On 22 June 2026, The Geneva Learning Foundation (TGLF) in partnership with Menoglobal, launched the peer learning course “Beyond the hot flash: A primer for health workers about menopause”. This article explores the experiences and insights that learners shared in their first week.
When you were asked to describe yourselves on the first day of this course, the shape of the group came into focus.
Most of you work in Africa, with smaller groups joining from Europe, Asia, North America, and Latin America and the Caribbean.
The overwhelming majority of you are women, though a small number of men are here too.
Most of you are under forty, which means many of you are writing about menopause that you have not yet lived, watching it instead in mothers, grandmothers, aunts, patients, and colleagues.
And two thirds of you work at the front line, in a health facility or out in the district, rather than in a national ministry or an international body.
That last fact matters more than it might appear.
The knowledge you are bringing to this course is the knowledge of the clinic room, the community outreach, the night shift, the family home.
It is knowledge that has been waiting for a language.
The word before the word
You were asked a simple question: when you hear the word menopause, what is the first word or image that comes to mind?
The answers were not simple.
They were, collectively, a map of where menopause lives in the world right now.
‘Transition’ came up again and again, from community health workers and public health workers across Africa, from a midwife serving internationally, from a doctor in North Africa who works at the national level.
Change surfaced too, from a community health assistant linking community members to a dispensary, who wrote that in her community people see it as “a natural change though some have limited knowledge about it.”
Then came the harder words.
From a medical social worker in Africa, under forty, working in civil society: “the first thought that comes to my mind is silence. Also disgust.”
She went on, “A woman is more important when she is fertile and when she can bear kids for the society. Once that stage is over, she is expected to go through it quietly.”
From a public health worker in West Africa, the word was stigma.
He explained that his language calls it “girma”, and that “it is the responsibility of elders and parents to disclose and share possible remedies,” but instead there is silence.
From a public health doctor working across multiple countries in a fragile setting, the image was starker still: a woman “who lives in a society without love affection or consideration,” a “forgotten person or almost not useful person in the society.”
Against those words, others reached for light.
A nephrologist and acupuncturist at a public hospital in Italy, in her late forties, wrote that her first image is “spring, with green fields and colorful flowers,” even as she noted that women where she lives often view menopause as “una jattura,” a misfortune.
A woman in civil society in Costa Rica, working at the district level on a community health board, seized on the same phrase from traditional Chinese medicine: “the second Spring.”
She wrote, “It gives me hope and peace, since I am going through this transition.”
What this vocabulary tells you is something the primer’s chapter on the data cliff explains clinically, but that the lived experience of course participants make visceral.
The knowledge gap around menopause is not simply missing information.
It is a gap that has been actively maintained, by silence in families, by dismissiveness in clinics, by systems that stop counting women’s health needs after age forty-nine, and by the intersection of ageism and sexism.
You named all of this before the primer named it for you.
The stories you came to tell
You were asked to tell one story.
The responses were remarkable not for what any single one contained, but for the pattern they formed.
The pattern is this.
In case after case, the story involved watching someone you loved suffer from symptoms that nobody named, and the suffering was made worse precisely by the absence of a name.
A community health worker in Kenya, under forty, working in the private sector, watched his aunt endure hot flashes and sleepless nights, “thinking it was normal suffering until we learned it was menopause and got her clinic support.”
A public health worker in Nigeria’s government watched her mother’s hot flashes, poor sleep, mood changes, and joint pains be “dismissed by those around her as signs of aging or stress,” until a provider finally connected them to menopause.
A public health worker in Kenya watched her grandmother move through “sudden discomfort and changes in mood” while the family did not understand.
The sharpest version of the pattern came from those who lived it themselves.
A woman in civil society in Africa, in her early fifties, working at the district level as a menopause coach, told her own story plainly.
“Menopause came with every imaginable symptom. I got no support from my primary provider or from my Gynae specialist. All I got was deal with it.”
When she asked for hormone therapy, “I was told I would have to have my womb taken out to have that.”
She suffered, she wrote, “for almost 5 years until I found a GP in the UK who was ready to listen to me. It affected my marriage and my mental health.”
That story is not an outlier.
An occupational health doctor in Africa, under forty, working in the private sector, named it as systemic.
Women, she wrote, “spend their lives in poor health resulting from systemic under research and lack of proper information on the topic among health care professionals,” and at the workplace “menopause remains silenced despite its impact on productivity and performance.”
She described a woman in the C-suite who “became vulnerable and confided that she was at the verge of quiting work due to the diminishing self confidence that had resulted from some of the symptoms of perimenopause.”
