Qualitative Analysis of Menopause Experiences and Care Gaps for Servicewomen and Veterans.

OBJECTIVE

To assess the midlife and menopause experiences and unmet health needs of servicewomen and veterans.

METHODS

For this qualitative study, we conducted virtual focus groups with servicewomen and veterans aged 45-60 years using a semi-structured, open-ended interview guide focused on midlife and menopause experiences and related health care access. Focus groups were held from June to August 2025 until thematic saturation was met. Transcripts were coded and thematic analysis performed using Atlas.ti software.

RESULTS

We conducted five focus groups with 30 participants (mean age 51.5 years; 53.3% active duty). Participants received health care across the Military Health System, Veterans Health Administration (VHA), and private sector. Four categories emerged: effects on personal life, menopause-related care delivery, effects on military and professional career, and recommendations for improvements. Within these categories, seven themes were identified: feeling unprepared and navigating menopause independently, effects on relationships, frustration with care delivery, positive care delivery experiences, effects on military performance and readiness, unique military settings complicating symptoms and treatment, and recommendations to improve menopause experiences and care delivery in the military. Frustration with care delivery included feeling dismissed, symptom misattribution or treatment of individual symptoms, lack of menopause knowledge among clinicians, inconsistent access to knowledgeable clinicians, and seeking care outside the Military Health System or VHA. Positive care experiences included symptom validation, provision of treatment, and continuity of care.

CONCLUSION

Menopause symptoms substantially affect quality of life and occupational functioning among servicewomen and veterans, with system-level gaps in menopause care overshadowing positive experiences. Findings highlight deficiencies in anticipatory guidance, workplace support, clinician education, access to care, and continuity of care across health systems. Targeted interventions to improve workplace culture surrounding menopause, menopause-specific clinical competency, and access to evidence-based care are needed to support quality of life and maintain military readiness.