Effects of Social Media Narratives on Affective and Behavioral Responses to Menopause Content: Randomized Online...

Social media is an increasingly prominent channel for communicating menopause information and experiences, yet the affective and behavioral consequences of different narrative framings remain unclear.

We examined how distress, normalizing, and transformative narratives influenced women's immediate responses to menopause content online, drawing on established narrative framings of menopause as normality, distress, and transformation.

In an online experiment, UK women aged 40 to 83 years who were perimenopausal or postmenopausal were recruited via Prolific, a widely used online recruitment platform for behavioral and social science research. A total of 737 women were randomly assigned to view 4 anonymized and standardized social media posts from a pool of 12 reflecting 1 of 3 narratives: normal (n=248, 33.6%), distress (n=241, 32.7%), or transformative (n=248, 33.6%). Participants then reported affective reactions, expected behavioral responses, and perceptions of the posts using 5-point ordered response scales. Ordinal logistic regression models tested demographic predictors and condition effects controlling for demographic factors.

Participants who viewed distress-framed posts reported greater levels of worry (β=.910; P<.001), confusion (β=.818; P<.001), and anxiety (β=.817; P<.001) and lower levels of reassurance (β=-.970; P<.001), optimism (β=-.708; P<.001), and empowerment (β=-.540; P<.001). Distress framing also increased perceived knowledge of menopause (β=.564; P<.001) despite participants feeling more negatively toward the posts. Neither distress nor transformative narratives influenced expected behavioral intentions to like, share, save, comment on, search for, or discuss social media posts compared with normalizing narratives. Postmenopausal status (β=-.630; P<.001) and older age (β=-.492; P<.001) were independently associated with less worry and anxiety. Participants rated distress (β=-.806; P<.001) and transformative posts (β=-.968; P<.001) as less representative of health professionals than normalizing posts; transformative posts were also judged to be less representative of newspapers or television (β=-.687; P<.001).

Narrative framing shaped immediate affect but not intended engagement with menopause content. Because this study assessed short-term responses to controlled, standardized posts, future research should examine whether these effects persist over time and how they operate in more ecologically valid social media environments. As public discussion expands, diverse, balanced narratives may help reduce stigma and temper the disproportionate salience of negative framing. This study advances understanding of how narrative framing shapes responses to health content online.