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

Dear Letena: I Can’t Shake the Feeling Something Is Wrong

Dear Letena Ethiopia, I’m a 29-year-old woman from Dallol, Afar. Please keep my identity secret. I’m writing to you because I don’t know where else to turn. I’ve been feeling scared and confused lately about what’s happening to my body. I’m hoping your team might be able to help me understand what’s going on or at least guide me toward the next steps 

It all began a few months ago when I started noticing unusual signs that have slowly become more worrying. At first, it was just a strange pressure in my lower belly, almost like something heavy is sitting there. I assumed it was just bloating since I get that from time to time. Then, about two months ago, I started noticing bleeding between my periods. It’s not heavy or anything, just small spots that show up unexpectedly on my undergarments. At first, I tried brushing it off, thinking maybe it was stress or that my body was just tired, but as time goes on, it’s becoming harder to ignore.
Lately, things have become even more unusual. I’ve noticed that I feel full just after a few bites of food, and most days my stomach feels bloated almost every day. I’ve also noticed a small lump when I lie down. It doesn’t hurt, but I know it wasn’t there before. Even going to Meelal to relieve myself hasn’t felt normal recently.

I’ve been married for a few years now, and I’ve never been pregnant; I don’t have any children. When I first got married, I used injectable contraceptives for a while, but aside from that, I’ve had a normal married life. Recently, I’ve started feeling discomfort and pain during sex, something I’ve never experienced before.
I honestly don’t know what this could mean, but deep down, I’m worried. That’s why I feel it’s important to reach out before things get worse.In a conversation with my friend, she mentioned that her aunt once had something similar, and it turned out to be a tumor. I don’t want to jump to conclusions, but I also can’t ignore the possibility.

I live in a small village of Dallol in the Afar region, where it’s hard to find someone who specializes in women’s health. That’s why I’m reaching out to you. I’ve heard that your organization helps women who don’t always have access to care, and I’m hoping maybe you can help me too. Either with advice or just pointing me in the right direction. I can’t shake the feeling that something is wrong.

Please let me know if there’s any way someone from your team could speak to me, even remotely. I don’t have many options. Your support would mean a lot in understanding what’s happening to my body.Please let me know if you can arrange a phone consultation or connect me to a women’s health specialist.

Thank you so much for reading this. Even just writing it down has been a bit of a relief.

Sincerely X

Why Youth Voice Matters in Reproductive Health Conversations

Youth are young, but not invisible. Youth voices carry the stories, struggles, and dreams of a generation, stories that deserve space in every conversation about reproductive health. Too often, decisions are made for the youth without us, as if we do not understand our bodies, challenges, or aspirations. Yet many youth are  living the realities of early pregnancies, period poverty, lack of access to accurate information, and the social pressures that shape choices. When youth voices are included, discussions become grounded in lived experience. Without us, policies and programs risk becoming distant and disconnected from the truth on the ground.

Youth voices matter because reproductive health is not only a medical issue, it is about dignity, empowerment, and the right to decide one’s future. When young people speak, we bring fresh perspectives, innovative ideas, and unfiltered accounts of what works and what does not. We know the stigma that comes with seeking contraceptives, the fear of judgment when asking questions, and the silent battles fought to protect well-being. Including our voices means creating solutions that truly work for those who need them, not just for the numbers in a report. It transforms reproductive health from a taboo subject into an open, safe, and empowering space.

When youth speak out, we speak for millions who remain silent because of fear, cultural barriers, or lack of opportunity. We show that young people are not merely recipients of change, we are its drivers. When youth voices are valued, society moves toward a future where reproductive health services are accessible, inclusive, and free from shame. Our voices matter because these are our lives, our bodies, and our futures, and no conversation about reproductive health is complete without us.

Reproductive health needs youth voices, all voices.

Written by :- Hermon Israel

Reproductive Tumors by the Numbers: What Young Adults Should Know

Although it can sound scary, “Tumor” does not necessarily mean cancer. Reproductive tumors are abnormal growths that come out of the reproductive organs. They can be non-cancerous or cancerous. Their origin can be from ovaries, the uterus, the cervix, fallopian tubes or in men, the testes, prostate or penis. The tumors that are usually the most worrying are the malignant types such as cervical, uterine (endometrial) or ovarian tumors. Even so, the benign types can also cause a lot of problems.

Most reproductive cancers occur in older age, while in younger people, low- severity variants are more common. This article explores how common these tumors are in Ethiopia, when they tend to be diagnosed, what signs to watch out for, and how to take measures to protect yourself. 

The most common type of non-cancerous reproductive tumor that affects women are fibroids. These are growths in the uterus that usually show no symptoms, and if symptomatic, are often mistaken for a particularly bad bout of PMS. Besides having an insidious presentation it is also very common. Some studies show that up to 8 out of 10(1) women develop fibroids by the time they are 50(2).

