Abstract / Summary
Menopause is a multifactorial transition shaped by biological, psychological, cultural, and structural factors. Despite increasing global attention, it remains under-recognised in many low- and middle-income settings, including Sri Lanka, where sociocultural norms and fragmented healthcare systems limit women’s access to support. With a rapidly ageing female population and rising rates of non-communicable diseases, understanding menopausal experiences is a pressing public health priority. This qualitative study, part of the MARIE Sri Lanka WP2a project, aimed to explore the lived menopausal experiences of Sri Lankan women through a multidimensional lens encompassing biological, psychological, sociocultural, and health system contexts. It examined the experiences of 53 women from rural, semi-urban, and urban regions using semi-structured interviews, which were thematically analysed to understand how women perceive and describe symptoms, seek care, and manage menopause within everyday constraints. Transcripts were coded inductively, integrating Sinhala and Tamil expressions to capture culturally embedded meanings. Findings revealed five key themes: biological transitions and the lived body; psychological distress, cognitive disruption, and emotional labour; sociocultural silence and gender norms; gaps in health systems; and women’s adaptive coping peer solidarity, and emerging agency. Stigma, limited provider knowledge, and financial barriers were common. Language played a central role in expressing distress and resilience. These findings provide qualitative evidence of how menopause is experienced in Sri Lanka, identifying experiential, cultural, and health system priorities that warrant attention. They underscore the value of recognising menopause within primary care through awareness, culturally sensitive communication, targeted services, and gender-responsive policy. Centering midlife women’s voices and culturally embedded practices can reframe menopause from a marginal concern into a cornerstone of inclusive health equity.