An exploration of women’s occupational participation and identity during menopause: Descriptive qualitative study

Abstract

Background:

The menopause transition is a significant stage of a woman’s life, marking the transition from reproductive to postreproductive life. Occupational identity often shifts in response to life transitions but this has not been explored in relation to menopause. Therefore, our study aims to explore women’s experiences of menopause through an occupational perspective, in relation to occupational participation and occupational identity.

Method:

A descriptive qualitative design was implemented. Semistructured interviews were completed with five perimenopausal women online via Microsoft teams. Reflexive thematic analysis was employed to analyse data gathered.

Findings:

The findings of this study revealed that a lack of understanding and awareness during the initial stages of menopause negatively affected women’s well-being. Women faced disruptions to their engagement in meaningful occupations, which in turn, impacted their occupational competence and occupational identity. The experience of menopausal-related changes influenced women’s sense of self-efficacy in engaging in occupations and roles that aligned with their occupational identity.

Conclusion:

Women face significant occupational disruption during the menopause transition. Negative impacts on occupational identity and participation were evident from the participants. This study explores menopausal women’s experiences from an occupational perspective and findings offer potential direction for future research.

Introduction

Menopause is characterized by a point in time 12 months after a woman’s last menstrual period (National Institute on Aging, 2021). Menopause occurs due to the loss of ovarian follicular function and decline in women’s level of estrogen circulating in the blood (World Health Organization, 2022). The menopausal transition is the years leading up to menopause when women experience irregular menstrual periods, also referred to as perimenopause (National Institute on Aging, 2021). Perimenopause is a significant stage of women’s lives, as it represents the transition from reproductive to post reproductive life (Santoro et al., 2021). The menopausal transition can last up to a decade and ends with the final menstrual period, marking the onset of menopause (Dalal and Agarwal, 2015). Postmenopause is described as the rest of a women’s life after she reaches the final menses. Natural menopause typically occurs between the ages of 45 and 55; however, women can experience menopause before the age of 40, referred to as premature menopause (World Health Organization, 2022).

Menopause is associated with a range of physiological, sexual, and vasomotor experiences, including hot flushes, night sweats, decreased libido, and joint pain (Health Service Executive, 2022). Psychological and social changes are also prevalent and range from anxiety and depression (Herbert et al., 2020), to irritability, anger, and poor memory (Wilbur et al., 2006). Menopausal changes can have deleterious impacts on women’s lives (Hooper et al., 2022), including their roles and relationships (Aljumah et al., 2023), work (O’Neill et al., 2023), and daily activities (Arar and Erbil, 2023). Despite this, literature has largely overlooked the occupational perspective of menopausal women’s lives.

Christiansen (1999) first proposed the idea that occupations build identity. Kielhofner (2008) further explored this concept and defined it as follows: “a composite sense of who one is and wishes to become as an occupational being generated from one’s history of occupational participation, volition, habituation, and experience as a lived body” (p. 106). Occupational participation is said to be engagement in occupations that are part of one’s sociocultural context and essential to one’s well-being (Kielhofner, 2008). Furthermore, Kielhofner (2008) proposed that occupational competence is “the degree to which on sustains a pattern of occupational participation that reflects one’s occupational identity” (p. 106). Occupational identity and competence are interconnected entities that manifest within a person’s environment. Occupational adaptation results when a person achieves occupational competence that aligns with their occupational identity, within the context of their environment (Kielhofner, 2008). In other words, occupational adaptation occurs when individuals face disruptions to occupational competence and occupational identity (Taylor, 2017).

