LAUSR

Abstract Background Palestinian health-care services are directed towards prenatal care and childbirth, marginalising women of different ages, especially in the menopausal period. We aimed to investigate factors affecting Palestinian women's menopausal symptoms and psychosocial health. Methods We used purposeful or convenience sampling to identify eligible women aged 45–65 years in 18 Ministry of Health clinics in north, central, and south West Bank. We developed a locally relevant instrument on the basis of published literature and results from a pilot qualitative study. We made scales to score women's reported medical history, non-communicable diseases (NCDs), pains, menopausal symptoms, and quality of life (ie, physical health, sense of control and fulfilment, and psychosocial health status) with good or more Chronbach's α values (0·7–0·8 or more). We used binary logistic regression to check for confounders. Ethical approval and verbal consent were obtained. Findings Between Oct 21, 2013, and Nov 20, 2013, we identified 1817 eligible women. After exclusion of 781 perimenopausal or menopausal women, we included 1036 postmenopausal in our analysis. Women with less than 12 years in education, living in crowded households, with no family support, and with one or more NCDs were more likely to report more menopausal symptoms than women with 12 years of schooling or more (OR 1·90, 95% CI 1·32–2·85), living in less crowded households (1·70, 1·19–2·32), with family support (1·60, 1·13–2·25), and with no NCDs (1·60, 1·13–2·20). Women with satisfactory psychosocial health were less likely to report menopausal symptoms than those with unsatisfactory psychosocial health (OR 0·10, 95% CI 0·07–0·15). Women who lived in north or south West Bank were more likely (OR 2·60, 95% CI 1·69–4·07 for north West Bank; 3·20 1·79–5·73 for south West Bank) to have unsatisfactory psychosocial health status than women who lived in the centre West Bank. Interpretation Our results highlight the need to address the psychosocial health of Palestinian menopausal women. Funding United Nations Population Fund, occupied Palestinian territory.