Indigenous, integrative, and biomedical perimenopause and postmenopause healthcare for Indigenous midlife peoples residing in the United States and Canada: A scoping review.

Background: Little is known about the menopause-related healthcare of Indigenous people of the United States and Canada. This scoping review mapped the existing literature on Indigenous, integrative, and biomedical healthcare for U.S.- and Canada-based perimenopausal Indigenous populations. Methods: We followed the JBI Manual for Evidence Synthesis. The protocol was registered on Open Science Framework. Eligibility criteria included records focused on Indigenous people of the U.S. and Canada perimenopause/postmenopause healthcare. Medline and eight other data bases were searched on June 1, 2023, and updated November 21, 2024. Covidence was used for selecting and extracting data. Findings: After screening 6,684 records, 45 met inclusion criteria. These focused on Indigenous people's experiences, care barriers, symptom reporting, and treatment preferences. Traditionality, community roles, and cultural beliefs influenced symptom experience and healthcare-seeking. Many participants preferred Indigenous or integrative interventions, sometimes in combination with biomedical care. Barriers included rushed encounters, language and cultural disconnects, and systemic inequities. Interpretation: Findings highlight the need for culturally responsive, patient-centered care during the menopausal transition with an emphasis on evidence-based interventions including Indigenous and integrative health approaches. Additional research, stronger community engagement, and healthcare-provider training will help improve perimenopause health outcomes for Indigenous populations in the United States and Canada. Funding: The authors disclose receipt of the following financial support for the research, authorship, and/or publication of this article. The first author received support from the National Clinician Scholars Program (NCSP) as a postdoctoral fellow at the University of Pennsylvania. Additionally, she was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number F31NR020431. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Indian Health Service. The authors were supported by a grant from the University of Utah office of the Vice President for Research.