Understanding the interplay between cognitive changes at menopause, the workplace, and mental health: qualitative findings from the MARIE-UK (WP2a) project

Background: Cognitive changes are widely experienced during the menopause transition and, when severe, can disrupt women's working lives and negatively impact their mental health. While prior research has documented the detrimental effect of menopausal symptoms on women's quality of life, there remains a paucity of empirical evidence specifically exploring the intersection between cognitive changes and identity reconstruction within occupational settings. The objective of this study was to understand women's experiences of cognitive changes at work during menopause, including how they navigate these difficulties.

Methods: This qualitative, exploratory study, involved in-depth interviews with 50 women aged 43–67 years (mean 52.3) recruited for the MARIE-UK (WP2a) project. Data were analysed using collaborative reflexive thematic analysis, through the lens of Conservation of Resources (COR) theory. Data trustworthiness was ensured through investigator consensus.

Results: The majority of participants experienced cognitive changes at menopause, such as brain fog and memory problems, which negatively impacted their mental health at work. Participants experienced loss of confidence in their abilities, an increase in anxiety, and a change in their sense of self. Due to the depletion of valuable resources (resources are anything an individual values), they struggled to regain a semblance of normality. Those who received workplace support managed to break the spiral of resource loss and better cope with the detrimental effects of the symptoms.

Conclusion: Understanding women's experiences of cognitive changes and mental health in the workplace through the COR theory has shown that menopause is a demand that can significantly deplete women's valuable resources to perform their work duties. Menopausal cognitive changes profoundly disrupted their sense of self and perceived ability to work effectively. The intersection of cognitive and psychological symptoms with workplace stressors exacerbated mental health burdens and perpetuated gender inequalities. Interventions to support workplace wellbeing are required, particularly as the proportion of menopausal women in paid employment increases.