“It’s all about the money.” Australian women’s perspectives about menopause and the commercial determinants of health

Abstract

With increased public attention on menopause, researchers have started to investigate the surge of commercial products and services which claim to provide solutions for menopausal symptoms. Few studies have explored the views of women about the commercial determinants of menopause. Using an online qualitative survey, this study sought insights from n = 509 Australian women aged 45–64 years about the factors that might influence the use of products and services for menopause, the risks associated with the increased promotion of commercial solutions for menopause, and the role of the pharmaceutical industry in sponsoring menopause-related women’s health events. Three themes were constructed using a reflexive approach to thematic analysis. First, women perceived that commercial actors sought to exploit women’s concerns to stimulate product demand through catastrophizing menopause, appearing to listen to experiences, and capitalizing on worries about ageing. Second, they stated that marketing, access, and perceived affordability of products and services intersected with lived experiences of menopause to amplify women’s vulnerability to commercial tactics. Third, there were mixed views about the roles of the pharmaceutical industry in sponsoring women’s health events. These ranged from significant scepticism about the motives of the pharmaceutical industry, to support for initiatives that helped increase information and awareness. This study highlights the risks associated with commercial practices related to menopause. It shows that women themselves are concerned about the exploitation of women’s health for profit. It emphasizes the need for increased critical focus on the role of commercial determinants in shaping women’s understandings and experiences of menopause.

Contribution to Health Promotion.

• Explores women’s opinions about the commercialization of menopause

• Shows that women are concerned about commercial practices that seek to capitalize and exploit lived experiences related to both menopause and ageing

• Highlights the appeal of easily accessible ‘quick fix’ solutions for menopause

• Identifies the need for focus on the tactics of a range of commercial actors, including the wellness industry

• Illustrates that there are mixed views about pharmaceutical industry corporate social responsibility activities

INTRODUCTION

Menopause is defined as the cessation of menstruation for 12 consecutive months (Delanerolle et al. 2025). Experiences of the transition to menopause are diverse, ranging from positive experiences, to those that may have significant negative impacts on health and well-being (Jean Hailes for Women's Health 2023, Wood et al. 2025). In the context of this paper, we use the term woman/women to refer to cisgender women, although we recognize that those born female but with diverse gender identities also experience menopause (Drysdale et al. 2025). Most menopause research to date has largely focused on medicalized models of symptoms and treatments—generally via pharmaceutical interventions such as menopause hormone therapy (MHT) commonly known in some countries as Hormone Replacement Therapy (HRT) (Hickey et al. 2024). There has been much less focus on the broader determinants that may influence the health and well-being of those experiencing the menopause transition (Hickey et al. 2024, Thomas et al. 2024c, Cronin et al. 2025). Researchers and women’s health organizations recognize that menopause collides with a range of social and economic pressures for women during midlife (Jean Hailes for Women's Health 2022, Brewis et al. 2025, Steffan and Loretto 2025). These may include intergenerational caregiving responsibilities, financial stress, gendered ageism, and workplace discrimination, which can have profound impacts on women’s health and well-being during midlife (Cowell et al. 2024). There is also evidence of the increasing commercialization of menopause through the ‘menopause market’, defined as:

…the collection of products, services, and solutions—including biomedical management, menopause remedies, and market-driven commercial offerings—designed to address the different symptoms and experiences of menopause. (Onculer and Onculer Yayalar 2025, p. 246)

This commercialization is particularly concerning given that research across a range of areas has identified that women’s health is vulnerable to commercial capture (McCarthy et al. 2023a). Despite these developments, most qualitative studies still focus on the individual and social determinants of menopause, with researchers calling for increased focus on the economic, commercial, and political determinants, which may intersect to influence experiences of the menopause transition (Wood et al. 2025).

The commercial determinants of health (CDoH) are defined as ‘the systems, practices, and pathways through which commercial actors drive health and equity’ (Gilmore et al. 2023, p. 1195). Commercial actors use a range of strategies to promote and market products, improve their reputations, influence public and political norms, manipulate and deny science, and delay regulatory reform (Thomas et al. 2024a). Recently, there has been increased focus on how commercial practices may specifically influence the health and equity of women (McCarthy et al. 2023a, Brassart Olsen 2024, Szabo et al. 2024). As menopause has gained significant visibility across media (Orgad and Rottenberg 2024), workplaces (Rowson and Jones 2025), and government agendas (Commonwealth of Australia 2024), there has been a surge in commercial interest in menopause. The global menopause market is projected to reach $24.4 billion by 2030 (Onculer and Onculer Yayalar 2025). A 2024 Lancet series on menopause highlighted the risks associated with this increased commercialization, stating that much information about menopause online is driven by commercial interests (Hickey et al. 2024). As Takhar and colleague’s comment:

The market is falling over itself to ensure that women can enjoy a “good menopause” as opposed to a hellish one suffered by previous generations of oestrogen-deprived consumers. (Takhar et al. 2025, p. 237)

