Objective: To assess the menopausal perceptions and experiences of older women from selected sites in Botswana. Design:
This study used snowball sampling to recruit 444 older women in four health districts of Botswana. Trained research
assistants administered a structured questionnaire to determine respondents’ menopausal symptoms, perceptions
and knowledge of menopause and sexual experiences. Multiple logistic regression procedures were used to evaluate the
association of socio-demographic characteristics with knowledge of menopause and factor analysis was used to cluster
menopausal symptoms. Results: Participants had low levels of knowledge and awareness of menopause. The three most
common changes identified were weakening of bones (78%), changes in sex drive (69.6%), and difficulty working
(56.2%). The majority of respondents perceived menopause as freedom from menstrual cycles (85%) and cost saving
(65%). Employment status was significantly associated with knowledge of menopause. The mean age at menopause
was 48.9 years. With an average life expectancy of 54.5 years, there remains about 6 years of postmenopausal life.
Recommendation: Public health care systems in and beyond Botswana should mobilize resources and take measures to
improve older women’s awareness and knowledge about menopause-related changes through educational training and
guidance to maintain active, healthy lives.