The menopause 'It's somewhere between a taboo and a joke'. A focus group study

Objectives To explore the menopause from the perspective of women in the community, with specific emphasis on their experience of menopausal symptoms, management strategies and support post the Women's Health Initiative trial. Methods Four focus groups were conducted with 14 middle-aged women living in the Grampian region of Scotland. The groups lasted up to 2 hours and were analyzed using the framework approach. Results Symptom experience was multifaceted and varied, depending on factors such as embarrassment from symptoms, loss of identity, expectations, social support and effectiveness of management strategies. Lack of support was highlighted as a reason why some participants felt confused about the symptoms that they could attribute to the menopause and the management strategies available to them. A variety of management strategies had been used including hormone replacement therapy, herbal remedies and lifestyle changes, with varying levels of success. Some women who chose not to use hormone replacement therapy (HRT) preferred to use lifestyle changes or felt that their symptoms did not warrant hormonal therapy. Some women felt that they had to persuade their family doctor to prescribe HRT and felt that their doctors were too restrictive in prescribing this treatment. Conclusions Although having good social support in general, some respondents felt less supported about the menopause and felt that improved support networks would diminish some of the confusion about symptoms experienced and management strategies available. In spite of the negative publicity surrounding HRT in recent years, a number of women perceived their family doctor as too restrictive when prescribing HRT.