Evidence from some countries suggests that the prescribing of pharmaceutical treatments for menopause has increased substantially in recent years, attributed to a range of factors including increased awareness of risk profiles, destigmatization, and media attention (Hickey et al. 2024, Christakis et al. 2025). For example, in England 13 million HRT items were prescribed in 2023/24—an increase of 22% from the previous year (NHS Business Services Authority 2024). At the same time, there has been an increase in media and public focus on menopause—described as the ‘menopausal turn’ (Jermyn 2023, p. 1), which has included celebrity testimonies which researchers have argued have played a role in ‘extolling the benefits of Hormone Replacement Therapy (HRT) for some to treat menopause symptoms’ (Jermyn 2025, p. 1039).

However, the commercialization of menopause extends beyond pharmaceutical interventions. Researchers have started to critically examine how those who profit from menopause (including the pharmaceutical industry, but also the wellness industry, for-profit health providers, and some celebrities and social media content creators or ‘influencers’) may promote their products, frame public narratives about menopause, and influence policy decisions about access to menopause treatments and services (McCartney 2022, Bettany 2024, Randle et al. 2024, Schneider Dallolio et al. 2025, Takhar et al. 2025). Studies investigating marketing messages about commercial solutions for menopause highlight the range of appeal strategies which draw upon aspirational narratives of self-care and control, and reinforce gendered expectations around productivity, appearance, emotional regulation, and personal responsibility (Rowbotham et al. 2019, Baber 2023, Corus et al. 2025, McCartan 2025). These strategies may also promote misinformation through claims of ‘solutions’ that respond to women’s fears and anxieties (Baber 2023), and which ultimately may reinforce harmful tropes and gendered ideologies, particularly relating to ageing (Bettany 2024).

More broadly than menopause, other commercial actors use a range of gendered tactics in their corporate social responsibility (CSR) and public relations initiatives (Bell et al. 2019). For example, CSR activities are often framed by actors that are harmful to health as efforts to advance women’s health and gender equity, allowing companies to present themselves as socially responsible and invested in women’s health and well-being (Hill and Friel 2020, McCarthy et al. 2023a). CSR activities also enable corporations to position themselves as credible voices in women’s health, shaping public discourse while promoting products and services that might not be appropriate, necessary, or evidence based. These initiatives have been criticized for being superficial and strategically designed to build reputation, deflect criticism, and influence policy outcomes in ways that undermine public health (Gilmore et al. 2023). While there is increasing attention to CSR activities in other areas of women’s health (Cousins 2022), there has been less focus on how these public relations strategies may be used by those commercial actors who may profit from menopause.

While the increased research focus on the products and practices of commercial actors in menopause is encouraging, there has been less research that has examined women’s own views about the commercialization of menopause. Using an interpretivist qualitative approach (Braun and Clarke 2025), this study aimed to explore Australian women’s understandings about the commercial determinants of menopause. Three research questions were used to guide the study:

• RQ1: What are the range of commercial strategies that women think are used to promote the consumption of menopause products and services?

• RQ2: How do women conceptualize any risks associated with promotions and novel products related to menopause?

• RQ3: How do women view the role of pharmaceutical industry CSR activities related to menopause?

METHODS

Approach

The data presented in this paper are part of a broader online qualitative survey examining the menopause experiences of n = 509 Australian women aged 45–64 years. One paper has been published from this study examining women’s views about the increased public focus on menopause (Thomas et al. 2025). The study used an experiential and interpretive qualitative approach (Braun and Clarke 2024), positioning women's experiences with menopause as socially embedded and situated within broader midlife contexts. Through a reflexive approach to thematic analysis, the study acknowledges the researcher team’s active role in knowledge construction and embraced subjectivity as an analytical strength rather than limitation (Braun and Clarke 2022, 2024). We acknowledge our positionality as public health and marketing researchers who are female, three of whom have lived experience of the menopause transition.

Qualitative surveys have been used to explore how women experience a range of health and social issues related to corporate practices (McCarthy et al. 2023b, Lunnay and Foley 2024). They are a novel but increasingly used qualitative data collection tool which offers a ‘wide-angle picture’ (Toerien and Wilkinson 2004, p. 70) on the opinions and experiences of diverse population subgroups (Braun and Clarke 2021, Thomas et al. 2024b). They offer a number of benefits for participants, particularly as an inclusive method for engaging a diverse group of individuals who otherwise would not be willing or able to take part in in-depth interviews. They allow individuals to participate in qualitative research at a time and place convenient to them, accommodating busy schedules and providing an inclusive alternative to time-intensive interviews. The data are collected anonymously, which means that individuals may also feel more comfortable sharing their experiences. Participants retain full autonomy over their level of engagement and are able to provide as much or as little information as they would like to without being prompted by a researcher (Braun et al. 2021, Thomas et al. 2024b). Ethical approval was received for the study from Deakin University (2025/HE000021).

