Domestic abuse survivors accessing support during perimenopause: a qualitative study with women.

Abstract

Menopause awareness in the UK has increased demand for GP appointments and menopausal hormone therapy. However, inequalities persist in accessing menopause care, particularly among ethnic minorities, individuals with disabilities, and those experiencing domestic abuse (DA). DA can exacerbate menopause symptoms and create additional barriers to care. To explore the experiences and healthcare needs of women navigating both DA and perimenopause, identifying key barriers and opportunities for primary care support. A qualitative study involving women from a national DA survivors' group in the UK with experience of perimenopause. Semi-structured interviews and focus groups were conducted online with 15 women experiencing perimenopausal symptoms and a history of DA. Data were analysed thematically using the 'one sheet of paper' technique and discursive analysis. The following three key themes emerged: 1) confusion over symptoms, with participants struggling to differentiate menopause symptoms from mental health issues, pre-existing conditions, or DA-related trauma; 2) medical avoidance and barriers to accessing support; and 3) experiences in primary care, with some receiving beneficial treatments while others felt dismissed or misdiagnosed, particularly with antidepressants instead of hormone replacement therapy. Participants highlighted missed opportunities for DA disclosure during GP consultations. The study underscores the need for trauma-informed menopause care in primary care settings. Primary care practitioners should integrate DA screening into menopause consultations and adopt a holistic, patient-centred approach. Further research and training are needed to support tailored interventions for DA survivors experiencing perimenopause.