Perimenopause and/or menopause help-seeking among women from ethnic minorities: a qualitative study of primary care practitioners experiences

Abstract

Background: Each woman’s experience of the peri/menopause is individual and unique. Research shows ethnic minority women often have different experiences from their white peers, and these are not being considered in conversations about the menopause. Ethnic minority women already face barriers to help-seeking in primary care, and clinicians have expressed challenges in cross cultural communication including the risk that ethnic minority women’s peri/menopause health needs are not being met. Aim: To explore primary care practitioners’ experiences of peri/menopause help-seeking among ethnic minority women. Design and setting: Qualitative study design in the primary care setting of England, with PPI consultations. Methods: We sampled 46 primary care practitioners across 35 practices in England. Using an exploratory approach, we conducted online/telephone interviews and analysed the data thematically. We presented our findings to three groups of ethnic minority women, to inform our interpretation of the data. Results: Practitioners described lack of awareness of peri/menopause among many ethnic minority women which they felt impacted their help-seeking and communication of their symptoms. Cultural expressions of embodied experiences could offer challenges to practitioners to ‘join the dots’ and interpret experiences through a holistic menopause care lens. Our groups of ethnic minority women illustrated the practitioner findings with examples from their own experiences. Conclusion: There is need for increased awareness and trustworthy information resources to help ethnic minority women prepare for the menopause, and clinicians to recognise their experiences and offer support. This could improve women’s immediate quality of life and potentially reduce future disease risk.

Challenges and Implications for Menopausal Health and Help-Seeking Behaviors in Midlife Women From the United States and China in Light of the COVID-19 Pandemic: Web-Based Panel Surveys

“…Social determinants of health, such as discriminatory and disabling beliefs about menopause, the accessibility of health care systems, the availability of treatments, social support, occupational characteristics, and general literacy, could be strongly related to the menopausal experience and may affect formal help-seeking [11]. Differences in cultural representations of the menopausal experience may also affect practitioners' understanding of their patients' distress and needs, especially with women from ethnic minorities [51]. Future studies may adopt a person-in-context approach to thoroughly explore microlevel, mesolevel, and macrolevel factors that influence menopausal help-seeking in midlife women.…”

Menopause in ethnic minority women

“…A substantial portion of the information available is from overseas research, articles and blogs. [3][4][5] There are differences in biological and hormonal changes in women of different races and ethnicity. There are significant differences among women's perceptions, attitudes and expectations surrounding menopause, and this is hugely influenced by their race, culture and ethnicity.…”

“…1,6 A better understanding of these similarities and differences will improve delivery of culturally appropriate care that may help with symptoms and increase the quality of life for midlife women of all ethnicities and races. 7 Barriers to ethnic minority women seeking help [3][4][5] People from different cultural and ethnic backgrounds may have different beliefs and attitudes, which can have an impact on their ability to seek help.…”

“…A substantial portion of the information available is from overseas research, articles and blogs. 3–5…”

“…16 • Discussions about sexual health can be quite challenging.• Mental health is not really talked about in these communities. 3 …”