Whispered Voices: Narrating Menopause in a Conservative Tribal Community in Nagaland*

Understanding the Community and the Silence Around Menopause

Menopause is a universal experience, yet one’s outlook or perception on it varies greatly across cultures and communities. The Chakhesang are one of the many indigenous tribes of Nagaland, a state in Northeast India. Most Chakhesang villages are located in Phek district, and they are primarily an agricultural community. But with the onset of urbanization and modernization, they are slowly transitioning from a traditional to a more modern society, though villages are still very traditional when compared to towns. While there have been developments in and discussions around women’s health, the focus is largely limited to reproductive health, primarily maternal and child care. Menopause, by contrast, remains a neglected and under-discussed topic. Midlife health issues, especially those related to menopause, remain overlooked, ignored, or even invisible, and so they are rarely recognized as legitimate health concerns. This may partly explain why many women do not come forward with their experiences or seek help. Instead, they learn to live with these issues, internalizing them as a natural, inevitable part of womanhood.

The Chakhesang community is still conservative when it comes to such topics. Conversations about menopause are uncommon and are rarely discussed. Though it is not considered taboo, it is wrapped in silence and not spoken about freely. There is no official or established term for “menopause,” “menarche,” or “menstrual cycle” in the Chakhesang dialect. Instead, they refer to it using culturally embedded expressions across different dialects: Nicümi zho in Kuzhale, Thünomi zho in Chokri, and Naotume ze in Poula, which roughly translates to a woman’s identity or essence, a sign of womanhood. These words are used interchangeably and may refer to any stage of a woman’s reproductive life, with no differentiation between onset, regular menstrual cycles or cessation of menstruation. The intended meaning is inferred from the context or the verb used in the sentence. For instance, when someone asks, “When did Nicümi zho start?,” they are referring to menarche, and when they ask, “When did Nicümi zho stop?,” they mean menopause. The absence of specific terminology might be a reflection of a deep-rooted cultural silence surrounding these experiences, which has been carried forward through generations. This has continued into the present times, making it difficult to recognize, articulate, or validate women’s reproductive transitions, including menopause.

It is in this context that this present narrative explores the experiences, perceptions, and silent struggles of rural Chakhesang women undergoing the menopausal transition. This paper draws from my fieldwork conducted across 22 Chakhesang villages, during which I interviewed and collected data from 594 women. It reflects the insights, thoughts, experiences, and observations documented during that time.

Studies on this topic have not been reported among the Chakhesang, and this work may give a glimpse into the menopausal situation among them. As a researcher, stepping into the field with a topic that has not been sensitized was scary and daunting. I was apprehensive about how I would be received and wary of the responses I would be getting. But as a Chakhesang myself, I also felt a quiet excitement and was eager to hear from them: the conversations less talked about, things which were discussed behind closed doors, the lived realities, the unspoken challenges, and the buried voices. Because these issues matter. The lives of menopausal women matter, and it is high time that their needs are recognized and their voices are heard.

Perceptions and Realities: Menopause Through the Eyes of the Chakhesang Women

Menopause, for Chakhesang women, is when their period stops or becomes irregular, when their joints start aching, when they lose stability in their footing (often slipping while walking), and when they become more prone to illnesses or physical weakness. Many were of the belief that these changes occur because the body is retaining the bad blood instead of expelling it. They perceive menopause as a natural event, and it is largely seen as a sign of ageing. This may be why menopausal symptoms are underreported, and there is delayed intervention, as rural women attribute such symptoms to ageing rather than hormonal changes (Anand & Radhakrishnan, 2015). The women I spoke to expressed mixed feelings about menopause. For some, especially those who had suffered from painful menstrual cramps, there was a clear sense of relief and even freedom. Some women expressed relief at no longer having to deal with the monthly “trouble,” unburdened by the discomfort they once silently endured. It was particularly inconvenient for them when they had to attend functions or engage in work outside the home. For these women, menopause marked a happy end to a phase of physical discomfort. However, for others, especially those who did not experience intense menstrual pain, there was a sense of neutrality, even indifference. For them, menopause had come and gone quietly, without much reflection or without any thought on it.

