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Ullman KE, Diem S, Forte ML, Ensrud K, Sowerby C, Zerzan N, Anthony M, Landsteiner A, Greer N, Butler M, Wilt TJ, Danan ER. Complementary and Alternative Therapies for Genitourinary Syndrome of Menopause : An Evidence Map. Ann Intern Med 2024. [PMID: 39250808 DOI: 10.7326/annals-24-00603] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Women seeking nonhormonal interventions for vulvovaginal, urinary, and sexual symptoms associated with genitourinary syndrome of menopause (GSM) may seek out complementary and alternative medicine or therapies (CAMs). PURPOSE To summarize published evidence of CAMs for GSM. DATA SOURCES Ovid MEDLINE, EMBASE, and CINAHL from inception through 11 December 2023. STUDY SELECTION Randomized controlled trials (RCTs) 8 weeks or more in duration that evaluated the effectiveness or harms of CAMs for postmenopausal women with GSM and reported 1 or more outcomes of interest, with sample sizes of 20 or more participants randomly assigned per group. DATA EXTRACTION Data were abstracted by 1 reviewer and verified by a second. DATA SYNTHESIS An evidence map approach was used to organize and describe trials. Studies were organized by type of intervention, with narrative summaries for population, study characteristics, interventions, and outcomes. Fifty-seven trials were identified that investigated 39 unique interventions. Studies were typically small (n < 200), and most were done in Iran (k = 24) or other parts of Asia (k = 9). Few trials evaluated similar combinations of populations, interventions, comparators, or outcomes. Most studies (k = 44) examined natural products (that is, herbal or botanical supplements and vitamins), whereas fewer reported on mind and body practices (k = 6) or educational programs (k = 7). Most studies reported 1 or 2 GSM symptoms, mainly sexual (k = 44) or vulvovaginal (k = 30). Tools used to measure outcomes varied widely. Most trials reported on adverse events (k = 33). LIMITATIONS Only English-language studies were used. Effect estimates, risk of bias, and certainty of evidence were not assessed. CONCLUSION There is a large and heterogeneous literature of CAM interventions for GSM. Trials were small, and few were done in North America. Standardized population, intervention, comparator, and outcomes reporting in future RCTs are needed. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality and Patient-Centered Outcomes Research Institute. (PROSPERO: CRD42023400684).
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Affiliation(s)
- Kristen E Ullman
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, Minnesota (K.E.U., C.S., N.Z., M.A., A.L., N.G.)
| | - Susan Diem
- Center for Care Delivery and Outcomes Research, VA Health Care System, and Department of Medicine, University of Minnesota, Minneapolis, Minnesota (S.D., E.R.D.)
| | - Mary L Forte
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota (M.L.F., M.B.)
| | - Kristine Ensrud
- Center for Care Delivery and Outcomes Research, VA Health Care System, and Department of Medicine and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota (K.E.)
| | - Catherine Sowerby
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, Minnesota (K.E.U., C.S., N.Z., M.A., A.L., N.G.)
| | - Nicholas Zerzan
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, Minnesota (K.E.U., C.S., N.Z., M.A., A.L., N.G.)
| | - Maylen Anthony
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, Minnesota (K.E.U., C.S., N.Z., M.A., A.L., N.G.)
| | - Adrienne Landsteiner
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, Minnesota (K.E.U., C.S., N.Z., M.A., A.L., N.G.)
| | - Nancy Greer
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, Minnesota (K.E.U., C.S., N.Z., M.A., A.L., N.G.)
| | - Mary Butler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota (M.L.F., M.B.)
| | - Timothy J Wilt
- Center for Care Delivery and Outcomes Research, VA Health Care System, and Department of Medicine and Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota (T.J.W.)
| | - Elisheva R Danan
- Center for Care Delivery and Outcomes Research, VA Health Care System, and Department of Medicine, University of Minnesota, Minneapolis, Minnesota (S.D., E.R.D.)
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Sawamoto N, Okawara M, Ishimaru T, Tateishi S, Horie S, Yasui T, Fujino Y. Association Between Menopausal Symptoms and Work-Related Factors Among Female Workers in Japan: A Cross-Sectional Study. J Occup Environ Med 2024; 66:e413-e417. [PMID: 38900931 DOI: 10.1097/jom.0000000000003170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
OBJECTIVE Although menopausal symptoms are an important issue for female workers, their association with work-related factors is not well studied. Here, we explored the association between work-related factors and menopausal symptoms in Japan. METHODS A cross-sectional study was conducted in 2023 among all 1465 female employees of a large Japanese company. Associations between occupational factors and moderate or severe menopausal symptoms, as measured by the Menopause Rating Scale (MRS), were examined using logistic regression analysis. RESULTS Several workplace-related factors were significantly associated with moderate or severe menopausal symptoms, including company support and the number of night shifts. A marginally significant association was also seen for commuting time. CONCLUSIONS Workplace menopause interventions for the factors identified in this study may satisfy unmet needs.
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Affiliation(s)
- Naoya Sawamoto
- From the Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (N.S., M.O., Y.F.); Department of Medical Humanities, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (T.I.); Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (S.T.); Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.H.); and Department of Reproductive and Menopausal Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan (T.Y.)
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Badawy Y, Spector A, Li Z, Desai R. The risk of depression in the menopausal stages: A systematic review and meta-analysis. J Affect Disord 2024; 357:126-133. [PMID: 38642901 DOI: 10.1016/j.jad.2024.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/28/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION For many women, menopause transition can be a period of emotional and physical changes, with different menopausal stages associated with varied risk for depressive symptoms and diagnosis. This review aimed to conduct a systematic review and meta-analyses to provide an estimate for the risk of developing a) clinical depression and b) depressive symptoms at different menopausal stages. METHODS We searched Medline, PsycInfo, Embase and Web of Science from inception to July 2023. Seventeen prospective cohort studies with a total of 16061 women were included in the review, and risk of bias was assessed using the Quality in Prognosis Studies tool (QUIPS). Seven papers with a total of 9141 participants were included in meta-analyses, using random effects models and pooled odds ratios (OR) calculated for depressive symptoms and diagnoses. RESULTS Perimenopausal women were found to be at a significantly higher risk for depressive symptoms and diagnoses, compared to premenopausal women (OR = 1.40; 95 % CI: 1.21; 1.61, p < .001). We did not find a significantly increased risk for depressive symptoms or diagnoses in post-menopausal, compared to pre-menopausal women. LIMITATIONS Studies used different criteria to classify the menopausal stages and different measures for depression, which may have contributed to the heterogeneity seen in some models. We were unable to include a model that compared peri to post-menopause, due to a lack of longitudinal studies comparing the two stages. CONCLUSIONS The risk of depression in perimenopause, shown in an ethnically diverse sample; highlights the clinical need for screening and support in this potentially vulnerable group.