Sample and recruitment

Australian cisgender women were invited to participate in the study (with participants choosing ‘Born female and identify as female’ in the study screening question to be able to continue with the study questions). The study focused on those aged 45–64 years to capture midlife experiences broadly (Jean Hailes for Women's Health, 2023) and reflect the typical menopause transition period of 45–55 years (World Health Organization 2024). Participants were not required to have experienced menopausal symptoms. We aimed to recruit n = 500 women based on sample sizes for similar studies exploring women’s experience of health and social issues (Pitt et al. 2023, Graeve et al. 2025, Mills et al. 2025) and to collect sufficient information to address the research questions (Malterud et al. 2016).

Recruitment for the study was conducted through the Qualtrics survey platform. Qualtrics sends information about the survey to partner panel companies, which maintain databases of registered individuals who earn points for each survey they complete. They then send the survey link to account holders who are likely to meet the inclusion criteria. Qualtrics keeps the survey open until the desired sample size has been achieved (including any quotas specified), recruiting extra participants to allow for the data cleaning process. Soft quotas for Australian geographical regions and age groups were implemented to ensure diversity in the sample. Eligible individuals reviewed a Plain Language Statement which included information about participating in the study, as well as information that the participants could leave the survey at any time without giving a reason. Participants accessed the study after providing consent to continue. As responses were completed, Qualtrics conducted technical checks of the data, removing those with duplicate IP addresses and nonsensical responses (such as random character responses) and replacing these with new participants until the sample was complete.

Data collection

Following piloting of the survey to test for comprehension of survey questions, the full survey was launched in April 2025. A total of n = 543 women completed the survey in a 1-week period. The survey collected data about participants’ general characteristics, which included age, geographic location, and country of birth; whether they were of Aboriginal and/or Torres Strait Islander origin; education; and employment status.

The open-text questions analysed for this paper included—whether women had seen any promotions for menopause products, and where they had seen these; if they had purchased products or services related to menopause, what they had purchased and what influenced this purchase; perceptions about whether they thought women might be influenced to try wellness industry products (with specific reference to supplements, skin care, weight loss, and fitness solutions); what they thought about expert opinions that the negative aspects of menopause may be used to drive product purchases; whether women may be vulnerable to tactics which seek to profit off menopause experiences; and perceptions about pharmaceutical industry sponsorship of health events related to menopause.

Data interpretation

In preparing the dataset for analysis, the research team reviewed all responses and removed individuals who provided nonsensical answers (such as random letters or numbers) or inadequate responses to the majority of questions (such as ‘I don't know’, ‘yes’, or ‘no’). While no prior indicators were set for inclusion/exclusion of those who had completed the survey, all decisions were discussed and agreed upon among the research team, with the overall goal of including participants who made a genuine attempt to complete the survey. This resulted in the removal of n = 34 individuals, leaving a final dataset of responses from n = 509 women.

Quantitative data were analysed using descriptive statistics. Open-text questions relating to recall of marketing and product consumption (requiring a shorter open-text written response) were coded a ‘1’ for no responses and ‘2’ for yes responses. Qualitative open-text data were analysed using Braun and Clarke's (2024) six-phase approach to reflexive thematic analysis. This iterative, non-linear analytical approach included collaborative reading and discussion of responses in team meetings; coding of semantic and latent meanings within and across each question; theme construction guided by the overarching research questions; and ongoing reflection and revision throughout analysis and reporting. This process continued through the peer reviews of the paper, with clarifications and revisions to themes occurring after suggestions from the peer reviewers.

RESULTS

General characteristics

A comprehensive socio-demographic profile of the study participants has been reported in detail elsewhere (Thomas et al. 2025). In brief, to contextualize the sample, the n = 509 women who participated in the study were aged between 45 and 64 years, three-quarters resided in Australia’s three largest states (n = 381, 74.9%) of New South Wales, Victoria, or Queensland and lived mostly in metropolitan areas (n = 320, 62.9%). The majority were born in Australia (n = 393, 77.2%), with n = 17 participants (3.3%) identifying as having Aboriginal or Torres Strait Islander background. There were 34 countries of birth outside of Australia, which included the UK, New Zealand, Malaysia, Hong Kong, Singapore, Philippines, Iran, Bangladesh, Zimbabwe, Macedonia, Brazil, the Netherlands, India, China, Uruguay, South Africa, Switzerland, Greece, the USA, Italy, Ukraine, Palestine, Vietnam, Germany, Samoa, Indonesia, Sri Lanka, Serbia, Fiji, Serbia, Croatia, Kenya, Africa, and Nepal. Almost one-third of participants reported working full-time (n = 160, 31.4%), one-fifth worked in a part-time capacity (n = 102, 20.0%), and just over one in ten were retired (n = 61, 12.0%).

