Projects

Ongoing projects

Cognitive symptoms of the menopause and impact on women in the workplace – a qualitative project (Paige Williams, Doctoral thesis)

On average, women report experiencing symptoms of the menopausal transition for over seven years during their forties and fifties. However, around a third of women experience long term symptoms. Women experiencing the menopausal transition are the fastest growing demographic in the workplace, bringing high levels of skill and experience and often being at the peak of their career. Despite this, women continue to feel forced into leaving the workplace or stalling their career progression due to symptoms of the menopausal transition. Stigma regarding the menopause continues to impact women in the workplace, with women reporting distress at perceived reactions to symptoms and identifying difficulties in discussing the menopause at work.   Cognitive symptoms, such as difficulties with concentration and memory, have been identified as particularly disruptive at work, however, research into the impact of these cognitive symptoms on women, and the relationship between the workplace and cognitive symptoms, is limited. This research will use qualitative methods to explore cognitive symptoms of the menopausal transition and the impact on women in the workplace, in order to harness rich data and enhance our understanding of the experiences of women in this stage of their lives.

Investigating the impact of ethnicity on menopause in the workplace (Alisha Mehta, Doctoral Thesis)

This project aims to investigate the impact of ethnicity on women’s experiences of menopause at work. It has been found that in UK workplaces, women from ethnic minority backgrounds, compared to White counterparts, are less likely to report menopause symptoms at work and are more likely to view the menopause as having a negative impact on their career progression. However, there is no research on how different minority ethnic groups compare with one another in terms of how they experience menopause symptoms at work. The research questions are:

• Is ethnicity a predictor of menopause symptom severity in the workplace? 
• In the workplace, are there differences between ethnic groups in: 1) Reporting of symptoms at work and barriers to reprting symptoms? 2) Perceived support from colleagues, managers and their organisation? 3) Perceived support and perceived stigma?

These questions will be addressed through the development and dissemination of a short survey, which will be shared with women working in UK-based organisations, who are currently experiencing perimenopause or have recently reached menopause.

This is the first study in the UK that aims to obtain an ethnically diverse sample of menopausal women to directly explore how ethnicity may intersect with menopause experiences at work.

The feasibility and effects of group Compassion Focussed Therapy (CFT) for adults experiencing menopause: a preliminary investigation (Simone Saidel and Kate Robinson, Doctoral theses)

This study aims to determine whether group-based compassion focussed therapy (CFT) can be feasibly used with adults experiencing menopause, to treat anxiety and depressive symptoms. Considering the existing literature, there is scope to investigate high intensity CFT as an intervention for treating psychological difficulties in menopausal adults. This project is intended as a preliminary exploration to establish whether intervention modifications are necessary and provide direction for further evaluation of intervention efficacy. This study will be a feasibility randomised controlled trial of online, group CFT plus treatment as usual compared to treatment as usual. A combination of quantitative and qualitative methods will explore the feasibility of recruitment and eligibility, participant willingness to be randomised, retention rates in both the intervention and overall trial, suitability of outcome measures and acceptability of group CFT for this population. Preliminary effects on a range of clinical outcomes will also be explored.

What are the main predictors associated with psychological symptoms at midlife in women? (Nora Bahhar, Doctoral Thesis)

Menopause is a complex phenomenon that manifests in different ways. Understanding the psychological mechanisms during this transitional period can help healthcare professionals to provide appropriate, individualised care for those who are struggling. Using data from a longitudinal, population-based study, the current research project aims to determine if mental health varies by menopausal status (i.e. pre-menopause, perimenopause and post-menopause). Secondly, given conflicting evidence regarding the nature of psychological symptoms during the menopausal transition, this research project will aim to determine if psychological poor health is more likely to be associated with concurrent life experiences (such as work stress, family stress, or physical health difficulties), or to menopausal status itself. Finally, the current project will aim to explore if early-life adverse experiences (such as history of mental health difficulties), predict poor psychological symptomology during the menopausal transition. Until now, studies that have attempted to answer these questions had methodological limitations or results that have not been replicated. The current research project will aim to address these gaps and will aim to make a valuable contribution to the current biopsychosocial understanding of mental health in menopause and the menopausal transition. 

Women’s subjective cognition experiences during the menopause transition: a cross-cultural perspective (Lexi He, PhD student)

People might experience diverse symptoms during their menopause transition. Brain-fog related symptoms, such as forgetfulness, poor memory and difficulty in concentration, are frequently reported by people during the menopause transition. The menopause research conducted in various cultures have challenged the notion of a universal menopausal experience, and emphasised the need to understand people's cognitive health and menopausal experiences with a cross-ethnic perspective. However, the majority of the current menopause research was conducted with Western populations from the White ethnic communities. Furthermore, a critical issue in the menopause literature is the lack of subjective cognition measures developed specifically for people transitioning into menopause and are validated in different ethnic groups. This study aims to review people's cognitive experiences during their menopause transition across ethnic groups, to critically look into the existing measures used in menopause research, and to develop and evaluate a subjective cognition measure for people from multi-ethnic groups in the United Kingdom.