Women’s sense of self and identity during various stages of menopause has been investigated in the literature. The quantitative research investigating self-concept and menopause illustrates a significant correlation between self-concept and menopausal symptoms. Psychological symptoms of menopause were significantly correlated with physical self-concept in perimenopausal and postmenopausal women (Shu et al., 2007) and sexual self-concept in postmenopausal women (Heidari et al., 2017). Moreover, Shu et al. (2007) identified a significant correlation between physical self-concept and physiological symptoms. In relation to self-esteem, Elavsky and McAuley’s (2005) findings were consistent with more recent research by Dąbrowska-Galas and Dąbrowska (2021). Women who engaged in a higher level of physical activity exhibited higher self-esteem. Moreover, postmenopausal women who report higher self-esteem have higher levels of successful aging and sexual quality of life (White and Taliaferro, 2016). Research by Sergeant and Rizq (2017) and Morrison et al. (2014) found that the changes associated with menopause enabled women to experience a positive shift in identity, illustrated by a renewed focus on the self (Sergeant and Rizq, 2017) and the emergence of a wiser, more mature sense of self (Morrison et al., 2014).

While menopause represents a significant life transition, the exploration of occupational identity and participation within this population remains unexplored. This underscores the necessity of investigating the occupational context of menopausal women’s lives, particularly focusing on their occupational identity. Therefore, this study aimed to explore women’s lived experience of (peri)menopause in relation to occupational participation and occupational identity.

Method

A descriptive qualitative design was used by focusing on the subjective perspectives of individuals to provide a clear and comprehensive understanding of the specific phenomenon they were experiencing (Kim et al., 2017).

Participants and recruitment

Nonprobability convenience sampling was used for participant recruitment. The gatekeepers for the study were two menopause Facebook pages and support groups. Upon ethical approval, gatekeepers shared posts outlining information about the study, and potential participants were invited to email the researcher.

The inclusion criteria for the research were

• Women over the age of 18 living in Ireland. The lower age of 18 was set to include women experiencing premature menopause.

• Women with sufficient English to partake in an interview.

• Women who have experienced symptoms of menopause or perimenopause, according to the symptoms outlined by the Health Service Executive (2022), in the previous 2 years. A period of 2 years was chosen, based on similar qualitative literature exploring women’s identity during menopause (Sergeant and Rizq, 2017). Self-reported symptoms were deemed appropriate, as self-identification of symptoms is suitable when the research aims to understand women’s perspectives, while simultaneously preventing shaping the interview discussion on a biomedical narrative (Sergeant and Rizq, 2017).

Through the consideration of pragmatic factors (researcher experience, the scope of the study, time, financial, and resource constraints) the proposed total sample was 8–10 participants. Upon participants expressing interest via email, the researcher verified their eligibility and provided participant information leaflets together with consent forms. Each participant provided informed consent to participate in the study.

Instruments of data collection

Data were collected using semistructured interviews. The primary researcher (RD) developed an interview schedule by reviewing interview guides in comparable qualitative studies, in line with best practice guidelines (Braun and Clarke, 2013; Kallio et al., 2016). Five topics representing different occupational domains composed the interview guide. Questions in relation to each topic were selected to capture participant’s occupational history, identity, and the influence of menopause on occupational participation. Questions were organized in a logical sequence under topic-based sections, each corresponding to a specific occupational domain (Braun and Clarke, 2013; Kallio et al., 2016). See Supplemental Appendix 1 for the full interview guide.

The interview guide was piloted on one potential study participant (a perimenopausal woman), while replicating the designed interview circumstances (Kallio et al., 2016). Following the pilot interview, it was identified that there was ambiguity regarding the meaning of the “Environment” related questions. Amendments were made to the interview guide, which included a more detailed description of the environment, highlighting the inclusion of social, cultural, economic, and political components, in addition to physical alone. The piloting interview was not included in the data analysis.

Data collection took place over a period of 2 weeks. Five women participated in a singular virtual semistructured interview through Microsoft Teams. The interviews, which ranged in duration from 33 to 73 minutes, were transcribed verbatim using the help of the transcription feature in Microsoft Teams. Each transcript was pseudonymised, with identifiable characteristics removed, and securely stored on a password protected cloud storage.

Data analysis

Reflective thematic analysis was the chosen method of data analysis for this study. An inductive approach was used while following the six-step process for thematic analysis as outlined by Braun and Clarke (2021). First, RD read and re-read transcripts to understand women’s experiences, noting initial impressions and ideas. Next, RD uploaded the transcripts to Nvivo12 Pro software and created semantic codes for each data segment that related to the research question. Using mind-mapping and reflexive writing, RD grouped similar codes together centered around a core concept. Additionally, RD and SH engaged in reflective discussions to review, revise, and define shared-meaning based themes that capture the essence of the participants’ experiences.

