Barriers to safe discussions of symptom management amongst pre-menopausal and menopausal women

Objective:

This project was conducted with the primary aim of identifying the barriers to the safe discussion of menopausal symptom management as perceived or experienced by pre-menopausal and menopausal women. These barriers would then be compared and contrasted between our two study groups to improve menopausal womens’ quality of life.

Design:

This qualitative study was conducted over a 2-month period with the support of Imperial College London. A qualitative methodology was chosen given the need to explore the individual experiences of women and their personal barriers to safe discussion.

Methods:

Participants (n=16) were recruited through snowball sampling, stratification was by age into both a menopausal (age 45-70) and a pre-menopausal group (age <45). The sampling process was continued until the point of data saturation. 16 semi-structured online interviews were conducted lasting 45 minutes each. Transcripts were then recorded and coded independently with the efforts of multiple researchers. Codes were thematically analyzed following Braun and Clarke’s six-step methodology of reflexive thematic analysis.

Results:

A total of 9 subthemes were identified by both pre-menopausal and menopausal women and organised into 7 higher themes regarding safe discussion of menopausal symptom management. Overall it was found that pre-menopausal women have a significant lack of preparation and awareness of the menopausal transition. This can be attributed to the factors explored through our higher themes, specifically a lack of substantial dialogue between relevant stakeholders and the societal stigma preventing psychological safety in discussing menopause as a topic.

Conclusions:

Overall all participants agreed that there was insufficient discussion and general knowledge surrounding menopause and that having more knowledge prior to this transition would improve their experience. It also highlights the valuable positions of healthcare practitioners (HCPs) and their ability to facilitate these safe discussions surrounding menopause with their patients. Interviewees also echoed the need for HCPs to address patients’ expectations and preferences when making decisions regarding menopausal management.

Acknowledgements:

No financial relationships or conflicts of interest to disclose.

Literature:

Braun, V. & Clarke, V. (2022) Thematic analysis : a practical guide. SAGE, Los Angeles.

Braun, V. and Clarke, V., (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), pp.77-101