Silent suffering: an exploration of menopausal attitudes and experiences among slum dwellers.

Abstract

Objectives: This study aimed to evaluate the knowledge, attitudes, and lived experiences during the peri and postmenopausal phases among women slum dwellers in Kanpur, Uttar Pradesh, India.

Methods: This qualitative study comprised 35 women slum dwellers aged between 40 and 64 years who had experienced menopause in the previous 5 years. Data were collected using semi-structured interviews and analyzed using reflexive thematic analysis after an iterative approach to understand the knowledge, attitudes, and lived experiences of women. The identified themes were further compared and discussed with the help of available literature to draw significant conclusions.

Results: This study unveiled the misery of women slum dwellers during the perimenopausal and postmenopausal stages in terms of sociocultural constraints, accessibility of services, information, and health-seeking behaviors. Attitudinal variations were also observed; the majority of women enjoyed this phase and viewed it as a sign of freedom from pain and mental liberation. In contrast, women also felt upset by viewing it as an end to their femininity and womanhood. Medical implications are generally ignored by these women despite experiencing a range of physical, emotional, and psychological changes. Those seeking medical support are vulnerable in terms of receiving the right information and guidance, making them further stigmatized for adopting traditional unsafe practices. Government policies also neglect women's health during menopause. All these factors lead to the creation of a vicious circle during menopause.

Conclusions: Breaking the culture of silence surrounding menopause empowers women to make their own decisions. If they are treated inappropriately, it may lead to severe health consequences. The findings underscore the critical need to design culturally appropriate, gender-sensitive, and community-oriented health education programs, along with improved access to menopausal health services, especially for women belonging to marginalized groups. A focused intervention with an integrated approach is substantially needed to improve menopausal health, along with providing the right information and encouraging healthy behavioral practices.