The Reflexive Thematic Analysis Reporting Guidelines (Braun and Clarke, 2024) was followed to ensure methodological coherence. RD utilized reflexive writing exercises throughout the duration of the study. This enhanced reflexive openness through critically reflecting on the influence of the researcher’s positionality on the research process. Peer debriefing with SH was also completed during data collection and analysis to address credibility of findings. While completing member reflections could have enhanced credibility by allowing participants to elaborate on findings and provide further insights, this was not feasible due to the constrained timeframe of the research.

Results

Five women participated in this study. Table 1 presents demographic information and menopause status. Three themes were identified from the analysis of data: “I just hadn’t a clue what was going on,” “I actually couldn’t do those things anymore,” “It’s just not the same.”

Table 1.

Participant demographic information.

Pseudonym	Age	Menopause stage	Age at symptom onset	Treatment	Relationship status	Children (age)
Pearl	50	Perimenopause	47	HRT	Married	Son (21) Son (14)
Jenny	46	Perimenopause	40	HRT	Single	None
Olivia	44	Perimenopause	39	HRT	Married	Daughter (16) Daughter 12)
Beth	44	Perimenopause	40	HRT	Partner	None
Alice	50	Perimenopause	46	HRT	Married	Son (16) Daughter (14)

Theme 1: “I just hadn’t a clue what was going on.”

The first theme reflects women’s experiences during the transition, before discovering that they were in perimenopause—the uncertainty that the women faced during this transitional period, and their struggle to identify the cause of the changes they were undergoing. It highlights the significant toll this uncertainty had on their mental health.

Women discussed their uncertainty about the changes happening within themselves and their lack of familiarity with perimenopause.

. . .but really and truly, I just hadn’t a clue what was going on . . . I had no idea what was going on, and it wasn’t really talked about very much. . . (Alice).

Another woman reiterated this experience, expressing that she hadn’t regarded menopause as a potential explanation.

. . .and perimenopause has never, like, wasn’t even on my radar, and I would consider myself quite well educated . . . and I’m interested in these kinds of things, but it was just never a phrase I had heard. . . (Beth).

Beth, who had a history of generalized anxiety disorder, expressed the detrimental effects on her mental health during the initial stages of the transition. She reported experiencing a mental health crisis which was totally out of the blue, describing it as like someone injected me with anxiety. She spoke about the frustration and confusion she faced during this unexplained change:

. . .I was getting the bus to work crying on the bus, crying on the way up to the up to the office. And I mean, for me, there was no, it was frustrating because I didn’t feel like there was any logical reason to it. I mean, I remember driving home down the motorway tears coming down my face ringing my partner saying what the F is going on? (Beth).

At the onset of the transition, Alice and Beth discussed how their menopause-related changes were attributed to anxiety and depression by doctors. However, both women displayed a strong awareness of self, expressing that these labels did not represent their experiences:

. . .I’m not a depressed person. I didn’t feel that. I felt very strongly about that actually. . .and your thinking, oh my god, you know, maybe this is, maybe I am depressed, but I didn’t think that I was (Alice).

After discussing her experience with a family member, Beth learned about perimenopause. Beth suggested to her psychiatrist that she suspected perimenopause as the cause of her changes; however, her doctor dismissed this notion and insisted that it was merely anxiety:

. . .I went back to the psychiatrist . . . and I was explaining what I had been looking into, and to say I was shut down was an understatement. She basically said, in 25 years of practice, perimenopause and menopause has never been an issue with mental health, we just need to increase . . . your dose to the maximum . . . so I’m kind of thinking, OK, this just isn’t right. And I walked out of the office, and I just said to myself: I’ve never been on the maximum dose of this medication ever . . . I just knew in my gut that it wasn’t, that I just, this isn’t normal. . . (Beth).

