Background: Little is known about the menopause in women with intellectual disabilities (ID) save that its onset is earlier than in the general population, and earlier still in women with Down's syndrome (DS). This study directly explored menopausal experiences in women with ID, both with and without DS, with the aim of identifying levels of knowledge of the menopause and of its health and reproductive implications. Methods Information was collected from 45 women with ID (17 DS, 28 non-DS; age 35-65 years) using a semi-structured interview. Results: Menopausal experiences of the women with and without DS were very similar. Most of the women were unaware of menopause-associated changes in their body and few understood why they menstruated. Difficulties in disentangling behavioural consequences of menopausal symptoms from behaviours arising from other causes were evident. A need for better health education training and more accessible health resources was identified. Conclusions: Promoting better awareness of menopause-related health issues in women with ID seems warranted. Appropriately-tailored health education materials need to be made more readily available. (Contains 2 tables.)