The concept at the heart of the study is menopausal health literacy, or MHL, which refers to the knowledge, motivation, and competencies women need to access, understand, appraise, and apply menopause-related health information in order to make sound judgments and decisions about their own care. Rather than treating menopause as a single clinical event, the researchers framed MHL as the foundation for effective self-management during a transition that can span years and touch nearly every system in the body, from thermoregulation and bone metabolism to mood and cardiovascular risk. Poor MHL, the argument goes, leaves women unable to distinguish normal transitional symptoms from signals of disease, unsure when to seek professional help, and vulnerable to misinformation.

To move beyond the familiar finding that women want more information, the team borrowed a quantitative approach from workforce training and program evaluation: Borich’s needs assessment model, paired with the Locus for Focus model. Borich’s method computes a discrepancy score by weighting the gap between importance and performance ratings, producing a numerical needs score for each educational item. The Locus for Focus model then adds a second filter, plotting items by the size of their discrepancy and their perceived importance so that only content falling into the high-need, high-importance quadrant is flagged as a true priority. This dual-method design matters because it converts vague demands for education into a ranked, actionable curriculum, something intervention designers rarely have at their disposal.

The survey instrument itself was carefully structured. Participants rated their perceived performance and perceived educational need for 31 MHL-related content items, which the researchers organized according to the three health domains used in the European Health Literacy Survey, or HLS-EU: healthcare, disease prevention, and health promotion. This framework allowed the team to see not just which individual topics mattered most, but which broad domains of health literacy concentrated the greatest unmet need. Statistical comparisons between need and performance scores within each menopausal group were corrected for multiple testing using the Holm-Bonferroni procedure, a conservative method that protects against false positives when many paired comparisons are made simultaneously. Even under this strict standard, the need-performance gap remained significant for all 31 items in both groups, with adjusted p values below .050.

The demographics of the sample sharpened the study’s practical relevance. Of the 192 women, 123 were pre/perimenopausal and 69 were postmenopausal, all drawn from community settings rather than menopause clinics, meaning the findings reflect the general middle-aged population rather than women already engaged with specialist care. Perhaps most telling was a baseline observation: very few participants had any prior experience with MHL-based self-management interventions, yet intention to participate in such programs was high in both groups. Women, in other words, are waiting for structured education that health systems have largely not built, and they are willing to sign up when it appears.

When the priority rankings were computed, a clear architecture emerged. Several high-priority content areas were common to both menopausal groups, including MHL-related content concerning cognitive symptoms, such as the memory and concentration difficulties many women report during the transition; professional assistance and healthcare facilities, meaning when and how to seek help and navigate the clinical system; and the prevention of psychosocial and musculoskeletal problems, covering mood disturbances and the joint, muscle, and bone issues that accelerate after estrogen decline. These shared priorities suggest a stable core curriculum that any menopause education program could deliver regardless of a participant’s exact stage.

But the within-group analyses revealed equally important differences. Among pre/perimenopausal women, priority content included hormone therapy, psychosocial symptoms and their management, and cardiovascular disease management and prevention. That profile makes physiological sense: women approaching or passing through their final menstrual periods face decisions about menopausal hormone therapy precisely when cardiovascular risk begins to climb, and the loss of estrogen’s protective effects on the vascular system makes this window a critical one for prevention education. Postmenopausal women, by contrast, prioritized MHL-related content concerning vasomotor and urogenital symptoms, the hot flashes, night sweats, and genitourinary changes that can persist long after menstruation has ceased and that are frequently underreported and undertreated.

Taken together, the domain-level pattern was unambiguous: high-priority content areas were concentrated in the healthcare and disease prevention domains, rather than in general health promotion. The authors interpret this as evidence that middle-aged women are not simply asking for wellness tips; they want clinically grounded knowledge that helps them interact with the healthcare system, evaluate treatment options, and prevent the chronic conditions that menopause can amplify. For intervention designers, the implication is that future MHL-based self-management programs should combine a shared core of content, covering cognitive symptoms, help-seeking, and psychosocial and musculoskeletal prevention, with flexible modules tailored to the priorities of each group, such as hormone therapy and cardiovascular prevention for pre/perimenopausal women and vasomotor and urogenital symptom management for those who are postmenopausal.

The study’s methodological choices deserve attention as much as its findings. By measuring need and performance on the same scale for the same items, the design avoids the trap of asking women what they want to learn without asking how capable they already feel, which can inflate priorities for familiar topics and hide gaps in areas women do not know exist. The cross-sectional design, however, means the data capture a single moment in time; they cannot show how educational needs evolve as women move through the transition, nor can they establish that closing the need-performance gap improves health outcomes. The sample, too, was limited to Korean women aged 45 to 55, so the specific priority rankings may shift in populations with different healthcare systems, cultural expectations around menopause, or age distributions. Still, the dual-model needs assessment offers a replicable template that researchers in other countries could apply directly.

What makes the findings resonate beyond academic circles is the sheer scale of the unmet need they document. Every measured topic, from the most clinical to the most everyday, showed perceived need outstripping perceived capability, in a cohort of women who overwhelmingly wanted to learn. As menopause moves from whispered conversation to public health agenda, this study provides something the conversation has lacked: a data-driven map of what to teach, to whom, and when. The next step, the authors suggest, is to translate these priorities into MHL-based self-management interventions and test whether closing the literacy gap translates into better symptom management, smarter healthcare use, and healthier aging for the millions of women navigating the menopausal transition each year.

Subject of Research: Educational priorities for menopausal health literacy among pre/perimenopausal and postmenopausal women

Article Title: Priorities for menopausal health literacy-related educational content among pre/perimenopausal and postmenopausal women

Article References: Lee, H., & Kim, J. (2026). Priorities for menopausal health literacy-related educational content among pre/perimenopausal and postmenopausal women. BMC Public Health. https://doi.org/10.1186/s12889-026-29823-7

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29823-7

Keywords: menopause, menopausal health literacy, health literacy, self-management, needs assessment, Borich needs assessment, Locus for Focus model, pre/perimenopausal women, postmenopausal women, health education, public health, BMC Public Health