Olivia spoke about her experience of extreme, unexplained brain fog in the initial stages of menopause. She discussed her fear that something was wrong with her brain, leading her to take extreme measures to try and understand what was going on, she revealed I think I’ve had 16 MRIs. She spoke about a significant incident that happened to her one morning while dropping her kids to school, where her brain fog caused her to forget where she was going, leading her to believe that she was experiencing dementia:

. . .I started to get very, very bad brain fog to the point of, that I thought I had dementia or something . . . I remember this one specific morning . . . I was doing the school run and I was driving down the road and it’s like you’re driving, but you don’t realise you’re driving. It’s hard to explain it, and so you’re just going with the motions really, and I ended up at the shopping centre down the road and I was like, what am I doing here . . . it got to the stage then where I was actually frightened . . . ohh my god what did I actually do? Why did I do that . . . there’s something actually wrong with me. I thought it was the start of dementia, I swear to God, because I couldn’t remember anything. . . (Olivia).

The prolonged journey of constant fear and relentless investigation without finding any answers resulted in deteriorations in Olivia’s mental health. She disclosed intense thoughts that she experienced during moments of profound struggle:

. . .I got to the stage where I was so kind of depressed as well . . . I didn’t understand what was going on because I had all of these symptoms and I was feeling, you know, a certain way that I did kind of get to the stage where I didn’t want to be here anymore. (Olivia).

Theme 2: “I actually couldn’t do those things anymore”

The impact on women’s performance of daily occupations during perimenopause is illustrated in this second theme. The menopause transition, along with its associated physiological and psychosocial changes, were reported to have caused disruptions for women across a variety of leisure and productivity occupations. Despite this, some women embarked on new career paths during this time, which proved to be a positive experience.

Many women described exercise-related hobbies, such as walking, yoga and tennis, as important occupations to them. However, they described how physical symptoms of menopause: aches, pains, and exhaustion, impacted their ability to engage in these occupations:

I enjoy exercise and so you know I’d be out every day doing a 5K walk, practicing yoga here, had a subscription online to weight class and things like that. And after a while I realised that I actually couldn’t do those things anymore because I would become so exhausted that I actually couldn’t even recover from those classes. (Jenny).

Women experienced a loss of motivation and enthusiasm for meaningful occupations. Three women referred to this as losing their mojo. Jenny discussed her previous spontaneity to engage in leisure occupations with her friends. However, she expressed a notable decline in energy, leading to a diminished desire to suggest and partake in occupations. When Olivia’s interest in exercise reduced, she felt prematurely aged, she said, I went to bed 39 and woke up 90. Women expressed no longer finding pleasure and enjoyment in social occupations in which they previously relished:

. . .my birthday. . .we’d always kind of go out for breakfast and go shopping. And I was like, there was no joy . . . it’s like all the joy was sucked out of it. (Pearl).

Participants discussed challenges associated with work arising from experiences of brain fog and exhaustion. Jenny described these as absolutely killer in trying to keep up with work demands, while Pearl shared, I was bracing myself every day to go into school as a result of these experiences. Challenges stemming from anxiety and diminished confidence surfaced for Pearl, causing her to pull back from her work, which she said she used to love doing. She highlighted a perceptible shift in her attitude toward her job in which she cherishes:

I’m 18 years working in the [workplace] and always loved it. And then I was like, I don’t wanna go to work. Never had that thought in my head. (Pearl).

For Beth, her contract in work had ended during the onset of her perimenopause. However, she revealed her inability to return to work as she grappled with understanding her own needs amidst the challenged posed by perimenopause:

I wasn’t ready to go back to work . . . and I had applied for a couple of jobs, but I just wasn’t ready like it was just, I was trying to figure out what was going on for me. What did I need? What did I want? It was almost like everything just collided. (Beth).

The menopause transition presented a chance for two women to embark on fulfilling careers that have positively influenced their lives. Both women allowed the transitional time of their lives to be a new start in a new career:

. . .I set up my own little business . . . so I’m so grateful. . . . it was such a negative time for me that I never would of thought that I could turn it into a positive. . . (Olivia).