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Affiliation(s)
- Yasmeen Badawy
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland
| | - Aimee Spector
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland.
| | - Zishi Li
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland
| | - Roopal Desai
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland
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Wasley D, Gailey S. Menopause and the role of physical activity - The views and knowledge of women aged 40-65. Post Reprod Health 2024; 30:77-84. [PMID: 38393976 PMCID: PMC11188563 DOI: 10.1177/20533691241235273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Menopause marks the end of female reproductive capacity. It is defined as the point after cessation of the menstrual cycle for 12 months (Nursat et al., 2008). Awareness about menopause has increased over the last decade, yet studies have shown that women still lack knowledge regarding the subject. Likewise, awareness of women between the age of 40-65 on the potential role of physical activity prior to and during menopause in women is unclear. Women (n = 162) aged 40-65 years completed a survey rating their knowledge, answered fact-based questions and reported their experiences of menopause. Their levels of, and beliefs on, the role physical activity on symptoms and menopause associated disease risk were also collected. Women reported their confidence in their current knowledge level at 67% reflecting 37% higher rating than an estimate of their knowledge 10 years ago. Their factual knowledge score was 56%. Knowledge was primarily gained through friends and family and almost half (46%) had not spoken to a healthcare professional. Frustration was expressed with lack of knowledge and support of healthcare and others. Women using HRT (44%) had mixed attitudes towards its role. A high proportion were active and felt that physical activity can help manage symptoms and impact long-term health consequences of menopause. Menopause education strategies for women, healthcare professionals and others need to be improved. Lack of education may be causing women to struggle and feel negatively towards this life stage. Physical activity was viewed positively for the symptoms and a treatment during menopause and long-term health.
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Affiliation(s)
- David Wasley
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Samantha Gailey
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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Spector A, Li Z, He L, Badawy Y, Desai R. The effectiveness of psychosocial interventions on non-physiological symptoms of menopause: A systematic review and meta-analysis. J Affect Disord 2024; 352:460-472. [PMID: 38364979 DOI: 10.1016/j.jad.2024.02.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Menopause, a crucial transitioning stage for women, can significantly impact mood and wellbeing. We aimed to evaluate the effectiveness of psychosocial interventions on non-physiological symptoms of menopause (depression, anxiety, cognition, and quality of life) through systematic review and meta-analysis. METHODS Five databases were searched from inception to August 2023 for randomized controlled trials. Pre- and post-test means and standard deviations for groups were extracted and used to calculate effect sizes. The effectiveness of Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Interventions (MBI) on depression and anxiety were examined by subgroup analysis. RESULTS Thirty studies comprising 3501 women were included. From meta-analysis, mood symptoms significantly benefited from CBT (anxiety: d = -0.22, 95 % CI = -0.35, -0.10; depression: d = -0.33, 95 % CI = -0.45, -0.21) and MBI (anxiety: d = -0.56, 95 % CI = -0.74, -0.39; depression: d = -0.27, 95 % CI = -0.45, -0.09). Psychosocial interventions were also found to significantly improve cognition (d = -0.23, 95 % CI = -0.40, -0.06) and quality of life (d = -0.78, 95 % CI = -0.93, -0.63). Mean total therapy hours ('dose') was lower for CBT (11.3) than MBI (18.6), indicating reduced costs and burden for women. LIMITATIONS Data regarding menopausal status were not collected, limiting our ability to identify the optimal timing of interventions. Potential longer-term, effects of interventions were not investigated. CONCLUSION Our review highlighted the value of psychosocial interventions in improving non-physiological symptoms (particularly depression and anxiety) during menopause, noting the heterogeneity of findings and importance of implementing effective interventions.
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Affiliation(s)
- Aimee Spector
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland.
| | - Zishi Li
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland
| | - Lexi He
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland
| | - Yasmeen Badawy
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland
| | - Roopal Desai
- Department of Clinical Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom of Great Britain and Northern Ireland
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Dhillon TK, Gammage KL. Understanding the relationship between body image and menopause in South Asian Canadian women. Body Image 2023; 46:280-293. [PMID: 37392676 DOI: 10.1016/j.bodyim.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/01/2023] [Accepted: 06/11/2023] [Indexed: 07/03/2023]
Abstract
Research regarding women's body image experiences during menopause is limited; few studies reflect the experiences of South Asian Canadian women. This study qualitatively explored body image and menopause experiences in South Asian Canadian women. Nine first-generation South Asian immigrant Canadian women (aged 49-59 years), in perimenopause or postmenopause, took part in semi-structured interviews. Overall, two themes were constructed. The push and pull of South Asian and Western cultures focused on South Asian and Western cultural perspectives on upbringing, beauty standards, and menopause. Navigating through uncertainty towards acceptance addressed the intricacy of body image, menopause, and aging experiences and the struggle to accept change to their bodies. The results highlight the intersectionality of gender, race, ethnicity, culture, and menopause status in participants' understanding, perceptions, and behaviours toward body image and menopause experiences. The findings demonstrate a need for critical examinations of social constructs (i.e., Western ideal, Western views of menopause) that nfluence participants' experiences, and indicate a need for the development of culturally-appropriate and community-based interventions and resources. Given the underlying narrative of influence and conflict between Western and South Asian cultures, examining acculturation may uncover potential protective strategies for subsequent generations of South Asian women.
