Dear Letena: From Fear to Strength

My name is Tsehay. I am a 45-year-old married woman living with my husband in Addis Ababa. My days are simple and familiar, following the rhythm and routine I have grown used to. Most mornings begin the same way: my youngest daughter brews coffee on the charcoal stove while I prepare breakfast. The clinking of cups and quiet conversations fill the room before I head to work, accompanied by the sound of minibuses and the morning rush echoing through the busy city.

I have two daughters, one is 25 and the other is 20. They are truly my world. Watching them grow into strong, thoughtful young women has been my greatest pride and joy.

Lately, however, I feel that the happy life I have built for myself is beginning to come undone. There is a heaviness that follows me through the morning and into the day. The rhythm I once relied on is quietly being replaced by worry I try to ignore but cannot.

It began a few months ago while I was bathing. I felt a small lump in my right breast. It was not painful, so I did not give it much thought at first. But over time, the lump grew larger, and my nipple began to pull inward. That was when I started to fear the worst. Out of curiosity and fear, I looked up information online and read that some of these changes could be signs of breast cancer. My heart sank, and I could not sleep that night.

The next morning, I gathered my courage and went to my local health center, where I was referred to Black Lion Hospital. The doctor examined me carefully and spoke with calm reassurance. She told me that not every breast lump is cancer and that some can be harmless. She also explained that checking early makes all the difference. The doctor described the warning signs I should look out for, especially as I get older, such as changes in the size or shape of the breast, dimpling of the skin, nipple discharge, or new pain that does not go away.

She also taught me how to examine myself at home, showing me how to use my fingertips in circular motions and to check both breasts and underarms at the same time every month. As she spoke, I realized how much I did not know about my own body and how easily ignoring it could have done more harm than good. I also thought about my daughters when the doctor mentioned how important family history can be for early detection. “Is there anyone in my family with breast or ovarian cancer? Could my daughters face this in the future?” I wondered.

After counseling and examination, she told me that I would need a few tests to know for sure. Waiting for the results was one of the hardest experiences of my life. Every day felt longer, filled with thoughts I could not push away. I went through many “what ifs.” But in that waiting period, I reminded myself that facing the truth, whatever it might be, is better than living in fear of the unknown.

Eventually, I found the courage to talk to my husband and, most importantly, to my daughters. They needed to know how much I loved them and that I needed their support to get through this.

Now I am still following up with my doctors and taking things one step at a time. I am learning that caring for myself is not selfish but necessary.

To all women reading this: listen to your body. Do not wait for pain to tell you that something is wrong. A small change may be your body’s quiet cry for help. Early care saves lives.

Disclaimer: This story is a work of fiction. Names, characters, and places are used for illustrative purposes only and do not represent real people or events.

Writer : Kidus Solomon

How to Do a Breast Self-Exam: A Guide for Young Women

A breast self-exam (SBE) for breast cancer detection is often discussed as a practice for older women, but it should actually be adopted by every young woman. An SBE is a simple way to check your breasts for unusual changes. It does not replace professional screening, but it helps you become familiar with your own body so that you can notice any new developments sooner. Ideally, this practice should begin early in life.

A breast self-exam involves looking at and feeling your breasts to understand what is normal for you. The purpose is to become familiar with your body and be able to detect anything that differs from your normal more quickly. Medical experts recommend doing this once a month, preferably just after your menstrual period ends. If you do not menstruate, choosing the same date each month helps create consistency.

Performing regular self-exams can help women identify abnormalities and seek medical advice sooner than they might otherwise. Early detection of breast cancer can be lifesaving. Many women first notice a change themselves before a doctor would. By practicing self-exams, you give yourself the chance to catch symptoms earlier.

The procedure for performing an SBE is simple but requires care and attention. The goal is to feel all around the breast, including the area above and to the sides of the chest muscle and each armpit. Use different motions and positions to make sure no area is missed. A mirror can help you spot visual changes and ensure every part of the breast is examined. Be focused and intentional, taking time to notice not only lumps but also any abnormalities in skin texture, nipple discharge, or differences in size or shape.

