there were a number of questions on menopause at the ALs.
“A thrilling experience was pasting large posters about these public meetings at main junctions in Colombo, along with Dr. Hemantha Perera and a few junior doctors at around 2 a.m., competing with political parties pasting their propaganda stuff,” he laughs.
Dr. Gooneratne touches on efforts to set up a National Task Force on Post-reproductive Health in 2016. Regrettably, a pilot project to train healthcare providers and integrate menopause in primary health care in the Kalutara district had not seen the light of day.
“In Sri Lanka, it is imperative that menopause should be included in the National Health Policy, so that its impact is mitigated,” he reiterates, looking at the economic impact of menopause.
The GDP (Gross Domestic Product) is about US$ 85 billion and the health expenditure is about 4% of the GDP. The proportionate expenditure on menopause is negligible. It is estimated that there will be about 5 million women in the menopausal age group by 2030.
Programmes in the estate areas on menopause management
According to him, the highest female participation rate in the female labour force is in the 40-44 age group. Thereafter, it drops markedly indicating the curtailing of career longevity. Menopausal symptoms result in absenteeism, early retirement, poor job performance and less productivity. The main menopausal symptoms include hot flushes, night sweats, insomnia, fatigue, mood swings, irritability and depression. Others like dementia, urinary and sexual problems too are common.
“These health problems will affect the economy. Further, an oestrogen deficiency at menopause can cause metabolic syndrome resulting in coronary heart disease, strokes, obesity and diabetes. Screening and proper management can bring about a reduction of malignancies and these conditions. When the cost of investigations and medical and surgical treatment of menopausal health problems is considered, it could amount to billions of rupees to the state,” he points out.
This is why Dr. Gooneratne urges that there is a need to consider the perspective beyond the frame with regard menopause.
MSSL’s inaugural scientific session in June 2002 at the SLMA auditorium
The first meeting of the Menopause Society in June 2000. The office bearers were: President Dr. M.D.P. Gooneratne; Secretary Dr. Hemantha Perera; President-elect Dr. Rohan Perera; Vice President Dr. Kolitha Sellahewa; Treasurer Dr. Marlene Abeyewardene; and Editor Prof. Indrajee Amarasinghe. The council comprised the late Dr. J.N. Rodrigo, Prof. Wilfred Perera, the late Dr. Lakshman Fernando, Prof. Harsha Seneviratne, the late M. Watawala, the late G.Y.K Fernando, Dr. Lakshman Senanayake and the late Dr. K.D.S. Ranasinghe . Pix by M.A. Pushpa Kumara
The flyer about the first MSSL public meeting at the Public Library auditorium in July 2001
| President hopes to bridge urban-rural care gap and prioritise psychosocial well-being Naming the Silver Jubilee “historic”, MSSL President Dr. Harsha Atapattu said that it is not just a celebration of the mere existence of 25 years, but of committed service, scientific progress and unrelenting advocacy for women’s health during and beyond midlife. The beginnings of MSSL were “humble” but it was a powerful mission: to improve the quality of life of post-reproductive women in Sri Lanka. Stressing that the jubilee was also a time to celebrate MSSL’s achievements, relationships built, the lives touched and the path paved for the future, he urged that they should carry forward the spirit of service, backed by science, compassion and community. The wisdom of the past, the strength of the present and the vision for the future should guide the MSSL in its journey ahead. Looking to the future, Dr. Atapattu said that the MSSL’s focus will include bridging the urban-rural care gap, integrating digital health, enhancing menopause education in primary care and prioritising psychosocial well-being, a subject often neglected in traditional models of care. The Chief Guest at the inauguration was Health Minister Dr. Nalinda Jayatissa and the Guests of Honour Saroja Savithri Paulraj, Women and Child Affairs Minister, and Prof. Mary Anne Lumsden, Professor of Medical Education & Gynaecology and Head of Reproductive & Maternal Medicine, University of Glasgow, United Kingdom.
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