Author: yvette.pyne

Mental Health and Perimenopause Study

This University of Bristol research project, led by Dr Jo Burgin, explored how women aged 45–55 understand and experience mental health symptoms during the perimenopause. It aimed to uncover how hormonal changes may be contributing to symptoms like anxiety, low mood, and depression, and how this is addressed in GP consultations. Although no longer recruiting, the study has contributed valuable insights into diagnosis and support needs for women in midlife.

Read more about the study →

Healthwatch Bristol have completed research looking at local people’s experience of menopause and menopause care and have produced a report.

A lack of compassion from healthcare professionals, difficulty identifying menopausal symptoms, and confusion around HRT and alternative treatment options are among the issues raised by almost 400 people who shared their experience.

Welcome to the home page for the “Understanding Perimenopause in Underserved Bristol Communities” project. This is a project run by Dr. Yvette Pyne and Dr. Jo Burgin, researchers from the Centre for Academic Primary Care at the University of Bristol sponsored by the Elizabeth Blackwell Institute via a Research for Equality, Diversity and Inclusion in Health and Biomedicine grant.

We have collated a list of resources to support people experiencing menopause and perimenopause, please check out the links at the top.

---

Project Background

Menopause is when a woman’s^* periods stop and happens around 51 years old. In the years before this time, a woman can have symptoms due to the changes in some of her hormones – this is called the ‘perimenopause’. Perimenopause symptoms can be very difficult to manage with a quarter of women reporting that they significantly negatively impact their quality of life.

While understanding of perimenopause is improving, the focus is still often on white, middle-class women and these women are significantly over-represented in both research and clinical treatment. Research has shown the main symptoms of perimenopause are experienced differently depending on social and cultural norms. This can make diagnosis difficult and can lead to unnecessary tests and referrals while leaving the symptoms untreated. Many women in underserved communities may not even approach a doctor about their symptoms adding to their existing health disadvantage.

This project aims to understand the awareness, experiences and concerns around perimenopause in the ethnically diverse and underserved populations of Inner City and East Bristol through two listening workshops. From these, we will create a health information tool to share with community groups and health practitioners. We also hope to raise awareness of the needs and concerns of the women in this community with the GPs who serve them.

*We use the words woman and women here as this is the gender most widely recognised to experience perimenopause but also acknowledge and actively wish to include other groups who may experience perimenopause such as trans men, non-binary people and other gender diverse people.

---

Project Aims

We plan to connect with two groups that already have a relationship with the University of Bristol’s Centre for Academic Primary Care (CAPC) “Patient and Public Involvement and Engagement (PPIE)” team. These are the Somali Resource Centre at the Wellspring Settlement, Bristol and a group of other women who are of African, Caribbean, and South Asian heritage who are based around Easton, Bristol. We will run workshops with them to help us understand:

• What are their experiences and knowledge of the perimenopause?
• Have they, or would they seek healthcare? If not, what would prevent them? If they have, what were their experiences?
• What would they want to know about the perimenopause and how would they want to receive and discuss this information?

Both Yvette and Jo will be introducing herself at an informal community engagement session facilitated by the PPIE team in September 2022 where she will discuss the project plans. After this, two workshops will be set up with costing included for:

• Paying participants for their time and their transport.
• Paying for hire of the venue and refreshments.
• Paying for professional support in the form of community support workers (who can also act as interpreters) and the PPIE team (to facilitate and support the organisation of the work).

Our project outputs and outcomes would include:

• Increased awareness of common symptoms of perimenopause in some of the underserved communities in the Bristol area; including people from Somalia and the African continent, from the Caribbean and South Asian populations through holding workshops.
• Co-production of one or more resources that address knowledge gaps and concerns of women in these communities. Any text would be translated into high need languages spoken in the communities with the highest proportion of women in perimenopausal age range in Bristol who do not speak English. These could be uploaded to the Bristol Remedy website (a local guidelines toolkit) for clinicians to print out for patients on demand and added to the relevant local websites such as the Wellspring Settlement Website or Bristol Women’s Voice. We have budgeted for translation of 500 words into four languages (provisionally Urdu, Punjabi, Arabic and Somali) at £0.30 per word.
• Key findings shared back to these communities and health professionals who provide care within them via the workshop participants, local community newsletters, websites and noticeboards, and potentially via local community radio. We hope to promote greater understanding of their needs and explore where further improvement and research is needed. We have budgeted a day of support from the CAPC Communications Team (Helen Bolton) to support this.

Going forward, this work and these relationships will contribute to Yvette and Jo’s Doctoral Research Fellowship (DRF) applications to conduct more comprehensive research projects related to perimenopause.

---

About the Centre for Academic Primary Care

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow on Twitter: @capcbristol.

A total of 18 people completed the survey we put out across the two workshops.

Workshop Feedback for our PPIE Workshops

With regards to the workshops themselves we received the following feedback:

On a scale of 1 to 5 – how useful was the workshop to help your understanding of menopause and perimenopause?

Everyone rated it  4 to 5 stars with 14 people (78%) giving it the full 5 stars.

On a scale of 1 to 5 – how much did you feel we listened to your questions and suggestions?

Again, everyone rated it 4 or 5 stars with 16 people (89%) giving it the full 5 stars.

When invited to offer freetext feedback, there were some requests regarding vouchers that had not been received which we dealt with promptly and effectively but most were offering very positive feedback such as:

“Really useful and your passion for womens health came across strongly. You created a safe environment so felt comfortable to ask questions.”

“It was staggering how much Jo & Yvette managed to get through – info wise- as well as allowing comments and listening to each other.”

“You managed to create a welcomed safe space to talk about something I have never talked about in public!”

“I have really enjoyed it and learnt a lot from it. It was absolutely amazing!”

Another theme in the feedback was wanting the session to be longer and that it felt a little rushed which is useful for us to know going forward.

Resources Feedback

Four types of resources were suggested and they were invited to answer the question “We hope to create some resources about perimenopause and menopause following the workshop. How likely would you be to use and share each of these?”

Here there were clearly resources that seemed to be more likely to be used and shared:

Figure 1: Barton Hill (Workshop 1) Answers

Figure 2 Easton (Workshop 2) Answers

This was a useful exercise as it points us away from the creation and filming of a ‘pretend GP consultation’ as something that would be used and shared.

Interestingly, the most popular choice was the webpage with information and links given this is already available in many ways.

The final question was about which language would be useful for these resources to be both spoken and written in. As this survey (and the associated email) was sent out in English, it is likely that this question was going to be biased towards English as an answer and most people answered with English. Other suggestions included Arabic, Punjabi, Hindi, Somali, Polish, Chinese, and Bengali.

As this was a freetext field, we also got interesting answers to consider with regards to the creation of the resources:

“For me English, but for my sisters in my community it should be in as many languages as possible eg; hindu, Polish etc Also  if photos are included then someone who looks like me may also grab my attention”.

Further Research

Finally, we have been given a total of 17 names/email addresses from people in answer to the question: “We will automatically send you our final report and resources but if you would like to be added to a mailing list for future research into menopause and perimenopause, please add your email and full name below.”