Recall of product advertising and the purchase of menopause products and services

Nearly a third of women (n = 155, 30.5%) stated that they recalled seeing advertising for menopause products. Participants mentioned that they had seen advertising on social media sites (including Facebook, Instagram, and TikTok), on morning shows on television, at local pharmacies, at health food stores, and in women’s magazines. Of those who saw advertising, most wrote that they recalled seeing advertising for wellness industry products, including vitamins and/or supplements, exercise programmes, and diet solutions. Some participants provided more detail about what they had seen, commenting that advertising claimed that these products would ‘relieve symptoms’ or would ‘help with menopause symptoms’ with specific reference to night sweats, hot flushes, weight gain, and mild anxiety.

Over a quarter of participants (n = 146, 28.7%) said that they had purchased products for menopause. For those who provided additional information, most of these product purchases were related to the wellness industry, including ‘natural’ vitamins and herbal supplements, skin products, and celebrity books about menopause, with one commenting that she had tried these products out of ‘desperation’. A few women specifically commented that they regretted spending money on wellness products, describing them as ‘expensive’, ‘useless’, or saying that ‘they did fuck all’.

Qualitative themes

Table 1 provides a summary of the three main qualitative themes and subthemes that were constructed from the data, with additional illustrative quotes from participants.

Table 1.

Key themes, subthemes, and illustrative quotes.

Theme 1: Commercial actors seek to connect with women and capitalize on their concerns for financial gain
Subtheme	Quote
Catastrophizing narratives about menopause	‘They can put ideas into women’s heads and make them bigger than they really are just to make a profit’—61 years old, Victoria ‘If there's something that can be bought that appears to be a miracle fix, then many women are going to fall for that. Just look at the dieting industry! “Oh, there's a pill for that? Sign me up!”’—57 years old, Victoria
Listening to women’s concerns and offering support	‘Many women don't wish to discuss menopause, and if the products are spruiked by an online influencer, this could lead them down the garden path even further’—59 years old, Western Australia ‘There are very vulnerable women out there who are ripe for the picking and the influencers, marketing firms and companies seeking profits fully understand this and will exploit this’—60 years old, New South Wales ‘…. I think these companies just take advantage of vulnerable women that promise a quick fix but don't deliver’—50 years old, Victoria
Capitalizing on women’s concerns about ageing	‘Yes, if you’ve gained a lot of weight and it’s making you really self-conscious, a company has a weight loss product of course you’ll want to try it’—46 years old, Victoria ‘Most women have been fooled into thinking that creams and cleansers will benefit their skin’—46 years old, New South Wales ‘It's the end of an era for us, we are finding a new identity. Also having concerns with aging due to health reasons or maybe just vanity. The promise of something to make us feel better, or more like our younger selves could be very appealing’—60 years old, New South Wales

Theme 2: Product availability and innovative marketing intersect with lived experiences to amplify vulnerability
Subtheme	Quote
Targeting women’s vulnerabilities during menopause	‘Women are looking for any kind of relief from the side effects of menopause but most of these companies are only interested in the dollar value’—63 years old, Western Australia ‘We grasp at anything that might make us feel better, so we are sucked in to buying all these products in the hope that it might just be ‘the one’ to help’—54 years old, Western Australia ‘They want to try anything as when your menopausal you’re desperate for a solution that will work, and we as women will try anything as we are very vulnerable as we want a cure for what we are going through at the time’—51 years old, Queensland
Influenced by affordability and accessibility	‘When you want help, you sometimes seek a quick resolve’—60 years old, Victoria ‘If they are available in pharmacies…it may negate the need to see a medical professional’—60 years old, South Australia ‘Women are wanting to feel better about themselves and are often time poor so they will grab any product that is labelled with the buzz words they are relating to’—55 years old, Victoria ‘I purchased a drinking powder from Carla Oates, The Beauty Chef. I spotted it on TVSN which I do have a lot of faith in their brands, I feel they are a reputable brand’—54 years old, Victoria ‘Of course, they would because it would then save having to make the appointment, pay a lot of money for advice and if you can relate to an influencer or advertising about a product then you'd just purchase whatever it is that you think will help’—59 years old, Victoria
Lack of support from medical practitioners	‘Some women may try them if they are not seeing results by what the doctor advised they should take’—64 years old, New South Wales ‘Those who want a quick fix or who have tried other treatments without success and are desperate for relief of symptoms will be vulnerable’—46 years old, Queensland ‘Women who are desperate may try anything and if they can’t find helpful options from their GP, they are quite likely to try the snake oil peddlers’—57 years old, Western Australia ‘Some women may try them if they are not seeing results by what the doctor advised they should take’—64 years old, New South Wales