It is important to understand that breast tissue naturally feels uneven and bumpy. Not every bump is dangerous. What matters is noticing any changes. This is why building this habit from a young age is essential. Starting early helps you become familiar with your baseline.

The idea that young women do not need to think about breast cancer is a myth. Cancer can occur at any time. It is important to notice anything abnormal quickly and take action. Some women worry that finding something unusual must mean cancer, but this is not true. Most lumps turn out to be harmless conditions. However, the only way to know for sure is to get checked by a healthcare provider. Another myth is that only people with relatives who have had breast cancer should practice this. Family history is not necessary to develop breast cancer. Only about 5 to 10 percent of cases are familial, and most occur in people without any family history.

A self-breast exam takes only a few minutes once a month and costs nothing. Adopting this habit is not about creating fear but about paying attention to yourself. If you notice something different, visit a health facility for advice and testing. Remember that going to the hospital is not only for those who are sick but also for maintaining good health. Early action saves lives.

Writer :  Dr. Hosaena Gebru

 

Dear Letena: Am I Ready to Be a Mother at Nineteen?

Dear Letena,

My name is Mekdes Abera. I am a senior in high school and just finished my University Entrance Exams. I do not want to brag, but I am one of the top students in my school. I recently won a national general knowledge contest. I have many hobbies, I play basketball, I have a good social life, and people often tell me about my potential to do great things. I believe that too. But something has happened that puts all of that into doubt for me. I am writing to you today because I feel overwhelmed and lost. I fear I might be pregnant.

My period is late. I have not told anyone yet, but in my heart I know that pregnancy is a possibility for me. My boyfriend and I are usually careful. We knew what we needed to do to prevent things like this, but to be honest we weren’t always careful. I think I even know when it might have happened. It was oldies day at our high school. Some friends had brought wine, and my boyfriend and I drifted away from the group. We were tipsy, enjoying the music, and we got carried away. I am ashamed to admit that, no matter how brave I think I am, I don’t always know how to say what needs to be said in the moment. Especially in intimate situations, it feels almost rude to speak up.

We are both so young. My boyfriend is kind and supportive, but he is just starting out in life, without stable income and still dependent on his family. Besides, there is so much we have yet to experience. Sometimes I imagine myself holding a baby, but then I remember the life I want to build: completing my studies, pursuing my career, and traveling. All those dreams feel like they could slip away if I become a mother now.

The thought of telling my family terrifies me. They are strict and have always warned me to wait, to be responsible, and to focus on my education. I do not know how they would react. They have always been supportive and progressive, but would that change in the face of something like this? What if they try to push me into a decision I do not want?

I have also been thinking a lot about abortion. I know it is a difficult subject for many, but right now it feels like an option I cannot ignore. I don’t want to end up resentful, trapped in a life I didn’t want. I want to make my own choice about my body, my life, and my future. Does this make me selfish, or does it make me honest to admit that I am not ready for motherhood yet?

I feel caught between fear and hope. On one hand, I do not want to disappoint anyone. On the other, I know that if I am pregnant, whatever choice I make will change me. I just do not know which path will be the right one.

NB: The character in this story is fictional, and the name generated randomly.

 

Writer: Dr. Hosaena Gebru

Dear Letena: Can I Become a Parent One Day

Dear Letena,

I am a 30-year-old man from Addis Ababa, and I am writing because I do not know where else to turn with my worries. For some time now, I have been struggling with a very personal concern.

My wife and I have been married for about three years. From the beginning, it has been an important part of our plan to build a family together. We have been trying to conceive month after month, but despite our hopes and prayers, nothing has happened. At first, I told myself it might just take time, but as the months turned into years, my concern has grown. The silence in our home feels heavier with each passing season. My wife has been patient, loving, and supportive, but I cannot escape the feeling that the problem might be me.

