Formation of Diverse Meanings of Menopause: An Integrative Literature Review

Objectives: To identify the diverse meanings of menopause in various contextual settings and to be mindful of how these meanings are formed. Methods: An integrative review was performed to analyze the existing literature on the meanings of menopause. Whittemore and Knafl’s five-step process was followed. Literature published between 2005 to 2022 was reviewed. Medline, CINAHL Scopus, Nursing Reference Center Plus, and Google Scholar databases were searched. The PRISMA flow diagram was used to illustrate the review process. For the quality appraisal of the articles, the Critical Appraisals Skills Programme (CASP) checklists were used depending on the study design. Qualitative, quantitative, mixed method, and systematic review articles were included. A data extraction form was designed encompassing author, year, methods, context, setting sample, country, related theme. For each study, findings were coded inductively, and codes were reviewed for their commonalities and differences. Key contributing pieces relating to meanings of menopause were grouped into themes. Results: A total of 65 studies were analyzed for this review. Different menopause meanings and their contributing pieces were identified. The five main categorized themes were bio-physiological, socio-cultural, sexual, psychological, and spiritual meanings and contributing factors. Conclusions: Although meanings of menopause among women can differ, the contributing pieces for meanings of menopause are common across countries. It is significant to consider a holistic care approach to support women achieve their optimal health. This study proposes additional sexual piece for holistic care model as it was identified a major theme and concern among menopausal women.