Theme 3: Pharmaceutical industry CSR initiatives may contribute to awareness but are perceived to have a primary motive of maximizing profit
Subtheme	Quote
Suspicion of profit based motives	‘Pharmaceutical companies are more about making money than actually helping people. They sponsor women’s health events to flood the market and make women think that their way is the only way I think it’s wrong’—61 years old, Victoria ‘That’s just typical of a pharmaceutical company they will jump on any band wagon that is going to make them money and menopausal woman are a strong market’—53 years old, Western Australia. ‘There is bias, that may skew the information to favour whatever product or service they seek to sponsor’—60 years old, Queensland ‘The pharmaceutical industry has decided to make even more billions through sponsorship as they want to essentially medicate the world’—57 years old, Queensland
Perceived benefits of industry support	‘I think it's good that they sponsor health events to acknowledge that there's such a stage of life that people go through and possibly provide more information/leaflets on it…’—61 years old, New South Wales ‘I think it is a good positive thing because it creates more opportunity for conversation’—49 years old, South Australia ‘Very helpful. Without information you don’t know what is available to help you deal with your issues’—61 years old, New South Wales ‘If they can campaign for women’s health and especially menopause as women would love an answer or something that will help them get through their menopausal period’—51 years old, Queensland

Theme 1: Commercial actors seek to connect with women and capitalize on their concerns for financial gain

Participants identified a range of strategies that commercial actors used to promote the consumption of various menopause products and services. These included catastrophizing narratives about menopause; listening to women’s concerns and offering support; and capitalizing on women’s concerns about ageing, including those related to weight gain and traditional beauty standards. Most participants perceived that financial gain rather than supporting the health and well-being of women was the primary motive of those selling menopause products and services, and were willing to ‘push anything to make a dollar’. Many participants specifically discussed different parts of the wellness industry, including companies that promoted vitamins and supplements, and alternative therapies:

There is big business with vitamins/minerals and any other type of medication to alleviate the symptoms of menopause—57 years old, Queensland.

I think there are definitely many markets. They would try capitalising on this. Definitely the natural health market, alternative therapies, etc—46 years old, New South Wales.

Some women described a process in which commercial actors created exaggerated and catastrophizing narratives about menopause, which increased women’s fears and concerns about menopause, then offered a solution to fit the narrative that they had created. For example, participants commented that marketing strategies were employed to create emotively charged messaging, including ‘scare tactics’ and ‘scaremongering’, which were used to drive sales. A few highlighted that these types of tactics were not unique to menopause and had become normalized across a range of industries targeting women's health and well-being:

There are some marketing tricks that will certainly pull people in, especially as women are suffering with their symptoms and just want to feel normal again—52 years old, Queensland.

They can make the symptoms sound horrible and put the idea into women’s heads that everything they feel is wrong is because of menopause and making them think it lasts forever, and it doesn’t—61 years old, Victoria.

It is still after all a business and these companies would want to rake in as much money as they can though it is very unethical—50 years old, Victoria.

Others stated that sophisticated marketing strategies positioned commercial actors, including social media content creators (influencers), as listening to the concerns of women. This included positioning themselves as being a primary support for women because ‘drs [doctors] aren't understanding’ and ‘influencers who just want to make sales and will say anything’. Some stated that women often felt alone with their menopause experiences, and marketing strategies capitalized on this to provide supportive communities, products, and services filling a gap in ‘information and support’, with women feeling ‘comforted’ by advertisers.

I think it would be easy for these companies to make money from women because they are the only ones who are listening and doing something about it—46 years old, Western Australia.

Participants noted that products available in pharmacies or online were often viewed as ‘quick solutions’ that offered convenience and hope without the need to seek professional advice. This accessibility made commercial solutions particularly appealing to women seeking immediate relief. Participants widely recognized that some women were struggling with symptoms and were actively seeking solutions to feel ‘normal’ again. However, there was strong concern that some commercial actors were deliberately exploiting this vulnerability by positioning their products as essential purchases for ‘all’ women during the menopause transition:

Especially with things like HRT you can already see a trend that women think this is something they have to have in order to cope with menopause—60 years old, New South Wales.

They will claim every issue a woman of a certain age is experiencing is due to menopause and sell a ‘solution’ for it—64 years old, Victoria.

Participants also identified that commercial actors strategically targeted women's insecurities about ageing, which they framed as being associated with menopause. Participants commented that menopause was now a central concept in the commodification of ageing for women. Commercial actors aligned menopause with broader insecurities associated with ageing, including weight gain, skin changes, and the desire to appear youthful:

I would agree that it's all about the money…. another example of this is the array of health pills and potions, weight loss products etc… all an absolute waste of money—64 years old, New South Wales.

Some participants extended their concerns beyond commercial entities to implicate medical professionals and governments in similar profit-driven behaviours. This broadened critique suggested that the commercialization of menopause was part of a wider structural issue whereby there is a lack of trust in medical professionals, governments and ‘experts’:

Medical professionals are just as bigger con artists as big pharma and the medical device industry—48 years old, South Australia.

All people who are profit driven do this. Government and their experts are masters at it—49 years old, New South Wales.