. . . . And now for me it’s, I get up, I take my time, I’m in a job that I love. Now I can enjoy sort of. I don’t work long hours anymore, I’m kind of allowing myself to rest a lot more . . . my routine has greatly improved, but I’ve allowed it to improve. (Beth).

Despite the challenges posed by perimenopause on Beth’s ability to return to work and Olivia’s satisfaction as a stay-at-home mom, engaging in these new chosen occupations allowed the women to adapt their time used and routines, and overall enhancing their well-being during this transitional phase of life.

Theme 3: “It’s just not the same”

This third theme will discuss women’s occupational roles during menopause. It explores the negative effects women experienced on their roles as mothers and wives during this transition. Furthermore, positive changes in relationships with oneself will be discussed.

All three of the women who are mothers expressed the importance of their role as mothers. However, each of them revealed that relationships with their children have suffered as a result of their perimenopause. Women expressed that the decrease in their patience and increase in irritability stemming from perimenopause impacted their relationship with their children. Pearl spoke about how she suddenly became annoyed by her children where she never would have been before. When discussing her youngest son, Pearl revealed, I just didn’t have the patience for him and we’d argue a bit more definitely. Alice described how challenges at work resulted in diminished patience with her children and influenced her ability to fulfil her role as a mother.

All participants described the impact that their menopause had on their relationships with family, partners, friends, and themselves. Olivia and Alice both discussed how their menopause transition coincided with their daughter’s puberty. While Alice did not mention that this impacted her relationship with her daughter, she stated, I’m sure it’s quite difficult for my husband and son. On the other hand, Olivia expressed how the clash in hormonal transitions introduced a significant strain on her and her daughter’s relationship:

My daughter went through puberty at the same time . . . I have to say it was rough on me, but I was probably rough on her . . . Because the two of us were gone through massive stages of our lives together . . . it did impact our relationship . . . it was a horrible stage of our relationship, to be honest with you. (Olivia).

Pearl revealed a tendency to spend extended periods in her bedroom. During these instances of self-isolation, she grappled with a sense of letting down her children:

There would be some days where I just either was so weepy or in pain or tired that I just would spend time in my room . . . I didn’t want to get up . . . I would nearly just hide away. And for that, I felt I was letting the boys down . . . I was up here hiding away from the world. (Pearl)

Participants who are married or in a long-term relationship articulated how their relationship with their significant other was negatively affected. Beth expressed that her feelings for her partner had completely switched off, disclosing that she felt as though she was a totally different person. Each of the married women revealed the impact of diminished libido and reduced physical intimacy on their relationships. Alice spoke about the differences she felt about her body, her husband, and libido, and how these factors together changed her relationship with her husband, as she stated, from a husband/wife perspective . . . it’s just not the same. Olivia discussed the pressure that her reduced libido created within her marriage:

. . .because like you lose yours and your libido and everything . . . a woman needs love to have sex and then a man needs sex to have love . . . when the two of them are really up against each other, it’s just a whole different scenario and it puts terrible pressure on your relationship. (Olivia).

Pearl’s experience echoed that of the other married women. She described a shift in her perception of her body and how this made her doubt her husbands’ compliments. Despite being a tactile couple prior to perimenopause, Pearl indicated that this had diminished, leading to a negative effect on her marriage:

. . .I couldn’t bear to touch off my own body . . . He was constantly commenting on me. You look amazing. You’re doing great and I was just thought he was lying . . . it definitely did put a strain kinda on our marriage . . . we would be quite tactile, you know, and all of a sudden, I wasn’t. . . (Pearl).

The profound impact of menopause on women’s relationships with their husband was shown through new perspectives of their marriage. There was a gratitude for the endurance of relationships because of long histories together. While Pearl reflected on the intensity of the strain perimenopause had on her relationship with her husband through expressing I could see how women ended up in the situations they did and marriages breaking down.

The change in relationship with themselves was also discussed by women interviewed. Women found that experiencing perimenopause enabled them to devote greater attention to nurturing their own energy and well-being:

. . .there were some good things where I just, I did start to look after myself a little bit, because I had choice, you know (Pearl).

