Menopausal transitional and postmenopausal women's voices: 'What influences their adherence to self-management': A systematic review and meta-synthesis of qualitative studies

Yan JiangMinfang TaoCuiqin Huang^*Qunfeng Lu^*

• Shanghai Sixth People's Hospital Affliated to Shanghai Jiaotong University School of Medicine, Shanghai, China

Background: Self-management plays an vital role in preventing the occurrence of severe menopausal symptoms and hazards. There has been a lack of systematic reviews to explore the influencing factors, and challenges of menopausal transitional and postmenopausal women about their self-management experiences and perceptions. Objective: To synthesize the self-management experiences, motivations and challenges among menopausal transitional and postmenopausal women. The results of this study were analyzed according to the capability, opportunity, and motivation model of behavior (COM-B) model, and suggestions for improvement were put forward. Methods: A meta-aggregation method was used to synthesize qualitative studies. Ten databases were searched for studies published up to 3 April 2025. Two researchers assessed the quality and risk of bias and extracted data from the included studies independently. Thematic synthesis approach was used to analysis the key findings. The findings were then analyzed using the COM-B model. Results: A total of 23 primary studies containing 808 participants were included. Six themes with fifteen sub-themes were recognized after reading and coding of the articles: Poor cognition (Misconceptions about menopause and treatment, Insufficient knowledge, Lack of active health literacy, Lack of empowerment); physical restriction(medical condition, fatigue); restricted environment(limited resources, restrictions on amenities); Impact of interpersonal circle(the influence of family support and understanding, social belonging, lack of useful advise from experts); Planning and adherence(setting solid plan, psycho-immune system); expectations for keeping health(perceived health benefits, health crisis concern). Analysis of the findings according to COM-B model emerged that poor cognition, physic restriction, restricted environment are the challenges faced by menopausal transitional and postmenopausal women. Expectations for keeping healthy are the motivation for selfmanagement behaviors. Impact of interpersonal circle, planning and adherence are the important influencing factors of maintaining self-management behavior in menopausal transitional and postmenopausal women.This study shows that knowledge and empowerment, family and social support are particular motivators for self-management in per-and post-menopausal women. We believed that meeting per-and post-menopausal women's knowledge needs, improving the knowledge and empower skills of healthcare providers and reinforcing environment construction for self-management behaviors, including physical activity, community health services, interpersonal circle environment and so on are effective interventions to promote women self-management.