Menopause affects half the world’s population, yet the issue remains shrouded in secrecy.
Most sexual and reproductive health services focus primarily on family-planning and maternal health, leaving menopause and its biological, societal and emotional impacts unaddressed. Comprehensive care means responding to sexual and reproductive health needs throughout the entire course of a person’s life.
Menopause, like menstruation, is a human rights issue and often represents a time of increased vulnerability to social exclusion and neglect by health systems. Factors such as race and sexual identity may impact individual experiences and also impede access to adequate and non-discriminatory health services.
For example, Black and Hispanic women in particular are vulnerable to more severe symptoms during menopause; transgender men and non-binary people may struggle to access gender-affirming menopausal care that addresses their unique health needs. We need readily available disaggregated data to improve targeted services, including for marginalized populations.
Menopause does not signal the end of sexuality, sexual health or reproductive rights. The need for pregnancy prevention may end during menopause – although contraception is recommended to avoid unintended pregnancy until after 12 consecutive months without menstruation – but the need for other sexual and reproductive health services continues.
A growing emphasis on the sexual well-being of menopausal women calls for health services to address issues such as vaginal dryness, pain during intercourse, incontinence and sexually transmitted infections, including HIV transmission. Health services should also address reproductive options and other health concerns after menopause, including cardiovascular risks.
