Susan Waigwa, a researcher raised in Nairobi and now based in Liverpool, sat across from a group of women one evening last spring, not in a clinic or lecture hall, but in a community center lit by soft overhead lamps and the quiet hum of shared understanding. Together, they spoke about hot flushes, sleepless nights, and the unspoken weight of silence—experiences shaped not just by biology, but by culture, migration, and identity. This moment was part of a larger effort led by Professor Susan Pickard and her team at the University of Liverpool, who, after working with 60 women from Black and Chinese communities in northwest England, have launched a groundbreaking Cultural Competency Toolkit for Menopause. The initiative, spotlighted in The Lancet Obstetrics, Gynaecology & Women's Health, responds to a glaring gap: most menopause research has centered white, middle-class women, leaving the diverse experiences of others overlooked in both medical training and patient care.
The toolkit is more than a checklist—it’s a bridge. Developed with input from community-based researchers and creative storytelling methods, it helps clinicians recognize how cultural beliefs influence how symptoms are described, understood, and even acknowledged. In some communities, for instance, discussing menopause openly may be taboo; in others, symptoms might be interpreted through spiritual or familial lenses rather than medical ones. The toolkit guides healthcare providers in navigating these nuances, challenging assumptions, and building trust through culturally sensitive conversations. Collaborators from Liverpool Women's University Hospital and Royal Holloway, University of London, helped shape its practical framework, ensuring it speaks not only to researchers but to doctors, nurses, and GPs on the front lines of care.
Professor Pickard, director of the Center for Aging and the Life Course at the University of Liverpool, sees this as a step toward equity. “We hope it will help health care professionals have more open and effective conversations with women from minority ethnic communities, particularly where experiences of menopause may differ from what is commonly assumed in clinical settings,” she said. The team acknowledges the study’s limits—a sample of 60 women from two ethnic groups in one region—but views it as a foundation. Their goal is to expand the research to include more communities, disciplines, and lived experiences, ensuring the toolkit evolves alongside the diversity it seeks to serve.
Already, the ripple effect is tangible. Clinicians who’ve reviewed early versions report feeling better equipped to listen, not just diagnose. Women who participated in the project say they finally feel seen. The Cultural Competency Toolkit for Menopause is now freely available, offering a model that could reshape how medicine meets culture—not just in Liverpool, but far beyond.