Women discussed a shift in their priorities, with women reporting that they withdrew from social occupations or relationship which they now deem less significant, focusing instead on their own needs and priorities:

. . .but I probably have seen myself, you know, shed some friendships where I would feel that, how would you even describe it? You know, just more those more high maintenance friends and I suppose I’m just maybe more conscious of minding myself and my own energy, yeah (Alice).

Pearl discussed how her experience of perimenopause, and its unexpected impacts on her mental health, led her to have a new focus in life on her mental health:

. . .I just didn’t expect the mental health side to be as bad you know, as it was. And so my goal for myself, my kids is to have good mental health because I think if you have that, everything else will just, you know, fall into place, you’ll have more confidence in yourself. . . (Pearl).

Jenny, who is single and has no children, described menopause as a point in her life where something clicked, in which she described as a level of maturity. She reflected on believing menopause allowed her to experience this shift in which most woman experience after having children. She emphasized that this prompted her to focus on herself more, and to do things she has always wanted to do:

if there’s things that I wanna do, I kind of need to get on with it now, you know . . . Just get on with it. Do you wanna do a degree? Yeah, I do. Right, go and do it and just do it you know. Stop thinking about it and thinking will I, won’t I . . . just getting kind of stuck into the stuff I’ve been talking about doing for years. (Jenny).

Discussion

This study explored women’s experience of the menopause transition, in relation to occupational participation and identity. Findings illustrate how women faced disruptions to participating in meaningful occupations during perimenopause, which in turn impacted their occupational identity. These findings support the idea that life transitions can threaten a person’s ability to engage in occupations therefore threatening their occupational identity (Vrkljan and Polgar, 2007).

The women interviewed faced uncertainty during the initial stages of their menopause transition. Women reported feeling uninformed about the changes they were experiencing due to limited insight and knowledge of perimenopause. Importantly here, despite having their experiences invalidated by doctors, women exhibited a strong sense of identity, recognising that the labels anxiety and depression did not align with their true experiences. Perimenopausal women in the United Kingdom displayed a similar sense of identity by rejecting labels given to them by their doctors (Harper et al., 2022). Women’s lack of understanding became evident while performing daily occupations, causing discomfort and fear which furthered their feeling that something was not right with them. It is apparent that the disconnect between the explanations given and women’s sense of identity took a toll on their mental well-being. Phelan and Kinsella (2009) extend the concept of identity beyond societal approval in relation to occupations, emphasising how society and social power can shape and influence identities. The failure of doctors to acknowledge women’s menopause experiences in this study could illustrate the potential impact of social power on women’s identifies by preventing them from understanding the meaning behind their occupational changes. When individuals experience unexpected occupational changes (Liddle et al., 2004) and lack the coherence to perceive them as manageable (Christiansen, 1999), it can profoundly impact their sense of identity during the transition. It can be concluded that if women had a better understanding of perimenopause and its expected experiences, along with accurate information from doctors, the menopause transition could be a more positive experience. This view was shared by postmenopausal women when reflecting on their own experiences (Aljumah et al., 2023).

In the second theme, it is apparent that women faced disruptions to their meaningful occupational participation during perimenopause. Leisure and productivity participation were significantly negatively impacted, which mirrors previous findings (Arar and Erbil, 2023; O’Neill et al., 2023). These disruptions appeared to be attributed to changes in women’s volition. Menopausal-related changes, including physical and psychosocial, impacted women’s sense of self-efficacy, which resulted in challenges to engage in hobbies and work. Women expressed a diminished sense of enjoyment and satisfaction from previous interests. Changes in volition resulted in a disruption to occupational competence, hindering women’s ability to participate in occupations that were aligned with their occupational identity.

