Understanding experiences and views of the menopause in Zimbabwe and South Africa: a qualitative study

Background: Menopause experiences are diverse and vary by social and cultural contexts. We explored midlife women’s experiences and views about menopause in urban settings in Zimbabwe and South Africa to inform co-production of supportive interventions. Methods: Forty semi-structured interviews were conducted with women aged 40–60 years. Purposive sampling identified women, considering age, comorbidities, HIV status and socio-economic background. Data were audio-recorded, transcribed, and analysed thematically. Findings: Three inter-related themes were identified: (1) loss and decline, (2) uncertainty, (3) acceptance and growth. For some women, fertility was integral to their identity, without which they felt “incomplete”. Several women described shock and confusion at their unanticipated experiences of bodily changes. Difficulties arose distinguishing menopause symptoms from other conditions, and women highlighted absence of information about symptom management. To gauge what was “normal”, women compared their experiences with those of trusted women. Some women in South Africa welcomed menopause as their transition to a respected elder; menopause meant freedom from menstruation and childbirth. Acceptance related to women’s sense of whether they experienced menopause at “the right time”. Interpretation: The study highlights similarities in women’s menopausal experiences across Africa, as well as affirming the existence of wide and varied local views.