Psychosocial impacts of spontaneous and medically induced premature ovarian insufficiency and early menopause: A systematic review and thematic synthesis of qualitative studies

In addition to physical symptoms, Premature Ovarian Insufficiency and Early Menopause may contribute to a range of psychosocial concerns, including when they are induced by surgical or chemical treatments for cancer and other health conditions. However, their psychosocial impacts have not been specifically or comprehensively examined, and comparison of experiences between spontaneous and induced Premature Ovarian Insufficiency/Early Menopause is lacking. This systematic review synthesised the findings from qualitative research exploring psychosocial difficulties associated with early experiences of menopause. Similarities and differences between spontaneous and induced Premature Ovarian Insufficiency/Early Menopause are considered, the latter especially amongst cancer survivors. Five databases and reference lists were searched, and 22 articles were reviewed. Thematic synthesis identified (i) 'Intra-personal impacts' and (ii) 'Inter-personal impacts' as central themes pertaining to the psychosocial experience of Premature Ovarian Insufficiency/Early Menopause, along with (iii) 'Contextual factors' that shaped how these impacts were experienced. Overall, Premature Ovarian Insufficiency/Early Menopause was associated with complex and evolving psychosocial challenges affecting emotional wellbeing, sense of self, bodily perception and inter-personal relationships. For those with induced Premature Ovarian Insufficiency/Early Menopause, particularly following cancer, such impacts were experienced as interwoven with, and compounding, the broader illness and survivorship experience. Psychosocial experiences were shaped by various personal, socio-cultural and systemic factors, including stigma and the availability and quality of support. These findings highlight the need for future targeted research to ensure the psychosocial needs of individuals with Premature Ovarian Insufficiency/Early Menopause, including in the oncology context, are appropriately addressed.