Sibu Hospital

Introduction: Menopause is a universal life transition with lived experiences shaped by biological, psychological, sociocultural and systemic factors. In Singapore, where diverse cultural norms intersect with a high-pressure professional environment, little is known about how these influences converge to shape symptom recognition, coping and care. Methods: This qualitative study formed part of the multi-country MARIE project on menopause and midlife health. Eighteen participants with different menopausal stages were purposively sampled ensuring variation in age, ethnicity, socio-economic status and health status. Semi-structured interviews explored symptom profiles, psychosocial well-being, family and workplace dynamics, and healthcare experiences. Data were analysed using the Delanerolle and Phiri framework, integrating biological, psychological, sociocultural and health system domains. Results: Participants described heterogeneous symptom trajectories, with vasomotor, genitourinary and cognitive symptoms as most prominent. Multimorbidity and surgical menopause intensified symptom burden and narrowed treatment options. Anxiety, low mood and brain fog impaired work, particularly without workplace support. Sociocultural silences and misinformation reinforced self-management and delayed care-seeking. Resilience rooted in peer and family support, and culturally familiar coping strategies buffered distress for some. Health system gaps included inconsistent general practitioner's knowledge, reluctance to prescribe hormone therapy and private care costs. Study participation itself triggered symptom recognition and help-seeking in some, underscoring menopause invisibility in routine care. Conclusion: Findings highlight that menopause in Singapore is navigated through intersecting clinical, cultural and structural determinants. Addressing inequities requires embedding women’s voices into clinical pathways, training clinicians in culturally competent care, and implementing workplace and public health policies that legitimise menopause as a health and occupational issue.

OBJECTIVE:To explore the lived experiences of perimenopause/menopause among Ghanaian women. DESIGN:Qualitative study using in-depth, semi-structured interviews. SETTING:Community and hospital based settings across Ghana, where women's lives are largely shaped by informal trade, caregiving, and gendered work roles. POPULATION:Perimenopausal, menopausal, and post-menopausal women aged between 18 and 99 years that provided informed consent. METHODS:A qualitative methodology was used based on a topics guide that was developed following an evidence synthesis, patient-public involvement and expert opinions. Interviews explored experiences linked to symptoms, healthcare access, coping strategies, work-life balance, and societal perceptions. Data were analysed using Braun and Clarke's six-phase reflexive thematic analysis to identify key patterns and meanings. MAIN OUTCOME MEASURES:Experiences and perceptions of menopause, including symptom burden, coping mechanisms, and barriers to care. RESULTS:Six interconnected themes were identified. Menopause intensified occupational and economic strain, with symptoms disrupting income generation and caregiving. Psychological burden and emotional disruption were widespread, often concealed due to stigma. Physical and somatic symptoms significantly impaired daily functioning. Barriers to healthcare included limited awareness, fragmented services, and low prioritisation of menopause. Women adopted coping and resilience strategies, such as herbal remedies and social withdrawal. Outlook, migration, and intergenerational lessons shaped planning for future generations. CONCLUSIONS:Menopause in Ghana is a neglected occupational and sociocultural health issue. Integrating menopause care into chronic disease and mental health services, improving access, and enhancing workplace protections are critical.

OBJECTIVE:To explore Nigerian women's lived experiences of menopause and identify sociocultural, structural, and health-system factors shaping symptom recognition, care-seeking, and wellbeing, using in-depth qualitative inquiry. DESIGN:Qualitative interview study. SETTING:Urban, peri-urban, and rural communities across Nigeria. PARTICIPANTS:Post-menopausal women aged 40-66 years experiencing natural, surgical, or medical menopause. METHODS:As part of the Nigerian arm of the MARIE project, semi-structured qualitative interviews were conducted with purposively sampled post-menopausal women to capture diverse menopausal stages, socioeconomic positions, and geographic contexts. Interviews were analysed using thematic analysis informed by an equity-centred, intersectional framework. Multiple researchers independently coded transcripts, with iterative discussion and triangulation to enhance analytic rigour and validity. RESULTS:Three interrelated themes characterised menopausal experiences in Nigeria. First, structural health-system inequalities were evident, including limited anticipatory information, inadequate clinician training, fragmented care pathways, and restricted access to hormone replacement therapy and non-hormonal treatments. Second, sociocultural and gendered norms shaped symptom interpretation and disclosure, with menopause often framed as a natural or inevitable life stage requiring endurance rather than care, compounded by stigma and silencing within families and communities. Third, women demonstrated adaptive coping and resilience, relying on peer networks, faith-based practices, and self-management strategies in the absence of formal support. Urban participants reported comparatively better access to information and services, while rural women described pronounced neglect and dependence on informal care. CONCLUSIONS:This qualitative study provides the first in-depth, context-specific account of menopausal experiences among Nigerian women, revealing substantial inequities driven by sociocultural beliefs, economic constraints, and systemic gaps in healthcare provision. The findings underline the urgent need for culturally sensitive, equity-oriented menopause care in Nigeria, including integration into primary healthcare, improved professional training, affordable access to evidence-based treatments, and public health education to reduce stigma and unmet need.

Objective: Traditional behavioral finance—which examines how cognitive biases, emotions, and context shape economic decision-making— often assumes cognitive stability, rationality, and consistent risk evaluation, based largely on male-dominated samples. Emerging evidence from the Menopause and Ageing Research in International Environments (MARIE) WP2a program, encompassing over 6,300 women across thirteen countries, suggests that the menopause transition brings about significant neurocognitive, emotional, and sociostructural changes that may influence financial decision-making processes. These influences remain under-theorized within current behavioral economics models. This study proposes a new conceptual framework—the Behavioral Finance–Menopausal Cognition (BF-MC) Model—that integrates menopause-related cognitive, psychological, and sociostructural dynamics with behavioral finance theory. Methods: A theory-building synthesis was conducted using quantitative and qualitative findings from the MARIE WP2a cohort. Menopausal symptom domains were mapped onto established behavioral finance constructs, such as risk aversion, present bias, and liquidity preference. The synthesis also explored sociostructural moderators across diverse contexts that shape these pathways. No empirical financial behavior data were analyzed in this framework. Results: The BF-MC Model identifies four interrelated domains: (1) neurocognitive regulation, (2) affective-behavioral regulation, (3) sociostructural mediation, and (4) economic adaptation and resilience. Menopausal symptom domains interact with sociocultural factors, such as employment conditions, caregiving responsibilities, and financial system design, to influence decision-making pathways. The model reframes midlife women’s financial behavior as a dynamic biopsychosocial process rather than a deficit, highlighting adaptive responses to fluctuating cognitive and emotional resources. Conclusion: The BF-MC Model provides a conceptual framework to understand how menopausal cognitive and psychosocial changes may shape financial decision-making. It highlights potential pathways and moderators that warrant empirical testing, offering a foundation for future research on gender-responsive financial behavior and policy. While the model identifies plausible mechanisms, its pathways remain theoretical and require validation with longitudinal financial data.