Despite women reporting an adverse impact on work, interestingly, two participants expressed how their perimenopause experience acted as an opportunity to embark on new careers. Women have been found to discover new paths in their career during their menopausal transition (Walter, 2000). Menopausal challenges disrupted the women’s sense of competence for performing productivity occupations. The shift into new jobs illustrates occupational adaptation, where women rebuilt their occupational competence in ways that align with their evolving occupational identities (Kielhofner, 2008). While both women described the outcomes as positive, one person additionally highlighted how her new occupation positively influenced her habituation, in relation to increased satisfaction with her time use and routines (Taylor, 2017).

An individual’s occupational identity is developed and shaped through their engagement in occupational roles (Bowyer et al., 2024). The third theme illustrated how perimenopause negatively impacted women’s participation in valued occupational roles as mothers and partners, which are integral to their sense of identity. Experiences of menopause affected women’s sense of efficacy and competence in meeting demands and expectations of these roles. Women described the adverse effects this had on their relationship with their partners and children. Relationship deterioration with children and partners has been previously highlighted in the research (Refaei et al., 2022; Yanikkerem et al., 2012). A positive discourse surrounding women’s relationship with themselves emerged. Consistent with McCloskey’s (2012) findings, women in the current study also reported a shift in values toward themselves and their own well-being.

The relationship between self-efficacy and occupational identity has been previously addressed. Christiansen (1999) and Vrkljan and Polgar (2007) separately proposed that a person’s sense of self-efficacy is central to shaping one’s occupational identity. For these women, it is evident that the threat to their occupational identity stemmed from diminished self-efficacy to engage in meaningful occupations.

Limitations

This study has a number of limitations. The method of sampling employed in this study introduces potential biases. Recruitment of women through menopause support groups and menopause clinic Facebook pages may have led to a potential self-selection bias, as it can be assumed that women had joined these pages due to having difficult experiences during menopause. Furthermore, participants in the current study were exclusively perimenopausal and receiving hormone-replacement therapy. This may limit the transferability of findings to the broader menopausal population. The participant group were White Irish and therefore the findings need to be viewed with this in mind. Future research should aim to explore the experiences of menopause with diverse ethnic and cultural groups and include a more diverse range of menopausal women, encompassing various menopause stages and hormonal status, to provide a more comprehensive understanding of occupational participation and identity during menopause.

Implications for occupational therapy

This study provides valuable insight into the lived experience of perimenopausal women in Ireland and highlights the need to adopt an occupational perspective when addressing this population of women. Findings offer potential directions for further investigation and can serve as a foundational reference for guiding future research in this area. Occupational therapists should be recognised as vital components of menopause care and support, as they can offer services that help maintain participation in meaningful occupations and roles, preserve occupational competence, and ultimately promote positive identities. If women are supported in maintaining or developing positive identities during perimenopause, their experience of menopause has the potential to be more satisfying and empowering.

Conclusion

This study aimed to explore women’s experiences during menopause from an occupational lens, with particular focus on occupational participation and identity. Participants discourse revealed that a lack of understanding and awareness of menopause during the initial stages had negative effects on women’s well-being. The findings illustrate how perimenopausal women’s participation in meaningful occupations was disrupted, which in turn impacted their occupational competence and occupational identity. The experience of menopausal-related changes influenced women’s sense of self-efficacy in engaging in occupations and roles that reflected their occupational identity. This study highlights the critical need for future research to explore menopause from an occupational perspective and demonstrates the important role that occupational therapists can play in addressing the needs of women during this transition.

Key findings

• Perimenopause impacted women’s participation in meaningful occupations and roles, which are central to their occupational identity.

• Disruptions to occupational competence were reflected in a diminished sense of self-efficacy in engaging in occupations.

What the study has added

The menopause transition has a significant impact on the occupational aspects of women’s lives, highlighting the need for further occupational research to address the unique needs of this population.

Supplemental Material

sj-docx-1-bjo-10.1177_03080226241310032 – Supplemental material for An exploration of women’s occupational participation and identity during menopause: Descriptive qualitative study

Supplemental material, sj-docx-1-bjo-10.1177_03080226241310032 for An exploration of women’s occupational participation and identity during menopause: Descriptive qualitative study by Róise Daly and Sinéad M Hynes in British Journal of Occupational Therapy