Regular physical activity is a key non-pharmacological strategy for alleviating menopausal symptoms and reducing the risk of chronic disease in later life. Despite these benefits, many Bahraini postmenopausal women remain insufficiently active. Understanding how their experiences and motivation are shaped by family, community, and healthcare contexts is essential for guiding culturally appropriate interventions. This study examined how Bahraini postmenopausal women aged 50 years and above perceive and experience physical activity, explored its perceived relationship to menopausal symptoms, and assessed how familial, community, and healthcare influences shape motivation and engagement. A qualitative narrative design was employed. Twenty-five Bahraini postmenopausal women (50 years and above; mean = 66.4) were purposively recruited through the three accredited healthcare facilities in Bahrain. Data were collected through short written narratives and 30–45-minute semi-structured interviews conducted in Arabic or English. Interviews were audio-recorded, transcribed verbatim, translated where necessary, and analysed using Braun and Clarke’s reflexive thematic approach. Trustworthiness was enhanced through member-checking, peer debriefing, reflexive journaling, and maintenance of an audit trail. Five overarching themes emerged: (1) holistic perceptions of physical activity as integral to daily routines, religious practices, and management of menopausal symptoms; (2) multi-level barriers including health conditions, sociocultural norms, and environmental constraints; (3) motivators such as familial support, health awareness, and faith-based purpose; (4) adaptive strategies and self-efficacy; and (5) Contextual Influences, including home-based routines, community engagement, and guidance from healthcare providers. These themes aligned with key constructs of the Health Belief Model. The findings underscore the need for culturally tailored, women-only, and climate-appropriate physical-activity initiatives that actively involve families, community networks, and healthcare professionals to promote and sustain participation among older Bahraini women.
Keywords: menopause; physical activity; qualitative research; Bahrain; Health Belief Model; healthcare providers, Bahraini women, menopausal women, physical activity in menopausal women.

References

1. Ilankoon I, Samarasinghe K, Elgán C (2021). Menopause is a natural stage of aging: a qualitative study. BMC Womens Health. 21(1):47.
2. Salah SM, Abdallah ES, Ahmed NME, Elsayed Zidan MM (2025). Elderly women’s Knowledge and Preventive Health Behaviors Regarding Post-Menopausal Problems. Zagazig Nurs J. 21(2):69–82.
3. Goluch-Koniuszy ZS (2016). Nutrition of women with hair loss problem during the period of menopause. Menopause Rev Menopauzalny. 15(1):56–61.
4. Apostolopoulos V, Al Dhaheri AS, Ismail LC, Ali HI, Stojanovska L (2023). Can Exercise improve symptoms in Menopausal women? In: Sex Hormones, Exercise and Women: Scientific and Clinical Aspects. Springer . p. 369–402.
5. Thomas A, Daley AJ (2020). Women’s views about physical activity as a treatment for vasomotor menopausal symptoms: a qualitative study. BMC Womens Health. 20(1):203.
6. Javadivala Z, Allahverdipour H, Jafarabadi MA, Emami A (2020). An Interventional strategy of physical activity promotion for reduction of menopause symptoms. Heal Promot Perspect. 10(4):383.
7. Garcia-Yu IA, Garcia-Ortiz L, Gomez-Marcos MA, Rodriguez-Sanchez E, Lugones-Sanchez C, Maderuelo-Fernandez JA, et al (2021). Cocoa-rich chocolate and body composition in postmenopausal women: a randomised clinical trial. Br J Nutr. 125(5):548–56.
8. Cho L, Kaunitz AM, Faubion SS, Hayes SN, Lau ES, Pristera N, et al (2023). Rethinking menopausal hormone therapy: for whom, what, when, and how long? Circulation. 147(7):597–610.
9. Sormunen E, Ylisassi H, Mäenpää-Moilanen E, Remes J, Martimo KP (2020). Co-operation in the prevention of work disability due to musculoskeletal disorders: A cross-sectional study among occupational health professionals in Finland. Work. 67(3):697–708.
10. Guthold R, Stevens GA, Riley LM, Bull FC (2020). Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1· 6 million participants. lancet child Adolesc Heal. 4(1): 23–35.