Theme 2: Product availability and innovative marketing intersect with lived experiences to amplify vulnerability

Participants stated that marketing, access, and perceived affordability intersected with women’s lived experiences of menopause and amplified their vulnerability to commercial tactics. Rather than symptoms, some participants discussed the emotional burdens and insecurities of menopause for some women, which they perceived could make them vulnerable to promises about solutions. This included that some women felt silenced, embarrassed and alone with their menopause experiences:

It is concerning as a lot will be preying on the insecurities of women. Women are going through changes they don't understand and are reaching out to find a solution—55 years old, Victoria.

Some women are too embarrassed to talk to anyone about what is happening because they feel they are the only one this is happening to. They grasp at any straws that say they can help—46 years old, Queensland.

Others stated that many women’s concerns were linked with their physical appearance and ageing. Those experiencing weight gain or visible ageing expressed frustration that previously effective strategies no longer worked, making them susceptible to products promising to help them ‘stay young’:

Menopause is a time of change and weight gain, and skin irritation is not uncommon. Women are looking for ways to still look and feel their best throughout Menopause. People will try ANYTHING these days!—60 years old, New South Wales.

As we age our bodies become different and personally for me, I would be influenced by fitness products to help me lose the extra kilos I have gained in the last 12 months—46 years old, Tasmania.

Affordability and accessibility also influenced decisions to purchase products. For example, a few participants stated that access to medical specialists was too expensive. Instead, they turned to direct-purchase alternatives that avoided specialist consultation fees and were more friendly and relatable. Some also stated they had been influenced by promotions on specialized menopause websites, social media platforms, celebrity endorsements, and online reviews. Some said that they were prompted to give a product ‘a go’ after seeing it advertised through a range of platforms. Others tried products from brands that they thought were reputable or had been recommended by friends, work colleagues, or family members:

It was moisturiser made specifically for woman with menopause. I’d seen it online & thought I'd give it a go—48 years old, Western Australia.

I purchased over the counter tablets to help ease symptoms after I heard good things about the brand from friends—63 years old, Queensland.

Some stated that women had multiple caring roles and work commitments and lacked the time to seek professional medical advice. The accessibility of over-the-counter products created an appeal for women who were seeking immediate, ‘quick fix’ solutions without the need to consult medical professionals:

Some people cannot afford the costs involved or the time to seek professional medical advice—56 years old, Australian Capital Territory.

Women are tired, distracted, trying to balance household expenses and meet everyone's expectations—they will take shortcuts or rely on ads to inform themselves—51 years old, South Australia.

Finally, some women commented that women might turn to over the counter or online products if they experienced dismissive healthcare encounters with medical professionals, or felt that prescribed treatments were ineffective:

If my GP wasn't helpful and I had menopause symptoms that were not improving, I would be desperate enough to try anything—55 years old, South Australia.

I think women might be influenced because at the end of the day GPs in Australia are dismissive of women's symptoms—46 years old, Western Australia.

Theme 3: Pharmaceutical industry corporate social responsibility (CSR) initiatives may contribute to awareness but are perceived to have a primary motive of maximizing profit

There was a range of patterns in responses about pharmaceutical company sponsorships of health events. The question prompted some very negative commentary about the motives of the industry, some positive responses about the role of the industry in raising awareness, and also mixed responses where participants could see both the risks and benefits of these types of activities. It is important to note that there were no discernible differences in responses according to socio-demographic characteristics such as age, education, or occupation.

First were those who were sceptical or negative about the motives of the pharmaceutical industry in sponsoring women’s health events related to menopause. Some of these participants expressed strong distrust about the involvement of the pharmaceutical industry in these events, characterizing them as profit driven and seeking to ‘push products rather than solutions’. Some used highly emotive negative language about the pharmaceutical industry, describing them as ‘con artists’, ‘accepted scammers’, ‘disingenuous and dangerous (on all levels)’, and stating that ‘THE PHARMA INDUSTRY IS EVIL’. Some perceived the primary motivation of pharmaceutical companies in aligning themselves with these events was about financial gain rather than a genuine commitment to supporting women through the menopause transition:

I don’t trust the pharmaceutical companies so of course they will be trying to profit—59 years old, Victoria.

Pharmaceutical is a billion-dollar industry that only care about themselves!—52 years old, South Australia.

Others commented that such CSR strategies were ‘about their own agenda’ and were aimed at boosting product sales rather than delivering meaningful support. For example, participants described the pharmaceutical industry as being ‘all about money’ and ‘just want to make a profit’. They challenged the legitimacy of pharmaceutical companies as being trustworthy actors in relation to menopause. Some used language that framed the industry as being predatory and ‘out to rip us off’ and stated that the industry's involvement in women’s health events was a calculated attempt to appear supportive and relatable, while ultimately serving commercial interests—‘a tactic to make money’ and ‘doing this to increase sales of their products’.

