Bridging the Gap between Evidence and Women’s Menopausal Experience: Aligning Malaysia’s Menopause Guidelines with Cultural, Religious, and Equity Realities (MARIE-Malaysia WP2a)

Objective: Menopause, a universal yet diverse life stage, profoundly influences women’s physical, emotional, and social wellbeing. In Malaysia’s multi-ethnic context, experiences are shaped by cultural meanings, religious beliefs, healthcare structures, and socioeconomic factors. Despite this, policies and services remain limited, with low uptake of hormone replacement therapy (HRT), poor workplace recognition, and uneven access to care. This study is designed to identify the different experiences of menopause in Malaysian population.Design: Qualitative study using semi-structured interviews.Setting and Population: Women in perimenopause, menopause, and post-menopause stages from the general population.Methods: Part of the Malaysian chapter of the MARIE WP2a project, this study explored lived experiences among women aged over 18, purposively recruited across ethnic, religious, and socioeconomic groups. Interviews conducted in English, Malay, or Mandarin were analysed thematically using the Delanerolle and Phiri equity-oriented framework to identify determinants at individual, community, health system, and policy levels.Results: Eleven women described a range of symptoms, from mild discomfort to severe vasomotor, psychological, and musculoskeletal issues. Surgical menopause caused abrupt, compounded symptoms. Coping strategies included exercise, herbal remedies, religious practices, and selective biomedical use. HRT uptake remained low due to cancer fears, cultural perceptions, and limited clinician engagement. Workplace support was minimal, with most relying on informal networks. Healthcare engagement was reactive, and anticipatory guidance scarce. Equity gaps emerged around affordability, rural–urban divides, religious norms, workplace stigma, and lack of culturally appropriate information.Conclusion: Menopause in Malaysia is shaped by biological, sociocultural, and systemic factors. Culturally sensitive clinical pathways, workplace reforms, and equity-focused primary care policies are urgently needed.