KRISTY RAM­NAR­INE

kristy.ram­nar­ine@cnc3.co.tt

Menopause and per­i­menopause are fi­nal­ly get­ting the na­tion­al at­ten­tion they de­serve. The Min­istry of Health (MOH) has of­fi­cial­ly made this as­pect of women’s health a pri­or­i­ty—a ma­jor step for­ward for women across the coun­try.

Dr Adesh Sir­jus­ingh, di­rec­tor of Women’s Health at the MOH, shared that the min­istry is putting greater fo­cus on im­prov­ing care and rais­ing aware­ness for women go­ing through this nat­ur­al stage of life.

“We want women to feel sup­port­ed, in­formed, and em­pow­ered,” he said.

In fact, menopause is now a stand­ing item on the agen­da at the MOH’s month­ly meet­ings with all Re­gion­al Health Au­thor­i­ties (RHAs), en­sur­ing that the con­ver­sa­tion around menopause care con­tin­ues at the high­est lev­els.

“We ac­tu­al­ly have menopause as one of our pri­or­i­ty items,” he said.

“What that has led to is post­grad­u­ate train­ing, where ex­ist­ing doc­tors are be­ing bet­ter equipped to man­age menopause.”

Dr Adesh Sirjusingh

He said some RHAs have al­ready be­gun of­fer­ing spe­cial­ist menopause clin­ics.

For in­stance, the Mt Hope Women’s Hos­pi­tal now op­er­ates a ded­i­cat­ed menopause clin­ic, and oth­er gy­nae­col­o­gy clin­ics are be­ing en­hanced to han­dle gen­er­al menopause con­sul­ta­tions more ef­fec­tive­ly.

“There is a broad range of is­sues re­lat­ed to menopause—some med­ical, some sur­gi­cal,” Dr Sir­jus­ingh not­ed.

“More than 80 per cent of menopause cas­es do not re­al­ly re­quire hor­mone re­place­ment ther­a­py (HRT) or med­ica­tion. It’s about man­ag­ing lifestyle.”

In recog­ni­tion of World Menopause Day, ob­served on Oc­to­ber 18, Dr Sir­jus­ingh high­light­ed this year’s theme—“Lifestyle Med­i­cine”.

“If we can man­age 80 per cent of pa­tients be­fore we reach the med­ical side, that would be ex­cel­lent,” he said.

“It’s about lifestyle changes—man­ag­ing stress lev­els, main­tain­ing a bal­anced di­et, ex­er­cis­ing, avoid­ing caf­feine and oth­er trig­gers, dress­ing ap­pro­pri­ate­ly in lay­ers, and ad­dress­ing is­sues like in­som­nia.”

He al­so ref­er­enced the 2020 Sex­u­al and Re­pro­duc­tive Health Pol­i­cy, which in­cludes a life-course ap­proach to man­ag­ing sex­u­al health.

“The doc­u­ment is very high lev­el,” he ex­plained.

“It speaks to pro­vid­ing a bas­ket of ser­vices for man­ag­ing menopause at the pub­lic pri­ma­ry health care to spe­cial­ist and re­fer­ral cen­tres. It al­so in­cludes ac­cess to nec­es­sary med­ica­tion.”

An over­ar­ch­ing com­mit­tee has been formed to guide these ef­forts, com­pris­ing a wide range of pro­fes­sion­als.

“In the com­mit­tee that I chair, is­sues re­lat­ed to menopause are on the agen­da. For the first time, menopause has start­ed to be pri­ori­tised,” Dr Sir­jus­ingh af­firmed.

“We are chang­ing the sys­tem; sys­tem change does not come overnight. It takes some­times months or years to see it hap­pen.”

When it comes to HRT, Dr Sir­jus­ingh is ad­vis­ing women to con­sult with their physi­cians. In the past, cer­tain drugs were avail­able; how­ev­er, they were not well utilised.

“We had oral med­ica­tion, but un­for­tu­nate­ly, on a year­ly ba­sis, we had to dump med­ica­tion. This is be­cause the drugs ex­pired; util­i­sa­tion was very poor. From my con­ver­sa­tions with the pri­vate sec­tor, they too would have had to dis­pose of hun­dreds of thou­sands of dol­lars in prod­ucts for the same rea­son, and they are re­con­sid­er­ing the mar­ket.

“It’s one of the is­sues when the Min­istry of Health tries to in­flu­ence the mar­ket, but it is not an easy one in the pri­vate sec­tor.”

Dr Sir­jus­ingh said that while med­ica­tion for menopause was not avail­able at this time, there are oth­er prod­ucts which can be used for per­i­menopause.

“There has been a short­age of drug sup­ply in the pri­vate sec­tor as well,” he added.

“We have recog­nised that, and that has been in­formed by the mar­ket, the phar­ma­ceu­ti­cal com­pa­nies.”

Dr Sir­jus­ingh said his staff was cur­rent­ly work­ing on a po­si­tion pa­per to make a case for get­ting new prod­ucts.

“We are in ac­tive dis­cus­sions of get­ting the new­er forms of HRT; this is not on the back burn­er,” he said.

“This has to go through the ex­ec­u­tive at the Min­istry of Health; it has not passed that stage.”

In Sep­tem­ber, Dr Sir­jus­ingh re­ceived the Cha­co­nia Medal Gold for Health­care from Pres­i­dent Chris­tine Kan­ga­loo at the Na­tion­al Awards cer­e­mo­ny at Queen’s Hall, St Ann’s.

In 2023, Dr Sir­jus­ingh was in­duct­ed in­to the An­tho­ny N Sab­ga Awards’ Caribbean Ex­cel­lence Col­lege of Lau­re­ates for “his achieve­ment in lead­ing the re­duc­tion of ma­ter­nal mor­tal­i­ty to a point where T&T is now cit­ed by the Pan Amer­i­can Health Or­gan­i­sa­tion (PA­HO) as a leader in the re­gion”.