Accessing support for menopause-associated cognitive difficulties in UK primary care: a qualitative content analysis

OBJECTIVE: Many women report challenges accessing menopause care, and these may be compounded for those experiencing less well-known (e.g. non-vasomotor) symptoms. We explored experiences of accessing support for menopause symptoms in the UK in a sample of women with menopause-associated cognitive difficulties; aiming to identify barriers and facilitators to effective care. STUDY DESIGN: A secondary qualitative analysis was conducted on free-text responses from a larger online cross-sectional survey examining cognitive difficulties during menopause transition. Participants (N = 153) were aged 42-60 years, self-identified as perimenopausal or postmenopausal, and reported subjective cognitive symptoms. MAIN OUTCOME MEASURES: Responses to two open-ended questions about experiences accessing healthcare support were analysed using inductive qualitative content analysis. RESULTS: Four themes were identified: (1) Healthcare professionals' knowledge and training, (2) Healthcare professionals' attitudes and approach to menopause, (3) Systemic issues in accessing care, and (4) Consequences. Many participants described healthcare professionals as under-informed and dismissive, particularly regarding cognitive difficulties. Systemic challenges included long wait times, limited treatment options, lack of follow-up and inconsistent information. Women reported practical and emotional consequences, including delayed support and feeling they had to self-advocate or seek private healthcare to receive support. CONCLUSIONS: Findings highlight dissatisfaction with menopause care in the UK for women experiencing cognitive symptoms. There is a need for enhanced training for healthcare professionals and increased emphasis on accessible information and shared-decision making.