KRISTY RAM­NAR­INE

kristy.ram­nar­ine@cnc3.co.tt

For years, Gillian Smith-Trum­pet lived in a state of con­fu­sion and suf­fer­ing. She was plagued by con­stant ill­ness, un­ex­plained symp­toms and frus­trat­ing med­ical dead ends.

“I was sick all the time, every sin­gle day for as long as I can re­mem­ber,” she re­called.

“I couldn’t un­der­stand it—go­ing to doc­tors, do­ing all these tests, and every­thing al­ways came back okay. I would go to the Port-of-Spain Gen­er­al Hos­pi­tal be­cause I re­lied on the free med­ical fa­cil­i­ties, es­pe­cial­ly for the ex­pen­sive tests—but when the re­sults re­turned, noth­ing was wrong.”

De­spite re­as­sur­ances, Gillian con­tin­ued to suf­fer.

What she didn’t know then was that she was ex­pe­ri­enc­ing the ef­fects of per­i­menopause and lat­er menopause—life tran­si­tions that re­main un­der-dis­cussed and of­ten mis­un­der­stood, par­tic­u­lar­ly in T&T and across the wider Caribbean.

“I may have heard the word once or twice, but my mind nev­er went in that di­rec­tion,” she said.

“I thought I was dy­ing, or that I was hav­ing a heart at­tack. I suf­fered from de­pres­sion and anx­i­ety, I was spi­ralling out of con­trol, and no­body knew what was wrong with me.”

Her jour­ney be­came even more com­pli­cat­ed with an­oth­er con­di­tion.

“My womb kept drop­ping and they in­sert­ed a pes­sary,” she ex­plained.

“The pres­sure of every­thing was com­ing down­ward. It didn’t re­al­ly reach all the way out, so that’s why the doc­tor end­ed up putting the pes­sary. I vis­it­ed a doc­tor in Ari­ma and he would rub the womb and push it back up, but every so of­ten it would come back down. I tried every­thing.”

The med­ical term for this con­di­tion, where the uterus de­scends in­to the vagi­nal area due to weak pelvic floor mus­cles, is uter­ine pro­lapse. Ac­cord­ing to one ob­ste­tri­cian-gy­nae­col­o­gist, a pro­lapse can oc­cur dur­ing the stages of menopause.

“This can hap­pen when you lift heavy things or have chron­ic cough­ing,” the doc­tor ex­plained.

“The ring pes­sary is one form of treat­ment used to put the womb back in place. The oth­er op­tion is surgery. For old­er pa­tients we rec­om­mend us­ing a pes­sary, and for younger pa­tients we of­fer surgery.

“As pre­ven­tion, we rec­om­mend kegel ex­er­cis­es to strength­en the vagi­nal mus­cles and avoid the drop­ping of the womb.”

For Smith-Trum­pet, how­ev­er, the pro­lapse per­sist­ed. Even­tu­al­ly, her doc­tor ad­vised her to un­der­go surgery.

“I did the hys­terec­to­my in my 40s, and when I thought things were bad be­fore, they got pro­gres­sive­ly worse,” she said.

“It was on­ly when they op­er­at­ed that they dis­cov­ered my or­gans were fused to­geth­er. They were stuck to my ap­pen­dix and I had a lot of scar tis­sue. I was even miss­ing an ovary, which had been re­moved with­out my knowl­edge about 20 years pri­or. It was a lot.”

In her 20s, Smith-Trum­pet had surgery to re­move what was thought to be a cyst, but the dis­cov­ery was star­tling.

“The cyst was ap­par­ent­ly my twin that I car­ried,” she said.

“My moth­er was sup­posed to be car­ry­ing twins, and I end­ed up car­ry­ing the twin in­side of me. It is an anom­aly—it on­ly hap­pens one in mil­lions.”

Smith-Trum­pet had what is known as a par­a­sitic twin, a rare de­vel­op­men­tal anom­aly in which an asym­met­ri­cal, non-vi­able con­joined twin is at­tached to the host body at birth.

Af­ter her sec­ond surgery, she en­dured years of de­bil­i­tat­ing symp­toms, wors­ened by the ab­sence of ad­e­quate sup­port.

“At the end of the day we hear all these sta­tis­tics about white women, Ital­ian women, Black women, but noth­ing is be­ing done on the Caribbean woman,” she said.

“Our eth­nic back­ground is so di­verse, so mixed, and there are no sta­tis­tics on us. I told my­self I couldn’t be the on­ly one go­ing crazy—some­body else had to be go­ing through it too.

“You know what it’s like to vis­it the doc­tor every minute and be told noth­ing is wrong?

“To have them look­ing at you like you’re mak­ing it up, like you’re mad?”

Smith-Trum­pet be­lieves there is a ma­jor mis­con­cep­tion that if you don’t ex­pe­ri­ence hot flash­es, you’re not tran­si­tion­ing in­to per­i­menopause or menopause.

“To me, that’s the least of the symp­toms,” she said.

“I got se­vere itch­ing—my whole back, my whole body, even my scalp. I woke up with things in my eyes, couldn’t see prop­er­ly, blurred vi­sion. I had ter­ri­ble acid re­flux.

“I would be in the of­fice, cough­ing and chok­ing, and went to see an ENT spe­cial­ist—but noth­ing was wrong. I de­vel­oped an ex­tra lay­er of skin un­der­neath my feet that peeled off like glue. I al­so ex­pe­ri­enced vagi­nal dry­ness and a com­plete loss of de­sire to be touched. That feel­ing of lone­li­ness and dark­ness. And when you try to ex­plain it to your fam­i­ly, they don’t un­der­stand.”

Re­fus­ing to suf­fer in si­lence, Smith-Trum­pet turned to re­search and al­ter­na­tive ther­a­pies. That’s when she fi­nal­ly dis­cov­ered what per­i­menopause and menopause were.

In 2023, she joined forces with a group of friends from Holy Name Con­vent to form MENO-TT—the Menopause Em­pow­er­ment Net­work of Trinidad and To­ba­go.

“The minute word got out, we start­ed to hear the sto­ries,” she said.

“We cre­at­ed a safe space for women to post anony­mous­ly, a pri­vate group where they could share open­ly.”

MENO-TT, she ex­plained, is more than a sup­port group.

“It is a safe com­mu­ni­ty ded­i­cat­ed to ed­u­cat­ing, em­pow­er­ing and up­lift­ing women as they nav­i­gate the com­plex­i­ties of per­i­menopause and menopause.”

Com­plex­i­ties which, as Smith-Trum­pet knows all too well, can lead to job loss and even the break­down of a mar­riage.

Look­out for Part 4