"Bridging tradition and modern care: a narrative review on managing menopause in Saudi primary healthcare settings".

Background: Menopause is a multifaceted biological, psychological, and social transition experienced by women worldwide. While global research describes variations in symptom prevalence and cultural interpretations, the Saudi context remains underexplored despite its unique cultural, religious, and social influences. Saudi women commonly report vasomotor, psychological, and musculoskeletal symptoms, yet intimate and urogenital concerns remain underreported due to cultural norms. Primary healthcare (PHC) services face documented gaps in training, readiness, and communication, further limiting comprehensive care for menopausal women. Objective: This narrative review examines the cultural, religious, psychological, and social dimensions of menopause among Saudi women, evaluates patient-provider interaction dynamics within PHC services, and highlights opportunities for integrating culturally appropriate management approaches. Methods: A narrative synthesis of national and international literature was conducted, drawing on studies related to menopausal symptoms, cultural perceptions, healthcare system readiness, traditional therapies, and patient-provider communication in Saudi Arabia. Results: Findings demonstrate that cultural and Islamic values strongly shape women's perceptions of menopause, coping strategies, and health-seeking behavior. Herbal and traditional remedies remain widely used, often preferred over hormone replacement therapy. Significant barriers affect PHC-level care, including limited provider training, gender dynamics influencing consultation comfort, lack of privacy, and the absence of national menopause management guidelines. Psychologically, many women experience mood changes, anxiety, and altered self-perception, while social factors-particularly family and marital dynamics-play a critical role in adjustment. Emerging community-based programs and telemedicine platforms offer promising culturally sensitive avenues to improve access and quality of care. Conclusion: Menopause among Saudi women is a complex biopsychosocial experience shaped by deep cultural and religious contexts. Current PHC services have notable gaps but also clear opportunities for improvement through clinical training, culturally competent communication, integration of safe traditional practices, and expansion of telemedicine. Developing national guidelines and community-based education initiatives is essential to enhance patient-centered, culturally congruent menopausal care in Saudi Arabia.