Reflecting through menopause: introducing the MIRROR cycle to support reflection during the menopause transition

Abstract

Background: The menopause transition is a complex biopsychosocial life-course event that often coincides with significant role changes, including caregiving responsibilities, evolving family dynamics and sustained workplace participation. Many women describe menopause as disruptive, isolating and threatening to identity, with implications for well-being, work performance and professional engagement. Aim: This paper argues for the integration of reflection into nursing practice, including education, clinical encounters and workplace well-being initiatives, to better support women in healthcare who are approaching or experiencing the menopause transition. Methods: Peer-reviewed and key grey literature examining menopause-related workplace impacts, healthcare gaps and service provision were reviewed. Established reflective practice models were synthesised and adapted, informed by the authors’ body of work on menopause and the nursing workforce. Results: An integrated menopause-specific reflective framework, the MIRROR Cycle, was developed. The framework outlines practical reflective strategies including journaling, reflective supervision, Schwartz rounds, structured debriefing, narrative work, mindfulness and appraisal checklists. Socio-cultural and systemic barriers including stigma, silence, fear, limited training, fragmented services and organisational ageism and sexism were identified as factors compounding menopausal distress. Conclusion: Embedding the MIRROR Cycle across education, clinical care and workplace policy may enhance coping, identity integration and organisational responsiveness, supporting inclusive and menopause-informed nursing practice.