During the New Year holiday, when our family gathered, one of our relatives asked us about children. That moment weighed heavily on my wife, and soon after she decided to have her fertility checked. The results showed no major problems. She gently asked me to get tested as well, but out of fear I reacted badly. I told her I was fine and became defensive, as if her suggestion was an accusation. Since then, I have found myself searching online in my free time, trying to understand what could affect a man’s fertility. I have read that past smoking, heavy drinking, untreated infections, stress, and even long hours of heat exposure can all play a role. Some of these apply to me. I smoked in my early twenties, I worked in hot and exhausting environments when I lived in Dire Dawa, and stress has been a part of my life for years. The more I read, the more I wonder if my lifestyle and choices could be the reason for our struggles.

All of this has left me feeling torn between shame and responsibility. I do not want to admit to myself, or to my wife, that the problem could be mine. At the same time, I know that denying it only creates more distance between us. Whenever she brings up the subject, I see the hurt in her eyes when I shut down the conversation. I want to be the husband who supports her, not the man I have become. The truth is, I feel scared. I am scared to get checked, scared of being judged by my family, and scared of what the results might mean for our future together.

That is why I am reaching out to you. I hope your team can offer me some guidance, whether it is advice, information, or the first steps I should take to get tested. I would also like to know where I can go for counseling if my fears turn out to be true. Even sharing my story here brings me some comfort. I want to face this openly for my wife, for our future, and for myself. I just need some support to take the right steps.

Writer : Kidus Solomon

Dear Letena: I See the Signs, but I Don’t Know How to Speak Up

Dear Letena,

I am a 25-year-old woman reaching out because I am experiencing changes in my body that I can no longer ignore or stay silent about.

For the past year, I have been gaining weight even though my eating habits have not changed significantly. No matter how hard I try, losing the extra weight feels almost impossible. At the same time, my monthly periods have become irregular. Sometimes I skip a month, while other times they come late and are unusually heavy.

I have also noticed an increase in hair growth on my face, chin, and stomach, while the hair on my scalp has started thinning. These changes have been very difficult for me, especially since I grew up in a family surrounded by men. Without a sister or mother figure to confide in, I often feel isolated when it comes to talking about what is happening to my body.

My partner has noticed these changes too. He tries to be supportive, but he is also concerned about my constant fatigue, mood swings, and acne breakouts. These symptoms have affected my confidence, and at times I feel embarrassed in front of him. It is difficult to explain that these issues are not something I can easily control.

After doing some reading, I came across information about Polycystic Ovary Syndrome (PCOS). Many of my symptoms; weight gain, irregular periods, excess hair growth, acne, and thinning hair seem to match what women with PCOS often experience. However, I have never spoken to a health professional, so I do not know for sure if this is what I am dealing with.

I am writing to Letena Ethiopia because I believe you provide a safe space for young women like me who cannot openly discuss reproductive health within their families. I want to understand what is happening to my body, learn what steps I can take to manage these changes, and protect my future fertility.

Writer: Hermon Israel

Dear Letena: My Body Feels Different and I Don’t Know Why

Dear Letena,

I don’t really know how to begin this letter, but I feel like I can’t keep everything inside anymore. I’m twelve now, and my body is changing so quickly. Instead of feeling excited about it, I mostly feel out of place. When I look at my friends, they still seem like kids, but I don’t. It feels as if I’ve stepped into a world I wasn’t ready for, while everyone else stayed behind.

Lately, my chest has been growing, and sometimes it aches in a way I don’t understand. I catch myself crossing my arms over it, hoping the discomfort will ease and that no one will notice. But the boys at school already have, and the teasing feels endless. They point, laugh, and make comments that sting more than I can admit. Every time it happens, I wish I could shrink back into myself and disappear.

I’m too embarrassed to bring any of this up to my mom. Just the thought of saying the words out loud makes my face burn. I even tried searching for answers online, but all I found were long explanations filled with big words and scary possibilities. Nothing seemed to speak to what I’m actually going through. So I’ve stayed quiet, carrying all of this by myself.

Sometimes I wonder why it had to happen to me first, why growing up feels less like moving forward and more like being pushed into a spotlight I never asked for. It’s lonely, confusing, and often I just wish I could pause everything until I feel ready.

I’m writing to you because keeping this inside has started to feel unbearable. I need to believe there is at least one place where my fears won’t sound foolish.

Writer: Bezawit Elias

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