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.

Abstract Objective Menopause, a universal yet diverse life stage, profoundly influences women's physical, emotional, and social well‐being. In Malaysia's multi‐ethnic context, experiences are shaped by cultural meanings, religious beliefs, healthcare structures, and socioeconomic factors. Despite this, policies and services remain limited, with low uptake of hormone replacement therapy (HRT), poor workplace recognition, and uneven access to care. This study is designed to identify the different experiences of menopause in Malaysian population. Design Qualitative study using semi‐structured interviews. Setting and Population Women in perimenopause, menopause, and post‐menopause stages from the general population. Methods Part of the Malaysian chapter of the MARIE WP2a project, this study explored lived experiences among women aged over 18, purposively recruited across ethnic, religious, and socioeconomic groups. Interviews conducted in English, Malay, or Mandarin were analysed thematically using the Delanerolle and Phiri equity‐oriented framework to identify determinants at individual, community, health system, and policy levels. Results Eleven women described a range of symptoms, from mild discomfort to severe vasomotor, psychological, and musculoskeletal issues. Surgical menopause caused abrupt, compounded symptoms. Coping strategies included exercise, herbal remedies, religious practices, and selective biomedical use. HRT uptake remained low due to cancer fears, cultural perceptions, and limited clinician engagement. Workplace support was minimal, with most relying on informal networks. Healthcare engagement was reactive, and anticipatory guidance was scarce. Equity gaps emerged around affordability, rural–urban divides, religious norms, workplace stigma, and lack of culturally appropriate information. Conclusion Menopause in Malaysia is shaped by biological, sociocultural, and systemic factors. Culturally sensitive clinical pathways, workplace reforms, and equity‐focused primary care policies are urgently needed.

Menopause is a pivotal stage in women's lives, shaped by biological, psychological, sociocultural, and health system factors. In Oman, where religious beliefs and cultural norms strongly influence health behaviours, menopause remains under-researched and under-discussed. This study, part of the MARIE WP2a project, explored the lived experiences of Omani and expatriate women to identify burden of the symptoms on their daily lives, key challenges, coping strategies, and perceived gaps in care. Findings aim to inform culturally responsive health system strategies. Qualitative study using semi-structured interviews. Outpatient clinics were used to recruit participants into the study. Twenty-five women across perimenopause, menopause, post-menopause stages including Omani nationals and expatriate women from urban and rural areas. Data were analysed using the Delanerolle & Phiri Theory and Framework, encompassing four domains: biological, psychological, sociocultural, and health system. Thematic analysis captured shared and divergent experiences, with verbatim quotes used to support findings. Symptom burden, health-seeking behaviours, cultural perceptions, and healthcare access. Symptoms ranged from hot flushes, insomnia, and joint pain to emotional distress. Natural menopause was viewed as a gradual, spiritual transition; surgical menopause was abrupt and distressing. Cultural silence and stigma hindered open discussion, with euphemisms such as harara dakhiliya ("internal heat") used. Healthcare interactions were limited to chronic disease care, with minimal menopause counselling or HRT options. Expatriate women reported additional barriers, including cost and limited awareness. Culturally sensitive menopause care, accessible HRT choices, targeted education, and specialized clinics are essential to enhance midlife women's health and quality of life in Oman.

Despite global prevalence of Menopause, evidence on lived experiences across diverse populations remains limited, particularly in Brazil. Addressing these gaps is essential for designing equitable health policies. MARIE-Brazil conducted a qualitative study to explore menopausal experiences. Twenty women were selected from a cohort of 262 women in the MARIE-Brazil quantitative study who consented to the qualitative phase. Semi-structured interviews were conducted using a topic guide with participants self-identifying as experiencing perimenopause, menopause, or post-menopause. Sampling captured heterogeneity across age, menopausal stage, socio-economic position, ethnicity, and healthcare access. The findings indicate intersecting biological, psychological, socio-cultural, and health system determinants shaping experiences. Participants reported vasomotor symptoms, sleep, cognitive, and urogenital changes that influenced quality of life and occupational participation. Barriers to care included limited clinical knowledge, "front-desk gatekeeping," and financial inaccessibility of treatments. Cultural stigma and gender norms exacerbated inequities, while peer networks and supportive clinicians improved coping. Menopause is not solely a biological milestone but a multifaceted transition shaped by structural and cultural determinants. Findings highlight urgent needs to adapt robust clinical protocols (e.g. Brazilian Federation of Gynecology and Obstetrics Associations-FEBRASGO, Brazilian Society of Climacteric-SOBRAC) for the public sector (SUS) and provide training for non-clinical staff, and accessible treatment pathways. Incorporating lived experiences into service design and policy frameworks is critical to promoting equity in menopause care across diverse Brazilian population.