A different kind of power.

A different kind of power Menopause is not experienced solely as a biological event. It unfolds within the wider context of a woman’s life, intersecting with career pressures, caring responsibilities for children and aging parents, and shifts in personal identity. This issue of the BJGP takes in this broader view, considering not only physical symptoms and psychological wellbeing during this time, but also social circumstances and cultural context, and what these mean for patients and for practice. Midlife has long been framed as a period of narrowing and loss, of slowing down and fading back. But that story is shifting, and contemporary narratives are challenging these old-school notions. The raw and embodied exploration in Miranda July’s All Fours, and the recent BBC series Riot Girls show menopause as a time of personal redefinition and empowerment, a period of growth, change, and renewed agency. It’s a reminder that change can also be power. In medicine, that shift in perspective matters. How we talk about menopause shapes how we care for those experiencing it. But, as Abi Eccles and colleagues highlight in this issue, menopause is not experienced uniformly across all communities. Women from minority ethnic backgrounds face unique challenges during menopause, including cultural stigma, limited access to information, and healthcare disparities that can lead to underreporting of symptoms and a lack of tailored support. Jo Burgin’s paper in this issue shows that the link between perimenopause and mental health is often missed, a reminder of the value of curiosity and open dialogue in consultations. Listening to these diverse voices is central to equitable, person-centred care. This issue points towards a more nuanced understanding of menopause, one that encompasses the psychological, social, and cultural dimensions of this varied stage in a woman’s life. It invites general practice to think differently, and to see menopause not just as a cluster of symptoms, but as a transition that affects women’s health, identity, and lives in complex ways. Menopause isn’t an ending at all, but a recalibration. What we need now is to meet this cultural expansion of women’s experiences of menopause by recognising complexity, embracing difference, and supporting every woman to find her own balance, and maybe even her own kind of power, in this transition. General practice sits at the intersection of these conversations, where biological change meets lived experience, and where listening well still counts for most. Nada Khan Associate Editor DOI: https://doi.org/10.3399/bjgp25X743613 © British Journal of General Practice 2025 537-586 Highlights The papers in this issue explore areas where general practice is still finding its footing. Sharon Dixon’ s team examine the uncertainties GPs face when diagnosing and managing endometriosis within wider healthcare constraints. Menopause care, meanwhile, offers a lens on equity where more affluent and informed women may be better placed to have their needs heard. In a series of articles, Sarah Hillman and colleagues consider how GPs and women experience menopause across diverse communities, revealing how inequities shape care and offering food for thought on how these can be challenged and addressed in everyday practice. And finally, in our Clinical Practice section, Jo Burgin looks at genitourinary syndrome of menopause (GSM) and gives practical tips for assessing and managing this common condition in practice. Editor’s briefing British Journal of General Practice, December 2025 EDITOR’S BRIEFING | 539 EDITOR Euan Lawson, FRCGP Lancaster DEPUTY EDITOR Andrew Papanikitas, FRCGP, PhD, SFHEA Oxford ASSOCIATE EDITOR Nada Khan, MSc, DPhil, MRCGP Exeter ASSOCIATE EDITOR Samuel Merriel, MSc, PhD, MRCGP Manchester ASSOCIATE EDITOR Thomas Round, BSc, MRCGP, DRCOG London HEAD OF PUBLISHING Catharine Hull PRODUCTION MANAGER Christopher Clough MANAGING EDITOR Amanda May-Jones PRODUCTION EDITOR Tony Nixon PRODUCTION EDITOR Thomas Bransby PRODUCTION EDITOR Jennifer Morris MULTIMEDIA EDITOR Erika Niesner DIGITAL & DESIGN EDITOR Simone Jemmott EDITORIAL ASSISTANT Margaret Searle EDITORIAL ADMINISTRATOR Khit Khin 2024 impact factor: 5.2 EDITORIAL OFFICE 30 Euston Square, London, NW1 2FB. (Tel: 020 3188 7400, Fax: 020 3188 7401). E-mail: [email protected] / bjgp.org / @BJGPjournal PUBLISHED BY The Royal College of General Practitioners. Registered charity number 223106. The BJGP is published by the RCGP, but has complete editorial independence. Opinions expressed in the BJGP should not be taken to represent the policy of the RCGP unless this is specifi cally stated. No endorsement of any advertisement is implied or intended by the RCGP. ISSN 0960-1643 (Print) ISSN 1478-5242 (Online) PRINTED BY WARNERS 01778 395111