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Affiliation(s)
- Taranjot K Dhillon
- Brock University, 1812 Sir Issac Brock Way, St. Catharines, ON L2S 3A1, Canada.
| | - Kimberley L Gammage
- Brock University, 1812 Sir Issac Brock Way, St. Catharines, ON L2S 3A1, Canada
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"Let's see what happens:"-Women's experiences of open-label placebo treatment for menopausal hot flushes in a randomized controlled trial. PLoS One 2022; 17:e0276499. [PMID: 36331921 PMCID: PMC9635716 DOI: 10.1371/journal.pone.0276499] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
Open-label (honestly prescribed) placebos are an ethical way to evoke placebo effects in patients. As part of a mixed-methods study, we conducted in-depth interviews with eight menopausal women who underwent and benefitted from open-label placebo treatment in a randomized-controlled trial of hot flushes. Data were analyzed using Interpretative Phenomenological Analysis. We found that the women had low expectations about the placebo treatment yet endorsed what they referred to as “hope” and openness to “see what happens”. Recording hot flushes via the symptom diary was viewed as a valuable opportunity for self-examination and appraising outcomes. Receiving relief from the placebo treatment empowered women and enhanced their sense of control and agency. In summary, participants’ initial openness towards placebos, their hopes to get better, monitoring symptoms closely, and taking the initiative to address symptoms were components of a positive open-label placebo experience.
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Faleschini S, Tiemeier H, Rifas-Shiman SL, Rich-Edwards J, Joffe H, Perng W, Shifren J, Chavarro JE, Hivert MF, Oken E. Longitudinal associations of psychosocial stressors with menopausal symptoms and well-being among women in midlife. Menopause 2022; 29:1247-1253. [PMID: 36099555 PMCID: PMC9613623 DOI: 10.1097/gme.0000000000002056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We examined longitudinal associations of psychosocial stressors with menopausal symptoms and well-being of women in midlife in a longitudinal cohort. METHODS This study is based on 682 women from Project Viva, a prospective cohort enrolled in 1999 to 2002 during pregnancy (median age = 33.3 y) and followed for almost two decades. In pregnancy, women self-reported psychosocial stressors (history of physical and sexual abuse and financial instability, from childhood to the current pregnancy). In 2017 to 2021 (median age, 51.6 y), they reported their menopausal symptoms (0-44 point scale) and well-being (general health [good/fair/poor vs excellent/very good], generalized anxiety symptoms, and depressive symptoms [both-more than minimal levels vs none/minimal]). We performed multivariable and logistic regression models to examine associations of psychosocial stressors with outcomes, adjusting for covariates. RESULTS History of physical abuse (reported by 37.3%) was associated with worse menopausal symptoms in the somatovegetative (odds ratio [OR], 0.46 points; 95% confidence interval [CI], 0.04-0.87 points) and psychological (OR, 0.52 points; 95% CI, 0.07-0.97 points) domains and with worse general health (OR, 1.73; 95% CI, 1.17-2.55) and greater depressive symptoms (OR, 1.74; 95% CI, 1.05-2.87). History of sexual abuse (7.7%) was associated with worse menopausal symptoms (OR, 2.81 points; 95% CI, 1.05-4.56) and worse general health (OR, 2.04; 95% CI, 1.04-4.03) but not with depressive symptoms. History of financial instability (10.8%) was associated with worse menopausal symptoms (1.92 points; 0.49 to 3.34), worse general health (OR, 2.16; 95% CI, 1.24-3.75), and greater depressive symptoms (OR, 2.68; 95% CI, 1.44-4.98). We observed no association between psychosocial stressors and generalized anxiety symptoms assessed at midlife. CONCLUSIONS Psychosocial stressors were associated with worse menopausal symptoms and well-being decades after initial report.
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Affiliation(s)
- Sabrina Faleschini
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Henning Tiemeier
- Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Sheryl L. Rifas-Shiman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Janet Rich-Edwards
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Women’s Health, Brigham and Women’s Hospital, Boston, MA, USA
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Hadine Joffe
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
| | - Wei Perng
- Department of Epidemiology, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jan Shifren
- Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Jorge E. Chavarro
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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Menopause Rating Scale (MRS) in the Malay language-translation and validation in a multiethnic population of Selangor, Malaysia. BMC Womens Health 2022; 22:347. [PMID: 35978305 PMCID: PMC9387051 DOI: 10.1186/s12905-022-01922-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The Menopause Rating Scale (MRS) is an internationally used tool to measure menopause-related symptoms and to date it is unavailable in the Malay language. We aimed to translate and validate the Malay language version of the MRS.
Methods
Translation of the English version of MRS into Malay was done by a bilingual expert and back translated. Translated version of MRS was reviewed by a panel to determine the face validity. A sample of 321 women aged 40–60 years residing in Klang, Selangor, Malaysia was selected by stratified random sampling method in a house-to-house survey. The Malay language version of MRS was self-administered. Reliability analyses, including test–retest reliability (on 30 women after a two-week interval) were conducted. To ascertain the construct validity, 11 items were analyzed confirmatory factor analysis was conducted to evaluate the structural model fit of the Malay language version of MRS.
Results
A total of 294 (91.6%) completed the survey and their mean age was 50.9 years (SD = 6.3). An overall Cronbach’s alpha for MRS was 0.904. Cronbach’s alpha for psychosomatic, urogenital, and somatovegetative subscales were 0.889, 0.846, and 0.776 respectively. The corrected item correlations were approximately 0.6 and inter-item correlations were between 0.3 and 0.9. On exploratory structural equation modelling, the chi-square test of goodness of fit yielded a significant value; χ2 = 78.4, df = 25, p < 0.001, (reported if N > 200). Additionally, the value of Tucker–Lewis Index (TLI) = 0.954showed a good fit to the model.
Conclusion
The translated English version of the Menopause Rating Scale into the Malay language showed excellent reliability, test–retest reliability, and construct validity. The instrument can be used to assess menopause-related symptoms among Malaysian women.