11. Fernández-Pérez AM, Villaverde-Gutiérrez C, Mora-Sánchez A, Alonso-Blanco C, Sterling M, Fernández-de-Las-Peñas C (2012). Muscle trigger points, pressure pain threshold, and cervical range of motion in patients with high level of disability related to acute whiplash injury. J Orthop Sport Phys Ther. 42(7):634–41.
12. Chaabane S, Chaabna K, Doraiswamy S, Mamtani R, Cheema S (2021). Barriers and facilitators associated with physical activity in the Middle East and North Africa region: a systematic overview. Int J Environ Res Public Health. 18(4):1647.
13. Elneil S, Delanerolle G, Pathiraja V, Mudalige T, Dasanyake L, Rathnayake N, et al (2025). Beyond the Veil of Homogeneity: Addressing the Variability of Women’s Health and Policy Gaps in the Middle East.
14. Carcelén-Fraile M del C, Hita-Contreras F, Martínez-Amat A, Loureiro VB, Loureiro NEM de, Jiménez-García JD, et al (2023). Impact of Qigong exercises on the severity of the menopausal symptoms and health-related quality of life: A randomised controlled trial. Eur J Sport Sci. 23(4): 656–64.
15. Alqahtani AS, Baattaiah BA, Alharbi MD, Khan F, Aldhahi MI (2023). Barriers and facilitators affecting physical activity among adults in Saudi Arabia during COVID-19 quarantine. Health Promot Int. 38(3): daab191.
16. Raymond SU, Greenberg HM, Leeder SR (2005). Beyond reproduction: women’s health in today’s developing world. Int J Epidemiol. 34(5):1144–8.
17. Vincenzo JL, Patton SK, Lefler LL, McElfish PA, Wei J, Curran GM (2022). A qualitative study of older adults’ facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Arch Gerontol Geriatr. 99: 104610.
18. Zhao YC, Zhao M, Song S (2022). Online health information seeking among patients with chronic conditions: integrating the health belief model and social support theory. J Med Internet Res. 24(11): e42447.
19. Carpenter CJ (2010). A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Commun. 25(8): 661–9.
20. Nunes NRDA (2021). The power that comes from within: female leaders of Rio de Janeiro’s favelas in times of pandemic. Glob Health Promot. 28(2): 38–45.
21. Alsairi R (2024). Young urban Saudi women’s attitudes towards healthy eating and physical activity: Applying a health belief model framework. Queensland University of Technology.
22. Anokye R, Jackson B, Dimmock J, Dickson JM, Kennedy MA, Schultz CJ, et al (2023). Impact of vascular screening interventions on perceived threat, efficacy beliefs and behavioural intentions: a systematic narrative review. Health Promot Int. 38(3): daad040.
23. Whiteley J, DiBonaventura M daCosta, Wagner JS, Alvir J, Shah S (2013). The impact of menopausal symptoms on quality of life, productivity, and economic outcomes. J women’s Heal. 22(11):983–90.
24. Al Ubaidi B, Almarabheh A, Alalawi M, Alaali S, Altamimi S, Mustafa M (2023). Assessment of Osteoporosis Knowledge, Health Beliefs and Self-efficacy in Premenopausal Women in the Kingdom of Bahrain. Bahrain Med Bull. 45(3).
25. Sharara E, Akik C, Ghattas H, Makhlouf Obermeyer C (2018). Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature. BMC Public Health. 18(1):639.
26. Qadmour AN (2022). Physical Activity, Cardiometabolic Disorders, and Guideline Adherence Among Post-Menopausal Versus Peri-Menopausal Women: Insights from the NHANES. Hamad Bin Khalifa University (Qatar) .
27. Braun V, Clarke V (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qual Res Psychol. 18(3):328–52.
28. Berger J, Humphreys A, Ludwig S, Moe WW, Netzer O, Schweidel DA (2020). Uniting the tribes: Using text for marketing insight. J Mark. 84(1):1–25.
29. WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Participants [Internet]. 2025.
30. Davis-Street J, Steinberg M (2020). Leveraging behavior change theories in program design improves workforce health. In: SPE International Conference and Exhibition on Health, Safety, Environment, and Sustainability? SPE . p. D052S005R001.