Menopause as an Embodied and Occupational Disruption: A Qualitative Study of Women's Experiences in Ghana (MARIE-WP2a).

Abstract

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.