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Bąk-Sosnowska M, Naworska B, Gruszczyńska M. Determinants of body image in perimenopausal and postmenopausal women. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2022.2083522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M. Bąk-Sosnowska
- Department of Psychology, Chair of Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - B. Naworska
- Departament of Gynaecology and Obstetrics, Faculty of Health Sciences in Katowice,medical University of Silesia in Katowice, Poland
| | - M. Gruszczyńska
- Department of Psychology, Chair of Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
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Decandia D, Landolfo E, Sacchetti S, Gelfo F, Petrosini L, Cutuli D. n-3 PUFA Improve Emotion and Cognition during Menopause: A Systematic Review. Nutrients 2022; 14:1982. [PMID: 35565948 PMCID: PMC9100978 DOI: 10.3390/nu14091982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/29/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023] Open
Abstract
Women show an increased risk of cognitive impairment and emotional disorders, such as anxiety and depression, when approaching menopause. Data on risk and protection factors have yielded robust evidence on the effects of lifestyle factors, such as diet, in preserving emotional and cognitive functioning. This review focused on the effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) on anxiety, depression, and cognition during the menopausal transition. This systematic review considered all articles published until 31 December 2021, and the search was performed on two databases, PubMed and Scopus. The fields of interest were "menopause", "n-3 PUFA" and "emotional and cognitive aspects". Out of the 361 articles found on PubMed and 283 on Scopus, 17 met inclusion criteria. They encompassed 11 human and 6 animal studies. Most studies reported relieved depressive symptoms in relation to n-3 PUFA intake. While controversial results were found on anxiety and cognition in humans, n-3 PUFA consistently reduced anxiety symptoms and improved cognition in animal studies. Taken together, n-3 PUFA intake shows beneficial effects on emotional and cognitive behaviours during menopause transition. However, further investigations could increase knowledge about the effectiveness of n-3 PUFA on psychological well-being in this delicate period of feminine life.
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Affiliation(s)
- Davide Decandia
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (E.L.); (S.S.); (F.G.); (L.P.); (D.C.)
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Eugenia Landolfo
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (E.L.); (S.S.); (F.G.); (L.P.); (D.C.)
| | - Stefano Sacchetti
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (E.L.); (S.S.); (F.G.); (L.P.); (D.C.)
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Francesca Gelfo
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (E.L.); (S.S.); (F.G.); (L.P.); (D.C.)
- Department of Human Sciences, Guglielmo Marconi University, Via Plinio 44, 00193 Rome, Italy
| | - Laura Petrosini
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (E.L.); (S.S.); (F.G.); (L.P.); (D.C.)
| | - Debora Cutuli
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (E.L.); (S.S.); (F.G.); (L.P.); (D.C.)
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
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Nik Hazlina NH, Norhayati MN, Shaiful Bahari I, Nik Muhammad Arif NA. Prevalence of Psychosomatic and Genitourinary Syndrome Among Menopausal Women: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:848202. [PMID: 35308492 PMCID: PMC8927867 DOI: 10.3389/fmed.2022.848202] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The menopausal transition represents the passage from reproductive to non-reproductive life and is characterized by a number of menstrual disturbances. We systematically reviewed the evidence on the prevalence of psychosomatic and genitourinary syndrome among menopausal women and compared the risk of symptoms between premenopausal, perimenopausal, and post-menopausal women. Methods We performed a systematic search in MEDLINE, CINAHL, and ScienceDirect through March 2021. Case series/reports, conference papers and proceedings, articles available only in abstract form, editorial reviews, letters of communication, commentaries, systematic reviews, and qualitative studies were excluded. Two reviewers independently extracted and assessed the quality of data using the Joanna Briggs Institute Meta-Analysis. The outcomes were assessed with random-effects model using the Review Manager software. Results In total, 29 studies had a low risk of bias and were included in the review. Our findings showed that the pooled prevalence of somatic symptoms in post-menopausal women (52.6%) was higher than in the premenopausal and perimenopausal stages (34.6 and 39.5%, respectively). There was a low prevalence of psychological symptoms in premenopausal women (28.4%). The genitourinary syndrome was highest among post-menopausal women (55.1%), followed by perimenopausal (31.9%) and premenopausal (19.2%) women. Conclusion Post-menopausal women have a higher risk of experiencing menopausal symptoms particularly genitourinary syndrome than premenopausal and perimenopausal women. It is pertinent for healthcare professionals to evaluate the symptoms in order to provide them with a better quality of life. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021235958
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Affiliation(s)
- Nik Hussain Nik Hazlina
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Malaysia
- *Correspondence: Mohd Noor Norhayati
| | - Ismail Shaiful Bahari
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Malaysia
| | - Nik Ahmad Nik Muhammad Arif
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Malaysia
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Moravcova M, Mares J, Horackova K. The Czech version of the Utian Quality of Life Scale questionnaire assessing women's quality of life during menopause. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2022; 21:1-9. [PMID: 35388277 PMCID: PMC8966422 DOI: 10.5114/pm.2021.110833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/21/2021] [Indexed: 12/02/2022]
Abstract
Introduction Menopause is a physiological process, forming a part of a lifetime that most women go through. This period of life is briefly described by experts as a triple transformation: biological, social, and psychological. For menopausal women, health care professionals can use one of 10 specific questionnaires to assess health-related quality of life and its symptoms. The authors herein speak about the preparation of a Czech version of one such questionnaire - the Utian Quality of Life Scale (UQOL). Material and methods A Czech version of the UQOL was created by repeated and backward translation. It was validated on a sample of 204 women after natural menopause (45-65 years old). We judged the reliability of the Czech version of UQOL using Cronbach's a. We assessed the instrument's validity by means of confirmation factor analysis. Results The authors modified the original version of the UQOL. The Czech version has 4 new domains with 18 items. This form was created using the results of confirmation factor analysis. Conclusions The Utian Quality of Life Scale questionnaire is completed by the women themselves, thus meeting the golden rule of all quality-of-life research stating that the primary source should be data from the client him/herself. However, this requirement raises some methodological problems.