On the other hand, some ovarian tumors are commonly seen in young women. These are most common between the ages of 15 and 30. They are often found during routine checkups or when a girl visits a clinic complaining of lower abdominal pain or swelling. 

The cause of reproductive tumors is not exactly known, but hormonal imbalances are undeniably associated. Both too much or too little hormones are frequently seen in reproductive tumors. Some signs of hormonal irregularity can be getting your period early in life, heavy periods and cramping as mentioned above. They can also be caused by taking the birth control pill, hormone therapy or having a child (both at too young an age or too old). 

Cancerous tumors can quickly spread to other parts of the body and cause a serious illness. Cervical cancer is the second most common cancer in Ethiopia. As of 2015, the prevalence was 18%(3) , and since then that number has only gone up(4) .

Though it is diagnosed in women over 30, the disease often begins years earlier. It begins in adolescence when HPV infection and early sexual activity set the stage. That might be why you have been hearing a lot about school girls’ HPV vaccination and cervical cancer screening campaigns these days. The studies since have shown that about 15 out of every 100 young women screened have these early warning signs for cervical cancer. 

Tumors, benign or malignant, often start silently. And although the stats show that many of them become apparent in older age, they often have early signs, and exposure to the risk factors occurs in youth. So it is important to pay attention to your body. If you’re experiencing unusual bleeding, pelvic pain, swelling, or a lump, don’t ignore it. For young men, a monthly self-check of the testicles can help catch problems early.

Even for the non-cancerous types, awareness and early treatment can be the difference between a healthy life and permanent complications. Especially in Ethiopia where harmful myths about sexual illnesses are rampant and access to care is scarce, it is important to keep informed, know your risk and take a proactive approach to screening and prevention.

1. (https://www.tandfonline.com/doi/full/10.1080/01478885.2023.2265185#d1e107)

2. (https://www.nejm.org/doi/10.1056/NEJMra1209993)

3. (https://pubmed.ncbi.nlm.nih.gov/33538338/)

4. 4. (https://journals.sagepub.com/doi/10.1177/11769351211068431#core-bibr2-11769351211068431-3)

Written by – Dr. Hosaena Gebru

How to Talk to a Doctor About a Lump or Pain Without Feeling Awkward

Let’s Be Real

Not every health concern is easy to talk about, especially when it involves your private parts. You might feel a weird pain in your lower belly, notice a new bump, or just get the sense that something down there isn’t quite right.

And before you even think about going to a clinic, your brain starts to spiral:

• “What if it’s something serious?”

• “What if they judge me?”

• “What if I go and it turns out to be nothing, and I look stupid?”

• “What if they tell me I have something I’ll never get rid of?”

So… you wait. You hope it’ll go away on its own.

Sometimes it does.

But too often, it doesn’t. And by the time you finally seek help, the issue has gotten worse. The cost, financially, emotionally, physically, is higher. And here’s the truth: this hesitation, this silence, it’s not because you don’t care. It’s because many of us were raised to feel ashamed. To think anything related to our genitals is dirty, secret, or “not to be talked about.”

But wanting clarity, comfort, or care? That’s not shameful. That’s human. You’re not overreacting. You’re not being dramatic. You’re doing exactly what you should do, listening to your body and wanting answers.

You Don’t Need to Say It Perfectly

You don’t need fancy words or medical terms. You don’t need to sound like a health textbook. You just need to say enough to start the conversation.

Try:

• “There’s a small lump near my groin.”

• “I feel a burning pain when I pee.”

• “Something just doesn’t feel right down there.”

Trust us, health professionals hear things like this every day. Their job isn’t to judge you. It’s to help you get the answers and care you need. If you’re nervous, that’s totally normal. But your discomfort won’t make them uncomfortable, they’re trained for this.

But What If They Don’t Take You Seriously?

Unfortunately, it happens. Sometimes a doctor dismisses your concerns. That is not your fault.

You’re allowed to ask again. You’re allowed to get a second opinion. You deserve to be heard, respected, and taken seriously, especially when it comes to your body.

When Should You See Someone?

If you’re dealing with any of the following, it’s time to reach out:

• A lump that hasn’t gone away after a week or two

• Persistent pain around your genitals

• Burning or discomfort while peeing

• Unusual discharge, odor or irritation

• Pain during or after sex

And honestly? If something just feels off, even if you’re not sure how to describe it, that’s enough of a reason. You don’t need permission to care about your health. And you don’t have to wait until it’s unbearable to get help.

Not Sure Where to Start?

Start simple. Call or visit your local health center. If you’re looking for a friendly ear and judgment-free support, message/call Letena. We’re here to help you figure things out, no shame, no lectures, just real answers.

You Deserve Peace of Mind

Whatever it is, knowing is better than guessing. Getting checked might feel scary in the moment, but living with uncertainty is scarier. Relief beats silence. Clarity beats fear. So go ahead. Ask the question. Start the conversation.

You don’t have to do it perfectly, you just have to do it.

Written by:- Bezawit Elias, Fifth Year Medical Student

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