A few stated that the pharmaceutical industry was seeking to manufacture a commercial ‘moment’ for menopause, seeing it as a lucrative business opportunity. Some also recognized the conflicts of interest that were associated with pharmaceutical industry involvement in these types of events. They commented that menopause events should be independent and that pharmaceutical company involvement was designed to ‘flood the market’ with their products and promote a narrative that ‘their way is the only way’ for those experiencing negative symptoms of menopause:

I think this is a problem because they are trying to promote themselves as the good guys who care for a women health but, they just want to make a profit off menopause—59 years old, New South Wales.

The second pattern in the data related to views that were more positive about the involvement of the pharmaceutical industry in sponsoring women’s health events. For example, some felt that the involvement of the pharmaceutical industry in such events was ‘helpful’, as these events were important platforms for elevating awareness about women’s health issues and could be used to disseminate valuable and ‘accurate’ information. There was a perception from some women that the more information that women received about menopause, the more able they would be in managing their menopause, which would help them to ‘feel better’. Several participants appreciated that pharmaceutical companies were ‘giving back’ and showing that they were supportive of women, that they were good at research, and that their intentions were aligned with women’s best interests. These participants were less concerned about for-profit motives and were more focused on the potential benefits of initiatives that could support and raise awareness about menopause. For example, they highlighted how these events could help women better understand menopause and the types of strategies that might help them feel better. Some noted that these events could provide supportive spaces to learn about available treatments, diet, and exercise and would promote more open conversations and contribute to the normalization of menopause, reducing stigma and encouraging women to seek support. They also felt that these events could encourage more ‘conversations’ about menopause:

The more coverage and spotlight the more normal it becomes…women don’t have to suffer in silence—49 years old, South Australia.

I think this is helpful to raise awareness and hopefully allow women who are embarrassed realise that it is a big problem, and they are not alone—59 years old, Western Australia.

Brilliant idea… like anything that needs to be educated in the right manner. I think it's bold and a perfect way to outline an important change in a woman body—53 years old, New South Wales.

Third, some participants held mixed views about pharmaceutical industry involvement in women’s health-related events. For example, while they supported sponsorship, they qualified this response by stating that this type of involvement should only be related to education, with no product promotions at such events:

I think it's good that they sponsor health events to acknowledge that there's such a stage of life that people go through and possibly provide more information/leaflets on it but I don't agree with targeting them with supplements/products for menopause.—61 years old, New South Wales.

Some felt that if there were not ‘ethical’ guidelines for pharmaceutical sponsorship of such events, such sponsorship could unduly influence women to purchase a range of products or services associated with the sponsor. Several participants also were wary that product promotion at these events could create a perception that all women could benefit from pharmaceuticals for menopause:

[There] may be a problem as pharmaceutical companies may have an interest in promoting their own products which could create a bias toward treatment that might not be effective or appropriate for all individuals—47 years old, New South Wales.

Finally, a few participants stated that while these events could be helpful in providing information to women, they were concerned that they could influence doctors to prescribe medications for menopause:

I think if doctors are persuaded to prescribe medication by the pharmaceutical companies that could be a problem. But there’s a good side if those events are going to clarify menopause symptoms and give solutions to women—48 years old, Queensland.

DISCUSSION

This study sought to understand women’s perceptions about the commercial determinants of menopause, with a particular focus on factors that could influence product consumption and perceptions of commercial public relations strategies. The study provides a starting point to guide further research and policy consideration of the role of commercial determinants in shaping women’s understandings and experiences of menopause.

Figure 1 provides a visual summary of the key findings of the study. The findings demonstrate that while many women are aware of the for-profit motives of commercial actors and are able to identify a range of tactics that are used to drive profit, the commercial determinants of menopause are also linked to women’s broader experiences in midlife. The findings from this study raise three points for discussion in relation to the research questions.

Figure 1.

How commercial actors shape women's experiences of menopause.

First, participants identified a range of strategies that were contributing to the commercialization of menopause and normalized the consumption of products and services as a part of the menopause transition. These included catastrophizing and exaggerating symptoms and negative experiences for profit; centring commercial solutions as essential in helping women to manage their menopause transition; and using menopause to capitalize on women’s broader fears and concerns about ageing. These concerns are similar to those that have been raised nationally by women’s health organizations (Jean Hailes for Women's Health 2023, Commonwealth of Australia 2024), and academic experts (Thomas et al. 2024c, Cronin et al. 2025). Expectations that women should consume menopause-related products and services during the menopause transition, obscures the structural imbalance of power between consumers and those who financially profit from menopause. Industry narratives about menopause may also reinforce an illusion of choice in environments (such as social media channels) where commercial influences are pervasive and often disguised as education or ‘empowerment’ (McCarthy et al. 2023a, p. 2, Miller and Wright 2024). This study also provides an important reminder to not forget the commercial power of the wellness industry. Those women who recalled seeing advertising for menopause products or services, mainly identified promotions for wellness industry products, and those who purchased products also mostly purchased (sometimes costly) wellness industry products. Studies investigating how different commercial stakeholders frame public narratives about menopause and for what purpose (e.g. how those with vested commercial interests may shape negative public perceptions about general practitioners or seek to discredit or create doubt about independent scientists) will be important in disrupting pathways to products or interventions that may be harmful to women’s health and equity (Thomas et al. 2024c). While mapping the commercial tactics of different stakeholders who seek to profit from menopause will continue to be important, future studies should also seek to understand in more detail how different commercial tactics may lead women towards menopause interventions that are unevidenced, or are outside of recommended clinical guidelines (McCartney et al. 2025).