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Affiliation(s)
| | - Jiri Mares
- Faculty of Medicine in Hradec Kralove, Charles University in Prague, Czech Republic
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Zou P, Luo Y, Wyslobicky M, Shaikh H, Alam A, Wang W, Zhang H. Menopausal experiences of South Asian immigrant women: a scoping review. Menopause 2022; 29:360-371. [PMID: 35213522 DOI: 10.1097/gme.0000000000001919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
IMPORTANCE AND OBJECTIVE South Asians make up a significant portion of global immigration. Immigrants often face challenges when navigating the healthcare system, which can influence their experience during the menopausal transition. The purpose of this scoping review is to summarize the existing literature on South Asian immigrant women's menopausal experience. METHODS Various electronic databases were systematically searched to identify research articles. The menopausal experiences of South Asian immigrant women were examined. RESULTS A total of 11 studies were included in this scoping review. A variety of physical symptoms were reported, including vasomotor symptoms, musculoskeletal symptoms, somatic symptoms, and early onset of menopause. Psychosocial symptoms included anxiety, depression, and decreased memory/concentration. Cultural experiences were both positive and negative, depending on the connotations surrounding menopause. Individual facilitators for a healthy transition included education and employment. Familial barriers included a lack of knowledge and support. Community and societal factors were both positive and negative, depending on the level of acculturation. Self-management was the most widely used intervention. DISCUSSIONS AND CONCLUSION Findings of this scoping review can help guide the development and evaluation of menopause interventions for South Asian immigrant women. Culturally sensitive care, increased discussion on sexual health, support networks, and reduction of socioeconomic barriers are needed to address the health needs of South Asian immigrant women. Further research is needed to better understand South Asian immigrant women's menopausal needs and help guide intervention design.
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Affiliation(s)
- Ping Zou
- School of Nursing, Nipissing University, Toronto, ON, Canada
| | - Yan Luo
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | | | - Haniah Shaikh
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Arzoo Alam
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Toronto Western Hospital Bariatric Surgical Program, University of Health Network, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
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Dąbrowska-Galas M, Dąbrowska J. Physical Activity Level and Self-Esteem in Middle-Aged Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147293. [PMID: 34299744 PMCID: PMC8305857 DOI: 10.3390/ijerph18147293] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022]
Abstract
Background: Physical activity (PA) is a behavioral modality that may help decrease negative symptoms of menopause and enhance some positive aspects of mental health, including self-esteem. Reduced self-esteem may put menopausal women at higher risk of negative outcomes of menopause and result in a more unpleasant and stressful menopausal experience. The objective of this study was to examine the role of physical activity level on self-esteem in middle-aged women. Methods: Women aged 45-60 from Poland took part in this study. The Rosenberg Self-Esteem Scale, the International Physical Activity Questionnaire, the Menopause Rating Scale and Beck Depression Inventory were used in this study. Results: Among the 111 women, the mean age was 51.7 ± 4.7. The most severe symptoms among studied women concerned sexual problems (1.71 ± 1.5), irritability (1.58 ± 1.37) and joint and muscular discomfort (1.56 ± 1.55). Women with higher total PA level had better self-esteem (p = 0.001). Conclusions: The results of this study showed that physical activity levels can be associated with self-esteem. Most middle-aged women reported high physical activity levels. These results have clinical implications for the inclusion of PA in the lives of middle-aged women to improve self-esteem and mental health.
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Affiliation(s)
- Magdalena Dąbrowska-Galas
- Department of Kinesitherapy and Special Methods, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
- Correspondence:
| | - Jolanta Dąbrowska
- School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
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Hunter MS, Chilcot J. Is cognitive behaviour therapy an effective option for women who have troublesome menopausal symptoms? Br J Health Psychol 2021; 26:697-708. [PMID: 34101946 PMCID: PMC8453849 DOI: 10.1111/bjhp.12543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/07/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Myra S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Joseph Chilcot
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Relationship between symptoms of menopause and personality traits in Polish perimenopausal women: A correlation study. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-018-0105-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Glyde T. How can therapists and other healthcare practitioners best support and validate their queer menopausal clients? SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1881770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Tania Glyde
- Counselling & Psychotherapy, School of Psychology, University of East London, London, UK
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Albergaria R, Leal I, Hunter M, Pimenta F. Menopause Representations Questionnaire: development and validation with Portuguese women. Climacteric 2021; 24:275-281. [PMID: 33554657 DOI: 10.1080/13697137.2021.1873937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to develop and validate a Portuguese version of the Menopause Representations Questionnaire (MenoSentations-Q), a self-report measure to assess cognitive appraisal of menopause, based on cognitive components of the Self-Regulation Model and the results from a previous Portuguese qualitative study. METHODS A total of 309 Portuguese women, aged 45-65 years, completed the questionnaire. Factorial, convergent, discriminant, and criterion validity, as well as reliability and psychometric sensitivity, were studied. RESULTS MenoSentations-Q has demonstrated acceptable factorial, convergent, and discriminant validity, as well as good values of sensitivity and reliability for the four factors (i.e. identity; positive consequences; negative consequences; and control, awareness, and cause). Criterion validity was only obtained for two factors. CONCLUSIONS MenoSentations-Q, a brief measure of menopausal representations, in this sample of Portuguese women provides information to inform interventions that might include challenging unhelpful menopausal representations. This instrument could be used in both clinical and community settings.
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Affiliation(s)
- R Albergaria
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - I Leal
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - M Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - F Pimenta
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
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20
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Süss H, Willi J, Grub J, Ehlert U. Psychosocial factors promoting resilience during the menopausal transition. Arch Womens Ment Health 2021; 24:231-241. [PMID: 32719937 PMCID: PMC7979610 DOI: 10.1007/s00737-020-01055-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/16/2020] [Indexed: 01/23/2023]
Abstract
Despite significant biological, psychological, and social challenges in the perimenopause, most women report an overall positive well-being and appear to be resilient to potentially negative effects of this life phase. The objective of this study was to detect psychosocial variables which contribute to resilience in a sample of perimenopausal women. A total of 135 healthy perimenopausal women aged 40-56 years completed a battery of validated psychosocial questionnaires including variables related to resilience, well-being, and mental health. First, using exploratory factor analysis, we examined which of the assessed variables related to resilience can be assigned to a common factor. Second, linear regression analyses were performed to investigate whether a common resilience factor predicts well-being and mental health in the examined sample of women. Optimism (LOT-R-O), emotional stability (BFI-K-N), emotion regulation (ERQ), self-compassion (SCS-D), and self-esteem (RSES) in perimenopausal women can be allocated to a single resilience-associated factor. Regression analyses revealed that this factor is related to higher life satisfaction (SWLS; β = .39, p < .001, adj. R2 = .20), lower perceived stress (PSS-10; β = - .55, p < .001, adj. R2 = .30), lower psychological distress (BSI-18; β = - .49, p < .001, adj. R2 = .22), better general psychological health (GHQ-12; β = - .49, p < .001, adj. R2 = .22), milder menopausal complaints (MRS II; β = - .41, p < .001, adj. R2 = .18), and lower depressive symptoms (ADS-L; β = - .32, p < .001, adj. R2 = .26). The α levels were adjusted for multiple testing. Our findings confirm that several psychosocial variables (optimism, emotional stability, emotion regulation, self-compassion, and self-esteem) can be allocated to one common resilience-associated factor. This resilience factor is strongly related to women's well-being as well as mental health in perimenopause.
