‘I Would Rather Manage It on My Own’: Cultural Stigma, Silence and Barriers to Professional Healthcare‐Seeking for Menopause‐Related Symptoms Among Perimenopausal Women in Public Universities in Southern Nigeria
Ukie Seimokumo Angaye, Turnwait Otu MichaelABSTRACT
Objective
The menopausal transition remains a neglected area of women's health in sub‐Saharan Africa, often framed as a private, non‐medical life stage. This study investigates how cultural stigma, norms of silence and healthcare‐system factors shape professional healthcare‐seeking for menopause‐related symptoms among perimenopausal women working in public universities.
Methods
A convergent mixed‐methods cross‐sectional study was conducted among 313 perimenopausal women in two universities in Bayelsa State, Southern Nigeria. Quantitative data were analysed using descriptive statistics, chi‐square tests, exploratory factor analysis and sequential multivariable logistic regression. In‐depth interviews were analysed thematically, and the qualitative and quantitative findings were integrated.
Results
Only 42.5% of respondents sought professional healthcare for menopause‐related concerns. Stronger cultural barriers were independently associated with lower odds of seeking professional healthcare (AOR = 0.041, 95% CI: 0.011–0.155). Women aged 45–49 years and those ≥ 50 years were significantly less likely to seek professional healthcare than younger women, whereas higher educational attainment and higher income were associated with greater healthcare utilisation. Qualitative findings revealed pervasive silence, stigma, misconceptions, and dissatisfaction with available healthcare services, reinforcing a preference for self‐management of menopausal‐related symptoms, encapsulated in the statement, ‘I would rather manage it on my own’.
Conclusion
Professional healthcare‐seeking for menopause‐related symptoms is shaped by intersecting cultural and socio‐structural barriers rather than individual choice alone. Addressing myths and misconceptions, strengthening culturally responsive care and integrating menopausal transition into workplace health programmes and primary healthcare policies are urgently needed to prevent the normalisation of avoidable suffering during midlife.