Among the Chakhesang women, talks on menopause were often met with shy gestures from women: awkward smiles, faces turned away, and hands covering their mouths as they smiled. This clearly showed that this was a topic that was not openly talked about. For most women, menopause was perceived as a physical change rather than one with social or cultural implications. The first thing they would respond to entering menopause is the acknowledgment that they are old now. Their societal roles and responsibilities remain the same as they were before attaining menopause, and there is no shift in their societal status. Attaining menopause does not grant them any additional status in leadership, religious participation, or other affairs. A similar perspective is also observed in menopausal women in other Eastern cultures, where menopause is regarded as natural and a part of ageing, a physical change with no impact on their social life or duties (Koc & Saglam, 2008).

One particularly striking observation was both humorous and poignant: something that was sad, different, and telling of the kind of culture we were in. Since menopausal status is an important criterion in the study, which would determine their inclusion in the study, we needed to ask the women directly about it. The local guide would have to whisper in their ears and ask them about it. Or pull them into a corner, lowering their voice, and inquire about it to avoid embarrassment or discomfort, both for the women themselves and for those around. This secretive act of inquiry affirms the conservative nature of the community. Another noteworthy observation was that the womenfolk were keen to know more about menopause, but there was no platform or opportunity to do so. They wanted to talk about their experiences, what they were going through, what was happening to their bodies, and they had questions. For a lot of them, the interview became a rare opportunity to come together, hear each other out, talk and laugh about their experiences too, while also realizing that they were not alone in this. Another important observation was that women felt more relaxed and comfortable when the interviews were conducted in familiar environments, especially in their own homes or in the company of friends and peers. They opened up more freely in group settings, where a sense of shared experience encouraged openness. Hearing one woman speak first often gave others the confidence to share their own stories, realizing that the struggles they faced were not theirs alone, but something many of them were going through together.

What I took away from these interviews was that many women kept their experiences to themselves, not sharing them with even their closest friends or peers. This highlighted that there was silence, not only in the public domain but also in close social circles. Sometimes, conversations would begin with soft, cautious questions like, “Have you reached menopause? When?” These questions stemmed from genuine concern and curiosity, and often opened the door for women to share their own experiences. And through these exchanges, they would open up to each other. A pattern I observed was that almost all of them expressed a desire for menopause to begin later rather than sooner. They showed concern and visible sadness when menopause occurred early, either for themselves or someone they knew. They may not have said it directly, but it was clear through their expressions and tone that they wanted to hold onto their youthfulness for a little longer. From their perspective, still menstruating meant being young and still being a woman.

Women also had mixed reactions regarding whether they should go for a check-up if their periods stopped or became irregular, in short, if they showed signs of menopause. If menopause ceased too early, they felt it was necessary to consult a doctor. Premature menopause was often viewed as a concern, prompting the idea that something must be wrong. For some, menopause was merely seen as a natural phase of life, and unless it was accompanied by physical discomfort or health issues, they did not feel the need to seek medical attention. At the same time, others believed that regardless of what one is going through, one should go for a check-up, emphasizing the importance of understanding what is happening inside the body. All these varied perspectives show that the health-seeking behavior during the menopausal transition is not uniform, which may be shaped by a combination of their cultural beliefs, personal experiences, and access to information. This also highlights the problem of low health literacy surrounding menopause, as many women tend to seek help only when the problem becomes too severe to ignore.

Challenges, Barriers, and Social Support

The majority of the women in the study were illiterate or had not completed middle school, so they had little to no information about menopause. The limited knowledge that they had came from oral sources—their mothers, grandmothers, aunts, or peers—which was communicated through vague descriptions, expressions, or bodily cues (such as “slippery feet”). There is a significant lack of awareness about this issue, and it is not sensitized enough to the community. The lack of awareness is further deepened by generational and technological gaps. In my study, most of the rural Chakhesang women who are going through the menopausal transition or have attained menopause come from a generation where access to formal education was limited, with many of them being illiterate or having had to drop out early due to familial or financial constraints. They also grew up in a time when technology was non-existent in their lives. Today, despite having access to mobile phones or even smartphones, the possibility of using them to access health information is unfamiliar to them. Their usage is often restricted to basic functions like making calls or taking photos. The limited education, coupled with low digital literacy and generational gaps, limits their ability to seek information about menopause or any other aspect of their health for that matter.