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Affiliation(s)
- Hannah Süss
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Jessica Grub
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050, Zurich, Switzerland. .,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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21
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Evandrou M, Falkingham J, Qin M, Vlachantoni A. Menopausal transition and change in employment: Evidence from the National Child Development Study. Maturitas 2020; 143:96-104. [PMID: 33308643 DOI: 10.1016/j.maturitas.2020.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 09/15/2020] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study aims to investigate the impact of the menopausal transition and severe symptoms on changes in employment. STUDY DESIGN This longitudinal prospective study analysed data from a population-based cohort study, the UK National Child Development Study Wave 8 and Wave 9, when the cohort was aged 50 and 55 respectively. The analytical sample comprised 3109 employed women at age 50. MEASURES The outcome variable was the employment change from age 50 to age 55, with three categories: i) continued employed without reduced working time; ii) continued employed with reduced working hours; and iii) exit employment. The employment dynamics of women were compared using multinomial logistic regression modelling. Key independent variables included menopausal transition status and severe menopausal symptoms experienced. RESULTS 53.5 % of employed women at age 50 reported at least one severe menopausal symptom. Women experiencing severe menopausal symptoms had a higher chance of employment exit or reducing their working hours. The odds ratios contrasting severely symptomatic women with those with no severe symptoms were 1.43 (95 % CI = 1.11-1.84) between exiting employment vs continued employment without reducing working hours, and 1.23 (95 % CI = 1.02-1.48) between reducing working hours vs continued employment without reducing working hours. The strength of the association between women's severe menopausal symptoms and the risk of employment exit or reducing working hours varied according to their HRT usage and their partner's economic activity. CONCLUSIONS Menopausal symptoms can pose obstacles to some middle-aged women in terms of remaining in employment or maintaining their number of working hours.
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Affiliation(s)
- Maria Evandrou
- Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK; ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Jane Falkingham
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
| | - Min Qin
- Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK; ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
| | - Athina Vlachantoni
- Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK; ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
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“Midlife crisis” on the road to successful workforce aging. INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY-PERSPECTIVES ON SCIENCE AND PRACTICE 2020. [DOI: 10.1017/iop.2020.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
This article describes cognitive behavioral therapy (CBT) for women with problematic menopausal symptoms, and provides the evidence from clinical trials of women going through the menopause, women with breast cancer treatment-induced symptoms and women with problematic symptoms in a work context. The CBT focus is primarily on vasomotor symptoms (VMS) but it also targets stress, low mood and sleep problems. CBT is a brief therapy (four to six sessions) that is theory- and evidence-based; it is acceptable to women and effectively reduces the impact of VMS, improves sleep and has benefits to quality of life. VMS frequency is also reduced significantly in some trials but not others. CBT has been found to be consistently effective when delivered in groups, self-help book and on-line formats (with or without additional support). The MENOS 1 and MENOS 2 CBT protocols are recommended for the treatment of VMS by the North American Menopause Society (2015); CBT has been recommended for the treatment of anxiety and depression for women during the menopause transition and post menopause (NICE, 2015); and telephone CBT has been shown to be an effective treatment for insomnia.
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Affiliation(s)
- M S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Guy's Campus, London, UK
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Bahri N, Latifnejad Roudsari R. "Moving from uncertainty toward acceptance": a grounded theory study on exploring Iranian women's experiences of encountering menopause. J Psychosom Obstet Gynaecol 2020; 41:154-164. [PMID: 31623492 DOI: 10.1080/0167482x.2019.1678018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Purpose: Menopause as a universal phenomenon is influenced by social norms so that women's experiences during menopausal transition are related to the social values and cultural symbols. This qualitative study was conducted to discover the Iranian women's experiences of encountering menopause.Materials and Methods: In this grounded theory study 27 women living in Mashhad and Gonabad, North East of Iran, from May 2013 to July, 2016 were selected using purposive and theoretical sampling. Semi structured in-depth interviews were conducted for data collection until data saturation was achieved. Data was analyzed using Strauss and Corbin's (1998) recommended method through open, axial and selective coding. MAXQDA 2007 software was used for organizing data and managing the process of analysis.Results: The analysis revealed the core category of "moving from uncertainty toward acceptance". The interrelated categories subsumed under the core category included challenging aging, observing the symptoms of menopause, responding to the menopausal symptoms, understanding the need for preparation, and assessing the right time to prepare.Conclusion: Moving from uncertainty toward acceptance was identified as the core concept in the Iranian women's experiences of encountering menopause. Modifying the beliefs of people about menopause and aging as well as increasing their knowledge and information about menopause can help women to experience the menopausal transition with more ease.
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Affiliation(s)
- Narjes Bahri
- Reproductive Health, Social Development & Health Promotion Research Center, Department of Midwifery, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
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Intensity of menopausal symptoms and quality of life in climacteric women. MENOPAUSE REVIEW 2020; 18:217-221. [PMID: 32132885 PMCID: PMC7045359 DOI: 10.5114/pm.2019.93113] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/10/2020] [Indexed: 11/17/2022]
Abstract
Menopause is a difficult period in a woman’s life, associated not only with the end of menstruation, but also with symptoms such as hot flashes, sweating, dizziness, and palpitations which occur due to fluctuations in the hormones oestrogen and progesterone. The aim of this study was to evaluate the quality of life of women (aged 48-55 years) in the physical, mental and social spheres, to determine the intensity of menopause symptoms and to ascertain whether the above indicators are influenced by sociodemographic factors. The study was conducted by diagnostic survey using two tools – the WHOQOL-BREF questionnaire for the measurement of the quality of life and the Kupperman index, which measures the severity of menopause symptoms. A total of 161 women not using hormone replacement therapy were examined. In their case, the intensity of menopause symptoms was moderate. The respondents assessed their functioning in the social sphere with the highest number of points (3.65) and in the physical sphere with the lowest number of points (3.14). The intensity of menopause symptoms positively correlated with the evaluation of the quality of life by the respondents. Higher assessment of the quality of life was reported by women working in a given period of time, with good material status, sexually active. The respondents suffered from chronic diseases, most often arterial hypertension. The occurrence of chronic diseases – arterial hypertension, coronary artery disease, diabetes and osteoporosis – negatively affected the quality of life of the respondents.
