A Qualitative Analysis of Social Media Narratives on Mental Health and Healthcare Access during Perimenopause”

Background: Perimenopause and menopause are increasingly recognized as critical periods for mental health vulnerability, yet they remain underexamined within social work research and practice. Individuals navigating these transitions frequently encounter fragmented care, stigma, and limited access to responsive healthcare. In alignment with this year’s theme, Social Work Research at the Service of Democracy, this study centers lived experiences shared in online spaces to elevate marginalized voices and inform more equitable, person-centered systems of care.

Methods: This study employed a qualitative design using publicly available posts from a large Facebook perimenopause support group. A purposive sample of posts reflecting discussions of mental health and healthcare access was extracted and de-identified. Three trained researchers conducted content analysis using an iterative coding approach. Coding discrepancies were resolved through consensus, and analytic rigor was enhanced through memoing and regular team debriefing.

Results: Analysis revealed four primary themes. First, participants described pervasive mental health challenges, including anxiety, depression, mood instability, and feelings of isolation, often attributed to both hormonal changes and lack of validation. Second, systemic barriers to healthcare access emerged, including dismissive providers, limited provider knowledge of menopause, and challenges obtaining appropriate treatment. Third, participants highlighted self-advocacy and peer knowledge exchange, with the Facebook group serving as a critical site for information-sharing, validation, and informal care. Finally, structural inequities and invisibility were evident, with participants noting disparities in care based on gendered ageism, race, and socioeconomic status, as well as a broader societal minimization of menopause-related health needs.

Implications: Findings underscore the need for trauma-informed, culturally responsive, and gender-inclusive healthcare practices that recognize menopause as a significant life stage requiring comprehensive support. Social work has a critical role in advancing health equity by integrating these lived experiences into practice, policy, and education. By leveraging digital narratives, this study contributes to a more democratic knowledge base—one that centers community voices, challenges systemic neglect, and advances rigorous, applied research to advance women’s health.