Abstract

Introduction Menopause is a normal part of aging but people with a learning disability (PWLD) and those who care for them may have a limited understanding of its impact on their learning disability and general wellbeing. Undiagnosed or unmanaged menopausal symptoms may invoke behaviour that challenges and result in inappropriate prescription of antidepressants (Adams et al., 2025). Research suggests that treatment of menopausal symptoms for PWLDs may be delayed as symptoms can be mistakenly attributed to their learning disability, (Corrigan et al., 2025; Trueland, 2023). This study explored the experiences of PWLD who are living with menopause, and identifies recommendations to reduce health inequalities for this oft-overlooked group. Materials and Methods Semi-structured interviews lasting up to 1 hour were conducted with 23 PWLD who were living in the NHS North-East North Cumbria ICB and NHS South Yorkshire ICB. Questions probed their understanding and experiences of the menopause focusing on the dynamics between symptoms of menopause and their learning disability in different contexts of their daily life. Data was analysed thematically. Results and Discussion Analysis identified 2 key areas: (1) Understanding and Biopsychosocial impact of menopause and (2) Situational Contexts - home, social and community, and medical settings. For PWLD, effective diagnosis and management of their menopausal symptoms are hindered by barriers to healthcare resulting in inequitable outcomes. PWLDs had limited knowledge of menopause and symptomology. Diagnosis of menopause is complicated by the level of understanding that the PWLD has of their body and menopausal ‘brain fog’ exacerbates existing communication difficulties for these patients. Similarities between psychological symptoms of menopause, such as mood swings, and those of learning disabilities create a significant challenge for PWLD and their healthcare team to differentiate between. PWLDs reported mental health issues including anxiety and feeling embarrassed or a burden to friends/family and carers. Participant narratives identify a need for early and on-going reproductive health education, resources available in accessible formats, and peer support. Improvements are required in healthcare practitioner confidence and competencies with training in communication skills and their clinical knowledge of how menopause symptoms may manifest in PWLD and their management.