Menopause in Brazil: lived experiences, inequities, and opportunities for inclusive care (MARIE-Brazil WP2a)

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Background Menopause, whether natural, surgical, or medically induced, represents a significant transition in women’s health, often accompanied by biological, psychological, and social challenges. Despite its global prevalence, evidence on lived experiences across diverse populations remains limited, particularly setting as Brazil. Addressing these knowledge gaps is essential for designing equitable health interventions and informing policy.Methods The MARIE-Brazil chapter conducted a qualitative study as part of work-package 2a to explore menopausal experiences. A topics guide was used to conduct interviews of participants that were purposively sampled aged 18–99 years that self-identified as experiencing perimenopause, menopause, or post-menopause. Sampling captured heterogeneity across age, menopausal stage, socio-economic position, ethnicity, and healthcare access. Data were transcribed verbatim, anonymised, and analysed thematically using Braun and Clarke’s six-phase approach. To enhance rigour, coding was conducted by multiple researchers, guided by the Delanerolle and Phiri framework, and reporting followed COREQ guidelines.Results The findings indicate intersecting biological, psychological, socio-cultural, and health system determinants shaping experiences. Participants reported vasomotor symptoms, sleep disturbance, cognitive difficulties, and urogenital changes that influenced quality of life and occupational participation. Barriers to care included limited clinical knowledge, fragmented pathways, and financial inaccessibility of treatments. Cultural stigma, gender norms, and workplace discrimination further exacerbated inequities, particularly among women with multimorbidities or marginalised identities. Conversely, peer networks, supportive clinicians, and targeted interventions improved coping and health outcomes.Conclusion Menopause is not solely a biological milestone but a multifaceted transition shaped by structural and cultural determinants. Findings highlight urgent needs for inclusive healthcare training, workplace policy reform, and accessible treatment pathways. Incorporating lived experiences into service design and policy frameworks is critical to promoting equity in menopause care across diverse global settings.

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