Women in perimenopause need access to quality health services and to communities and systems that can support them. Unfortunately, both awareness of and access to information and services related to menopause remain limited in most countries. It is common for menopause not to be discussed in families, communities, workplaces or health-care settings.

Women may not realize that the symptoms they are experiencing are related to the perimenopausal transition or to menopause, or that they can obtain advice or treatments that will help relieve these symptoms. People with menopausal symptoms may sometimes feel embarrassed or ashamed to draw attention to what they are going through and to ask for help.

Health-care providers are not always trained to recognize symptoms of perimenopause and postmenopause and to advise patients on treatment options and ways to stay healthy after the transition to menopause. In many health worker training programmes, menopause currently receives only limited attention.

The sexual well-being of postmenopausal women is neglected in many countries. This means that common gynaecological effects of menopause, including vaginal dryness and pain during sexual intercourse, may not be treated. Similarly, older women may not see themselves as being at risk of sexually transmitted infections, including HIV, or may not receive appropriate counselling from health-care providers on safer sexual practices or on testing.(iii)

Many governments lack health policies and funding that would allow diagnostic, counselling and treatment services related to menopause to be included in routine services. Services related to menopause are a difficult challenge in settings where there are often other urgent, competing priorities for health funding.