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Süss H, Ehlert U. Psychological resilience during the perimenopause. Maturitas 2020; 131:48-56. [DOI: 10.1016/j.maturitas.2019.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/14/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
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Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E668. [PMID: 31581598 PMCID: PMC6843314 DOI: 10.3390/medicina55100668] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/23/2019] [Accepted: 09/27/2019] [Indexed: 12/22/2022]
Abstract
During the menopausal transition, which begins four to six years before cessation of menses, middle-aged women experience a progressive change in ovarian activity and a physiologic deterioration of hypothalamic-pituitary-ovarian axis function associated with fluctuating hormone levels. During this transition, women can suffer symptoms related to menopause (such as hot flushes, sleep disturbance, mood changes, memory complaints and vaginal dryness). Neurological symptoms such as sleep disturbance, "brain fog" and mood changes are a major complaint of women transitioning menopause, with a significant impact on their quality of life, productivity and physical health. In this paper, we consider the associations between menopausal stage and/or hormone levels and sleep problems, mood and reduced cognitive performance. The role of estrogen and menopause hormone therapy (MHT) in cognitive function, sleep and mood are also discussed.
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Affiliation(s)
- Giulia Gava
- Gynecology and Physiopathology of Human Reproduction, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy.
| | - Isabella Orsili
- Gynecology and Physiopathology of Human Reproduction, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Stefania Alvisi
- Gynecology and Physiopathology of Human Reproduction, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Ilaria Mancini
- Gynecology and Physiopathology of Human Reproduction, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Renato Seracchioli
- Gynecology and Physiopathology of Human Reproduction, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Maria Cristina Meriggiola
- Gynecology and Physiopathology of Human Reproduction, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
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Banks S. Menopause and the NHS: caring for and retaining the older workforce. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2019; 28:1086-1090. [PMID: 31518539 DOI: 10.12968/bjon.2019.28.16.1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Menopause is a natural transition affecting most women between the ages of 45 and 55. Three-quarters of women will experience mild to moderate menopausal symptoms and a further quarter will report them as severe. Symptoms can include night sweats, hot flushes, poor concentration, tiredness, poor memory and lowered confidence. The workplace can exacerbate these symptoms and for some women can influence their decision to stop working earlier than previously intended. The need for support and understanding from managers is crucial and can make a major difference to how a woman deals with her menopause. Many women enter the menopause at the peak of their productive lives. These women have valuable skills, knowledge and experience that employers need to retain, so they should be developing resources to help navigate this normal and natural stage of the ageing process.
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Affiliation(s)
- Suzanne Banks
- Chief Nurse, Sherwood Forest Hospitals NHS Foundation Trust, Sutton in Ashfield, and Visiting Fellow, Staffordshire University, Stafford Campus
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Molefi-Youri W. Is there a role for mindfulness-based interventions (here defined as MBCT and MBSR) in facilitating optimal psychological adjustment in the menopause? Post Reprod Health 2019; 25:143-149. [PMID: 30880559 DOI: 10.1177/2053369119835964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Pimenta F, Ramos MM, Silva CC, Costa PA, Maroco J, Leal I. Self-regulation model applied to menopause: a mixed-methods study. Climacteric 2019; 23:84-92. [PMID: 31365272 DOI: 10.1080/13697137.2019.1640196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Considering that bio-psycho-sociocultural variables influence menopause, this research aimed to assess the suitability of the self-regulation model in explaining the menopausal experience, and to explore differences among participants with different characteristics (e.g. health, sexual related) regarding menopause representations.Methods: Overall, 27 Portuguese women aged 40-65 years were assessed for sociodemographics, health, and sexual activity, as well as menopausal status and symptoms. Semi-structured in-depth interviews were conducted. A directed content analysis was performed, and the qualitative data presented. Afterward, the frequencies of the categories were analyzed through quantitative methods (Mann-Whitney U tests).Results: Aging was the most frequently mentioned feature regarding menopause Identity, whereas vasomotor symptoms were the most mentioned regarding Negative Consequences and menses cessation regarding Positive Consequences. Features related to Cause (hormonal changes) and Control (need for acceptance) of menopause were also identified. No differences were found in the frequency of menopause representations between women with different characteristics (e.g. with higher vs. lower vasomotor symptom severity).Conclusion: The suitability of the self-regulation model to explain these women's menopause experience was confirmed and the representations did not vary among participants with different characteristics. This research might help professionals and researchers in developing comprehensive interventions, based on this theoretical model.
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Affiliation(s)
- F Pimenta
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - M M Ramos
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - C C Silva
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - P A Costa
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - J Maroco
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - I Leal
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
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Ussher JM, Hawkey AJ, Perz J. 'Age of despair', or 'when life starts': migrant and refugee women negotiate constructions of menopause. CULTURE, HEALTH & SEXUALITY 2019; 21:741-756. [PMID: 30280959 DOI: 10.1080/13691058.2018.1514069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
There has been a call for research on migrant and refugee women's negotiation of diverse discourses and cultural constraints associated with sexual embodiment, including menopause, in order to facilitate sexual and reproductive health and understand gendered subjectivity. This study examined the construction and experience of menopause among migrant and refugee women who had settled in Australia or Canada in the last 10 years. Eighty-four individual interviews and 16 focus groups comprising 85 participants were conducted (total n = 169), with women aged 18 years and over from Afghanistan, India (Punjab), Iraq, Somalia, South Sudan, Sri-Lanka (Tamil), Sudan and various South American (Latina) backgrounds. Thematic decomposition identified three discursive themes: Menopause as the Age of Despair; a Discourse of Silence and Secrecy; and Menopause as a Life Stage - or when Life Starts. Negative constructions of menopause, associated with silence and secrecy, were evident across different cultural groups, with implications for women's positioning and experience of menopausal change and embodiment. However, resistance to negative discourse was also evident. This was primarily associated with having received menopause education and more open communication about menopausal change, suggesting that education and health information can facilitate affirming aspects of menopause.
