Managing menopause after cancer: a qualitative analysis of healthcare professionals’ perspectives

Abstract Background Menopausal symptoms after cancer (MSAC) are common and can affect overall quality of life. Cancer survivors experience a variety of symptoms for which they may seek support from healthcare professionals (HCPs). Yet, managing MSAC may be challenging for some HCPs. Therefore, understanding HCPs’ perspectives and challenges in providing MSAC care could help propose solutions to improve care provision. Methods Using semi-structured, one-on-one interviews, we explored the perspectives and challenges of 20 HCPs from a range of specialties involved in the care of women with MSAC. Interviews were transcribed and analyzed using a reflexive thematic approach with NVivo v12. Results Twenty HCPs aged 37–68 years were interviewed. The sample comprised females ( n = 17), with primary care physicians being the largest HCP grouping ( n = 6), of whom half were MSAC specialists. Participants’ clinical experience ranged from 1 to 35 years (19.95 ± 9.88), and their experience in managing MSACs ranged from 3 to 35 years (14.25 ± 8.69). Five themes with 10 subthemes were identified: (1) contested view of menopause after cancer; (2) HCPs’ resilience in patient-centred care; (3) multidisciplinary patient care; (4) trial, adaptation, and the search for symptom relief; and (5) care constrained by uncertainty and risk. Conclusion HCPs recognized the substantial burden of MSAC and have adopted patient-centred care and multidisciplinary approaches. However, the confidence in prescribing menopausal hormone therapy was identified as an area for improvement in clinical practice. For all categories of HCPs, upskilling through targeted education and decision-support tools may improve care. Implications for Cancer Survivors For cancer survivors, these findings indicate that HCPs recognise the burden of menopausal symptoms after cancer and that improvements in clinician education, decision‑support tools and clearer referral pathways should translate into timelier, evidence‑informed care (including considered use of MHT where appropriate), better multidisciplinary support and shared decision‑making — all of which aim to reduce symptom burden and improve quality of life.