That moment, she wrote, “drove home the silent struggles women at the helm of leadership go through that the workplace might never acknowledge.”
A male nurse working in a government health facility in Cameroon, under forty, told a workplace story too, about a colleague whose hot flashes and fatigue required the whole team to reorganize each day.
The colleague hesitated to speak, and only after “episodes of vertigo and irritability” did she disclose what was happening.
The director then offered simple accommodations, adjusted hours and a cooler workspace, and “she felt better understood.”
His closing question stays with the reader: how many women, in workplaces “that demande performance and profitability at all times,” are dismissed as incompetent and never manage to speak?
The pattern reaches into the medical profession itself.
A coach in North America, in her late forties, who had taught sexual health to “over 14,000 women” across fourteen years, wrote that she “never once heard the word menopause in those teachings.”
When she sought help for her own symptoms, “I was told I was too young for perimenopause and advised not to return until I was 50,” and was instead “offered antidepressants and even opiates for pain.”
A nurse in a government health facility in Cameroon, in her early fifties, thought she had malaria, tested negative repeatedly, and only learned from colleagues that it was menopause.
An obstetrician-gynecologist in Africa, in her early fifties, who teaches medical residents, “underwent series blood tests and diagnostics, only to find out later I was going through climacteric period.”
Her conclusion was unsparing: “Medical curriculum even until recently lacked depth and breath when it comes to Menopause care.”
What connects you
When we asked you what you would change, a different map appeared.
Awareness was the most common answer, but in your usage it means something specific.
Not a poster, not a pamphlet, but the kind of information that lets a woman name what is happening before she concludes she is failing, aging badly, or losing her mind.
A founder in the femtech sector in Asia, in her late forties, described an industry “shifting from community-based organisations to measurement and tracking digital solutions,” and cited a finding that only 31% of women in Southeast Asia believe there is adequate workplace support.
A young researcher in Africa, not affiliated with any institution, asked the question almost no one else thought to ask: who is “looking out for the other groups of people that go through menopause,” including “intersex persons, non-binary people, transmen and people living with chronic illness.”
A public health leader working internationally in civil society, over sixty, described menopause as “a gap across medical learning, inadequate healthcare, unfair workplace conditions, data silos and inadequate research,” and asked simply that “women will be looked at holistically and not just as the sum of their different reproductive parts.”
What emerges across these voices is a diverse group of health workers arriving at the same conclusion from different directions.
The youngest among you, the students and community health workers under forty, the doctors in their fifties, the coaches and advocates in between, are converging on one idea: that menopause has been systematically ignored, that the cost falls hardest on women already carrying the most, and that the knowledge to change this already exists in the rooms where these conversations are quietly being had.
Some of you insisted on holding the hope alongside the harm.
The doctor in Italy described menopause as the moment “where a woman can finally stop being tied to her menstrual cycle and start preserving herself.”
A community health worker in civil society in Kenya, under forty, wrote of watching her own mother that “she still carried herself with such grace while teaching me about resilience.
It was a clear, quiet moment that showed me just how much strength is required during this period of life.” Her first image of menopause was “a woman gaining a new sense of freedom and wisdom.”
What comes next, and why it matters
On Monday you move into the structured peer learning at the center of this course.
You will respond to three questions: one that asks you to see menopause in one specific woman’s experience, one that asks you to test the primer’s concepts against your own setting, and one that asks you to commit to a single concrete action over the next four weeks.
These are not exercises.
They are the mechanism by which the knowledge each of you brought, from a government clinic in Cameroon, a district health board in Costa Rica, a public hospital in Italy, a private practice in Kenya, a femtech network in Asia, a humanitarian programme spanning multiple countries, becomes more than the sum of its parts.
The Nigerian community health worker’s aunt, the Cameroonian nurse’s colleague, the Kenyan grandmother, the C-suite executive, the woman who waited five years for a doctor who would listen: each of these is one data point.
Read together, reviewed by peers across at least twenty countries, they become evidence.
Your reviewers will not know who you are.
They will know only what you write.
And what you write will carry the weight of what you have already shown you know.
That silence costs women their health.
That naming a thing correctly is the first act of care.
That systemic change begins the moment a health worker decides to look at the whole picture rather than a diagnostic category.
And that you are not alone in believing this matters.
You came from everywhere.
You brought the same story.
Now you will read each other’s versions of it, and the reading will change what you are able to see.
Menopause: learn, take action, and get certified
Share your experience and learn from colleagues about menopause. Learn more and enrol in this certification from The Geneva Learning Foundation: AGEING-EN-002 Beyond the hot flash: A primer for health workers about menopause