Breaking the silence and building strength; rethinking menopause care through exercise and cultural insight

Menopause remains a largely neglected aspect of women's health in many low- and middle-income countries (LMICs), particularly across Asia, Africa, and the Middle East. Despite the profound physical, cognitive, and emotional changes it entails and the long-term health implications, access to menopause care is limited, and cultural taboos often prevent open discussion and timely support. This article explores the critical role of exercise as a cost-effective, sustainable, and culturally adaptable intervention for managing menopausal symptoms, including vasomotor disturbances, depression, anxiety, cognitive decline, and sleep disruption. Drawing on evidence from neuroscience, public health, and sociocultural research, it highlights the neurochemical benefits of physical activity, such as mood regulation and improved brain function. It also critically examines how religious beliefs, social norms, gender roles, and policy gaps influence women's ability to engage in exercise across different cultural settings. Community-based programmes, corporate initiatives, and digital adaptations underscore pragmatic approaches to integrating exercise into menopause care. We call for healthcare systems, policymakers, and researchers to address systemic neglect, normalise menopause discourse, and embed culturally sensitive, movement-based interventions into broader women's health strategies.