There is an instance shared by a woman who had started having irregular periods, which were early signs of the menopausal transition. She was concerned about what was happening to her, so she sought help at the local health center. But to her dismay, she was dismissed harshly by the nurse on duty, who stated that it was a normal occurrence and there was no need to seek medical help. She probably left feeling disheartened, confused, and ashamed. For villages in rural areas, the doctors or nurses in the primary health centers must provide help to women going through the transition by truly hearing them out properly, listening to them, acknowledging their concerns, and taking their complaints seriously. A lot of women shared that they had also wanted to go for check-ups for their irregular periods during this phase, but refrained from doing so because they were either too embarrassed or had the fear of being dismissed. In such settings, the absence of a non-judgmental and supportive healthcare facility may compel the women to manage the symptoms themselves instead of looking for medical advice or seeking guidance. They keep it to themselves and bear the burden of it alone, as they believe that it is a natural process that simply has to pass. They cope in silence. This was also reported among menopausal women in Karnataka, where unawareness and shyness surrounding menopause may have contributed to this silence. Many women were unaware of what they were experiencing, some did not bother and neglected it altogether (Nayana & Sandeep, 2022). All these factors, coupled with the responsibilities women have in caring for their families and the overall lack of awareness, affect their quality of life, both physically and emotionally (Naik, 2025).

The Chakhesang community is traditionally patriarchal, with the father as the head of the household and men holding important decision-making roles within the family and in the wider community. Women are generally expected to be submissive to their husbands, often accepting the decisions of their fathers or spouses as final. This was evident during fieldwork when we approached women for their participation in the research. Many responded with, “I am not sure. Let me ask my husband.” Depending on the decision of the husband, they would either participate or decline to be included. While times are gradually changing and some women now hold decision-making power within the community, such instances remain limited. In this setting, women shoulder the responsibilities of caring for their children, husbands, and in case of joint families, their in-laws as well. Their daily routine revolves around household chores, cooking, and agricultural work in the fields. Due to these demanding roles, it was not easy to arrange interviews since they were busy all through the week with little free time for themselves. Most of the conversations and interviews took place on Sundays because that was the only day they had time to rest and unwind. I also observed that Sundays served as a social space for women to meet friends, relax, and share stories. This made it a good opportunity for group discussions and interviews, where the women could laugh, talk freely, and even learn new things from one another.

In a society such as this, women often grow up internalizing their role as caregivers, always putting the needs of their children, husbands, and families before their own. This selfless instinct, which is rooted in love and responsibility, may place their own health and well-being to the backseat. As a result, many women do not communicate their physical or emotional struggles during menopause. Consequently, their families or husbands may remain unaware of the challenges they are facing, not because they deliberately ignore them, but because their pain is never expressed. In this way, the lack of support may not always be due to deliberate disregard, but rather the indirect effect of accumulated, unspoken struggles and invisible burdens carried quietly by women themselves over time.

Tadayon et al. (2024) reported that a husband’s support during this transition had a positive impact on the menopausal experience. We also observed this in the present study, highlighting the importance of social support during the menopausal transition. Women who openly discussed their midlife problems with their husbands were more relaxed and seemed less anxious. Some men even accompanied their wives during interviews, and helped them recall details of when their last period was, or how long it had been since menopause, or the problems they had experienced. It was endearing to witness husbands so engaged in their wives’ health and well-being. However, this was not the case for all. In some instances, the husbands would excuse themselves when we touched upon menstruation or menopause, saying they would let “the women” converse freely, which often drew shared laughter. Whether these actions stemmed from respect or discomfort remains debatable. Regardless, it points to a broader issue: the lack of awareness and sensitization surrounding menopause, even among close family members. Social support plays a crucial role in women’s midlife health. Good social support led to better self-esteem, a sense of belonging, and greater motivation to adopt a healthy lifestyle. Support from spouses, peers, and community members can improve their quality of life during menopause by alleviating complications related to psychological, physical, and emotional distress (Abasi & Keramat, 2020).

Among the many challenges shared by women, issues related to sexual health were the least talked about since this was a topic surrounded by discomfort and embarrassment. For some women, this issue caused strain in their relationships with their husbands and emotional distress. A woman going through the transition shared that she no longer felt the desire to engage in sexual activity with her husband, which made him angry. Feeling lost, ashamed, confused, and unsure of what was happening, she turned to us for guidance. Sexual problems such as decreased libido, changes in sexual activity and sexual satisfaction, and painful intercourse were also reported in Cirebon women (Utami & Wahyuni, 2018). Painful intercourse may result from poor lubrication, which happens due to the thinning of the vaginal wall, reduced elasticity, and thinning of epithelial cells. Also, reduced libido in menopausal women could be due to sleep problems, depression, or night sweats. This highlights the need for education and sensitization around midlife changes, including sexual health, which continues to remain hidden and largely unspoken even within intimate relationships.