Developing an evidence-based intervention for cognitive symptoms of the menopause (Danielle Proctor, doctoral thesis).

The aims of the study are to better understand: 1) What are the key cognitive difficulties experienced by perimenopausal and postmenopausal women? Are there differences between groups on subjective memory measures?; 2) What strategies might women already be using to help manage their cognitive difficulties, and what support do they receive?; 3) What could a novel intervention look like? Can we identify key intervention components based on the needs of this population?

Data will be collected through an online survey. Additional qualitative data will also be collected through qualitative interviews with perimenopausal or postmenopausal women experiencing cognitive difficulties. There is a distinct lack of research within this area, despite it being a research priority (Department of Health and Social Care, 2022), and available non-pharmacological interventions are limited. It is important that women are able to access interventions to support them with menopausal symptoms, particularly cognitive difficulties, which can be highly distressing and greatly impact their lives. By the end of this project, we will have produced and evidence-based intervention for the cognitive symptoms of menopause. The next step will involve testing its feasibility.

 

Navigating Menopause: An Explorative Qualitative Study of British South Asian Women's Experiences, Beliefs, and Attitudes towards Menopause

The UK is a multi-ethnic, multi-racial country and, in 2018, 13.8% of the UK population had an ethnic minority background. There is however limited research evidence of menopause experiences in British ethnic minority women. British Menopause Society (BMS) reported several variations in the symptomatic experience and prevalence of menopause in minoritized groups. It is reported that South Asian women tend to experience less typical symptoms such as hot flushes and sweats; instead, reporting more fluctuations in mood, heightened anxiety and musculoskeletal pain including bone and joint aches. A substantial portion of the information available is from overseas research, articles and blogs.

This study therefore aims to explore British South Asian women's experiences, beliefs, and attitudes towards menopause. The research questions are:

• What are British South Asian Women’s attitudes and beliefs towards menopause?
• How do British South Asian women identify and label the symptoms and experiences associated with menopause within their cultural context?
• What are the experiences of British South Asian Women of emotional wellbeing and mental health throughout menopause?

This study aims to fill a gap in current research by using a culturally sensitive qualitative approach to gather in-depth insights from this demographic.

Completed projects

The Effectiveness of Psychosocial Interventions on Non-physiological Symptoms of Menopause: A Systematic Review and Meta-analysis (Aimee Spector, Zishi Li, Lexi He, Yasmeen Badawy, Roopal Desai). Published in the Journal of Affective Disorders.

Menopausal symptoms of physiological changes, psychological difficulties and cognitive impairment are suffered by increasing number of women. Research shows that these concerns have been under-supported by standardized interventions. Some women are exposed to culturally stigmatized values around menopause and are reluctant to seek professional support, whereas others lack knowledge of where to access help. The conventional and most widely offered menopause intervention is hormonal therapy, but this does not suit all women. This systematic review and meta-analysis examines the effectiveness of psychosocial interventions on non-physiological symptoms of menopause, including mood, cognition, and quality of life. Thirty Randomized Controlled Trials (RCTs) that examined 3501 women were included. Findings based on pre- and post-intervention scores generally favored the effectiveness of Mindfulness-Based Interventions in improving menopausal symptoms. Other interventions including Cognitive Behavioral Therapy (CBT), Self-care Education, and Group Counselling also generated partially significant findings on certain outcomes. We identified menopausal cognitive functioning as an under-researched domain, and the high heterogeneity of findings point to a need for more research. In terms of implications for managing non-physiological menopausal symptoms, access to supportive social environments that promote an unbiased understanding of menopause may be helpful.

Read the publication here.

Read the publication here.

The Risk of Depression in the Menopausal Stages: A Systematic Review and Meta-analysis. (Yasmeen Badawy, Aimee Spector, Zishi Li and Roopal Desai). In preparation for publication.

The menopause transition can be a period of emotional and physical changes that may be debilitating. The different menopausal stages have been associated with an increased risk for depressive symptoms and diagnosis. The purpose of this review was to conduct a literature review and meta-analyses to provide an estimate for the risk of developing clinical depression and depression symptoms in different menopausal stages. Sixteen prospective cohort studies on menopausal stage and depressive symptoms for diagnoses, as measured by standardized tests or structured interviews, were included. The meta-analyses included fourteen of the studies using seven random effects models, and the pooled odds ratios were reported for depressive symptoms and depression diagnoses. Perimenopausal women were found to be at a significantly higher risk for depressive symptoms but not clinical depression compared to premenopausal women. There was a trend that did not reach significance for a higher risk of depressive symptoms but not clinical depression in the post-menopausal stage compared to the premenopausal stage. Given that the menopausal transition is a period of increased vulnerability to depressive symptoms and disorders, early screening is necessary. It is important to note that more longitudinal research is needed in non-Western countries to be able to generalize these results.