Emotional and social well-being during perimenopause in Barcelona: a photo-elicitation study

Abstract Background Although perimenopause is a critical stage for women and people who menstruate, its emotional and social implications, particularly in socioeconomically vulnerable populations, remain underexplored and largely overlooked in public health strategies. This study aimed to explore the experiences of emotional and social well-being among women and people in perimenopause in Barcelona (Spain). Methods A gender-based qualitative study was conducted. Twenty women in perimenopause or at the onset of menopause, participated in three discussion groups in February-March 2024. Photo-elicitation techniques were employed to promote group interaction and to elicit in-depth narratives. Sampling was purposive, with participants recruited through key institutions, community services, social networks and snowball sampling. The participants were recruited in neighbourhoods with high levels of socioeconomic deprivation. Data were analysed through thematic analysis. Results Our findings highlight a range of experiences around perimenopause, structured around two predominant narratives. One frames perimenopause as a time of decline linked to aging and the end of fertility, while the other sees it as an opportunity for self-awareness and freedom from gendered social pressures. Participants frequently reported a lack of accessible information, which hindered their ability to identify the onset of perimenopause and interpret its symptoms. The healthcare system was often described as unresponsive, and the need for community-based, supportive spaces was emphasized. Overall, perimenopause emerged as a moment of identity renegotiation, marked by conflicting and liberating emotions. Conclusions The study underscores the importance of questioning dominant gendered discourses around perimenopause, fostering public awareness, and developing targeted health policies to support those navigating perimenopause. This research can inform public health prevention and promotion activities. Key messages • Perimenopause is a complex and ambivalent experience of identity renegotiation, shaped by narratives of loss and of liberation from social gendered imperatives. • There is a need for collective and structural responses to support emotional and social well-being during perimenopause.