From Disruption to Control: Insights from Focus Groups Exploring Nutrition and Chemosensory Changes During Menopause

Background: Menopause is associated with metabolic, sensory, and psychosocial changes that may reshape eating behaviours and nutrition-related quality of life. This study explored how women experience nutrition and chemosensory changes during menopause and how these intersect with identity, control, and social practices. Methods: We conducted online focus groups (Microsoft Teams) with women living in Ireland (n = 40; mean age 58.3 years (±4.5 years)) between January and March 2025. Discussions followed a semi-structured guide focused on taste/smell, appetite, food choice, and coping. Sessions were recorded, transcribed, anonymised, and analysed following Braun and Clarke's thematic analysis. Results: Four themes captured patterned meanings in the dataset: (1) Chemosensory Changes-reports of diminished taste, contrasted with heightened smell and selective intensification (sweetness), prompting compensatory behaviours (more salt/spice/strong coffee) and new aversions (e.g., cucumber, spicy dishes) alongside unexpected likes (e.g., dark chocolate); (2) Behavioural and Emotional Consequences-increased snacking, sugar/salt cravings, and perceived loss of satiety co-occurred with weight gain and altered body shape, undermining food pleasure and self-confidence; (3) Interacting Influences-affecting vasomotor symptoms, sleep disturbance, joint pain, and "brain fog" compounded dietary disruptions and social withdrawal (e.g., embarrassment about appetite, reduced desire to dine out); (4) Strategies for Wellbeing-women described medical approaches (HRT, prescribed medications) alongside food modifications and the importance of diagnosis, information, and peer/professional support. Conclusions: Menopause reshapes sensory perception and eating behaviour in complex, individualised ways that extend beyond biology to identity and social life. Nutrition care should integrate symptom management with person-centred strategies and improved access to evidence-based information, diagnosis, and support networks.