Bridging the Gap: Listening, Acknowledging, and Moving Forward

The topic of menopause urgently needs to be sensitized—not just among women, but among men as well. There is a critical need to build up social awareness and social support for women navigating midlife. Government bodies and women’s resource departments at the central, state, district, and village levels should take initiatives and develop policies to address the unique challenges women face during this transitional phase. Everyone must understand that menopause is a natural biological process, and there is nothing shameful about it. Women should be encouraged to consult healthcare professionals for any difficulties they may face during or after menopause, while also being empowered to speak openly about their experiences. Opportunities for open discussion through workshops, seminars, support groups, and health outreach programs are essential, as such platforms will help break the silence surrounding menopause. These spaces allow women to not only learn from each other through open collective dialogue, but also help them feel less lonely and more liberated and empowered. Understanding the physical, psychological, and social changes they face will encourage them to have a more positive attitude, making the transition not just bearable but supported and acknowledged. Similarly, men, especially husbands, need to be educated about menopause. They should be made aware of the challenges or problems their spouses may encounter during this transition, and encouraged to provide emotional and social support to them. Support should be extended to women in multiple forms, whether social, emotional, or informational. Receiving such support will reassure them that they are not alone or ignored, and this will help them feel seen, heard, and valued.

Carrying the tag of a “researcher” had its fair share of drawbacks. I had to introduce my research topic with great caution, knowing that for many of the women, it was their first time talking about menopause, let alone speaking openly about it. Despite clear initial explanations, some became reluctant to share their experiences fully with me during the interviews. I could sense their discomfort through their body language; some seemed uneasy, while others appeared offended or even slightly angry at certain questions. At times during the interviews, they would exchange glances or quietly comment to one another about the nature of the questions being asked. Having a reliable and trusted guide helped immensely in such moments. We often had to reassure the women and gently remind them of the importance of such questions, and assured them that their identities would remain anonymous. All these moments made me ponder: had these questions been posed by someone from their own community or someone without a research label, would they have shared more in detail and more openly?

It was also not easy to convince women to participate in the study, and many were surprised that something like menopause was even being studied. Several declined due to shyness, discomfort, or fear. There were also times when it took a lot of convincing, not just from me, but also from the guide and sometimes even from the women’s own peers, to get them to participate in the study. It required a lot of patience and persuasion from us all. Some were initially reluctant, choosing instead to linger around. They would listen to the interviews and observe what we were doing—taking anthropometric measurements, measuring blood pressure, blood glucose, and cholesterol levels. Their curiosity would get the better of them, and later, they also wanted to be included in the study. This made me realize that their reluctance did not stem from disinterest but from fear. They were not unwilling; they were unsure. What they needed was trust, a sense of comfort, and the assurance that they were safe, heard, and respected.

Before going into this research journey on menopause and before meeting the women, I had a sense that menopause would not be seen as taboo among the Chakhesang. But I was uncertain about how open the women would be in sharing their experiences. I was anxious about whether they would be comfortable enough to share or speak about something very personal. To my surprise, many of them—if not most—were eager to share their experiences and were outspoken about it too. Amidst the mix of shyness, outspokenness, and candidness, one thing was crystal clear: all of them wanted to be heard, to speak, and to be acknowledged. They were happy and expressed gratitude that someone was taking an interest in what they were going through. Many admitted they had held misconceptions about themselves and what they were going through, and were shy to talk about it, but through the interviews, they gained clarity and felt enlightened.

Among Chakhesang women, menopause is seen as a very personal and intimate experience, which one often keeps to oneself. A loud silence surrounds this transition in the rural tribal context, rooted in generations of limited awareness, low literacy, and lack of opportunity. The experiences the women shared in this study reveal significant gaps in the policy and healthcare realm. It is time the concerns of midlife women were brought to the forefront. They spend more than one-third of their life in the menopausal stage (Rostami-Moez et al., 2023), having already devoted their time to caring for their families, homes, and communities. It is unjust that they are left unheard during a time when they are most vulnerable- mentally, emotionally, and physically. They deserve to be seen, supported, and cared for. The need of the hour is to sensitize communities, put pressure on healthcare systems, and create awareness around menopause. Through this narrative, by bringing their voices to the forefront, we want them to not only be heard but also help bridge this gap of arrogance and call for a more inclusive, empathetic, and careful approach to women’s midlife health. Because menopause is not just a biological process or event, it is a real, lived experience and deserves attention and empathy.