Second, participants were able to identify how personal experiences with menopause and midlife (especially ageing) may exacerbate vulnerabilities to commercial tactics. They described how the broader emotional burdens associated with navigating menopause, the stigma that prevented women from talking about their experiences, the perceived accessibility and affordability of solutions, poor health care experiences, and concerns about ageing could all play a role in creating a pathway to commercial products. This shows that while there is a need for targeted investment in independent (with no commercial conflicts of interest) menopause education campaigns (Liss et al. 2024), culturally responsive care (Onculer and Onculer Yayalar 2025), and accessible service delivery (Hickey et al. 2024, Borges do Nascimento et al. 2025), all of these initiatives must recognize that menopause is just one part of a range of challenging health and social experiences that women may experience during midlife. This study shows that women perceive that commercial actors may place menopause at the centre of these broader midlife experiences, to sell products which seek to capitalize on women’s fears about ageing, while appearing to listen to and empathize with their concerns. Further research and policy consideration should consider how to address the range of structural factors that may exacerbate vulnerabilities during midlife, and develop a range of approaches to safeguard women from commercial practices which may seek to exploit or capitalize on these vulnerabilities.

Finally, there were mixed views about the CSR tactics of the pharmaceutical industry. While some participants felt that pharmaceutical companies had the ability to do good in supporting efforts to raise awareness about menopause and potential treatments, many others questioned and were highly critical of the motives of the pharmaceutical industry. They viewed the pharmaceutical industry as primarily seeking to make profits instead of caring about the health and well-being of women. Some saw the pharmaceutical industry through a moral lens describing their behaviour as predatory, exploitative, and pushing products, while others felt that pharmaceutical industry engagement in sponsoring women’s health events showed a commitment to women’s health and equity. While this study did not explore why women hold these differing views about the pharmaceutical industry, this is an important area for further investigation. It is important that women are aware of and understand the motivations behind the commercial tactics of the pharmaceutical industry and can critically reflect on these. However, blanket negative views of the pharmaceutical industry may be problematic if they stop women from accessing medical support and turn to other less evidence-based industries (such as the wellness and supplement industry) for solutions.

While the concerns of some women mirror broader academic and health professional concerns about the conflict of interests associated with pharmaceutical industry sponsorship of health-related events (McCartney 2025), it is important to note that while women may express scepticism about CSR strategies, this scepticism may not necessarily undermine the effectiveness of these strategies. Studies have observed similar patterns with medical professionals with even subtle promotional tactics may have a measurable influence on prescribing behaviour (Wazana 2000). However, some public relations and promotional activities are more covert than others, and the actors behind influential activities (such as government inquiries, guideline development, or front groups which develop educational materials) as well social media promotions such as commentaries may be less visible (McCartney 2022, Randle et al. 2024). While we asked specifically about the tactics of the pharmaceutical industry in this study, we recognize that further attention is needed to sunshine the range of promotional and public relations activities of those with a range of vested interests in menopause, and ensure that strategies are in place to create a norm of separation between those with for-profit interests and women’s health.

CONCLUSION

The commercialization, marketing, and subsequent proliferation of menopause-related products and services, alongside pharmaceutical sponsorship, have the potential to impact the health and equity of women during the menopause transition. In a landscape where credible and accessible information is often scarce, this study demonstrates that women themselves think that commercial actors in menopause may exploit women’s broader vulnerabilities in midlife for profit. A continued focus on the commercial determinants of menopause will be important in developing strengths-based approaches that respond to a range of challenges that women may experiences during midlife.

Conflict of interest

K.W.: None to declare. S.M.: Holds the position of Social Media Coordinator for Health Promotion International and was involved neither in the review process nor in any decision-making on the manuscript. H.P.: Holds the position of Editorial Board Member for Health Promotion International and was involved neither in the review process nor in any decision-making on the manuscript. M.R.: None to declare. G.A.: Holds the position of Social Media Coordinator for Health Promotion International and was involved neither in the review process nor in any decision-making on the manuscript. S.T.: Holds the position of Editor-in-Chief for Health Promotion International and was involved neither in the review process nor in any decision-making on the manuscript.

Funding

Data collection was supported by Jean Hailes for Women’s Health. K.W. is funded by an Australian Government Research Training Program stipend from Deakin University. S.M. is funded by a Faculty of Health Dean’s Postdoctoral Research Fellowship at Deakin University.

Data availability

The data from this paper are not available due to the need for privacy and confidentiality of participants.