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Affiliation(s)
- Jane M Ussher
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Sydney , New South Wales , Australia
| | - Alexandra J Hawkey
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Sydney , New South Wales , Australia
| | - Janette Perz
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Sydney , New South Wales , Australia
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Understanding the complex relationships underlying hot flashes: a Bayesian network approach. Menopause 2019; 25:182-190. [PMID: 28763402 DOI: 10.1097/gme.0000000000000959] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The mechanism underlying hot flashes is not well-understood, primarily because of complex relationships between and among hot flashes and their risk factors. METHODS We explored those relationships using a Bayesian network approach based on a 2006 to 2015 cohort study of hot flashes among 776 female residents, 45 to 54 years old, in the Baltimore area. Bayesian networks were fit for each outcome (current hot flashes, hot flashes before the end of the study, hot flash severity, hot flash frequency, and age at first hot flashes) separately and together with a list of risk factors (estrogen, progesterone, testosterone, body mass index and obesity, race, income level, education level, smoking history, drinking history, and activity level). Each fitting was conducted separately on all women and only perimenopausal women, at enrollment and 4 years after enrollment. RESULTS Hormone levels, almost always interrelated, were the most common variable linked to hot flashes; hormone levels were sometimes related to body mass index, but were not directly related to any other risk factors. Smoking was also frequently associated with increased likelihood of severe symptoms, but not through an antiestrogenic pathway. The age at first hot flashes was related only to race. All other factors were either not related to outcomes or were mediated entirely by race, hormone levels, or smoking. CONCLUSIONS These models can serve as a guide for design of studies into the causal network underlying hot flashes.
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No Author. Chapitre 4 : Symptômes vasomoteurs. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41 Suppl 1:S68-S72. [DOI: 10.1016/j.jogc.2019.02.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Validation of the 10-item Cervantes Scale in middle-aged Portuguese women: paper-and-pencil and online format assessment of menopause-related symptoms. Menopause 2019; 26:203-210. [DOI: 10.1097/gme.0000000000001180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Włodarczyk M, Dolińska-Zygmunt G. Searching for predictors of sense of quality of health: A study using neural networks on a sample of perimenopausal women. PLoS One 2019; 14:e0200129. [PMID: 30605472 PMCID: PMC6317781 DOI: 10.1371/journal.pone.0200129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 06/20/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We assumed that perimenopausal women's sense of quality of health (SQH) is a subjective evaluation of their psycho-physical health, and comprises three dimensions: sense of quality of life, menopausal symptoms, and the level of positive and negative affect. PURPOSE The aim of the study was to: 1) test a model about SQH, and 2) explore the role of personality traits, self-esteem, body self, and self-stereotype as predictors of SQH. METHODS The sample included 201 women aged between 45 and 55 (50.11±3.07). Participants filled out the Rosenberg Self-Esteem Scale, the Personality Inventory based on the Big Five Factor Model, the Body Self Questionnaire, and a survey querying perimenopausal women's self-stereotype. To determine the individual SQH dimensions we used the Sense of Quality of Life Questionnaire, the Menopause Symptom List, and the Positive and Negative Affect Schedule. To verify the assumptions of the SQH model and look for SQH predictors we conducted a neural networks analysis with structure optimization via genetic algorithms (a multivariate analysis). RESULTS The SQH model was verified in the course of several neural networks analyses with structure optimization via genetic algorithms (R = 0.849, R2 = 0.723, F = 133,232, p < 0.01). Moreover, we confirmed that SQH comprised three dimensions: quality of life, menopausal symptoms, and affect. SQH and menopausal symptoms were correlated. Similarly, positive and negative affect modified the women's global sense of quality of life. SQH predictors included: personality traits, self-esteem, the body-self, and menopausal woman's self-stereotype. CONCLUSION In practical terms, our findings may help raise awareness among women and medical practitioners, calling for a holistic approach to the health of menopausal women. Our findings may also facilitate the creation of both prevention and therapeutic programs for women transitioning through menopause, for example, cognitive-behavioral therapy.
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Del Sueldo M, Martell-Claros N, Abad-Cardiel M, Zilberman JM, Marchegiani R, Fernández-Pérez C. Health perception in menopausal women. Int J Womens Health 2018; 10:655-661. [PMID: 30425587 PMCID: PMC6205132 DOI: 10.2147/ijwh.s173891] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM The aim of this study is to find whether the worsening of health perception was related to the menopausal (MNP) state or to its negative consequences on cardiometabolic risk factors (CMRF) and the presence of depression/anxiety. METHODS In this study, 2,562 women, 1,357 (53%) MNP and 1,205 (47%) non-MNP, were analyzed. Blood pressure, heart rate, body mass index, waist circumference, and depression/anxiety screening using the Hospital Depression/Anxiety Scale (HADS) were measured. We collected a blood sample in fasting state for glycemia, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides. Logistic regression models were fitted with a backward method from the potentially confusing variables of the menopause study groups. RESULTS Age 49.4 (±15.9) years; 10.1% belonged to semi-rural population; 87.5% had children. Regarding the educational level, 22.1% had <5 years of education, 31.3% had between 6 and 7 years, 33.4% had between 8 and 12 years, and 13.2% had >12 years of education. The prevalence of CMRF was significantly higher in MNP women, except for smoking. We did not find any differences in the prevalence of depression or anxiety between MNP and non-MNP women. Health was perceived as worse among MNP women (P<0.05) and patients over 45 years of age than patients younger than 45 years. We found a relationship between the negative health perception with metabolic syndrome, depression, and anxiety, having children, smoking, residing in rural area, and low educational level; nevertheless, it is not correlative with MNP status. CONCLUSION Perceived health should be viewed as a multifaceted condition related to social circumstances, and various symptoms in women, including menopause symptoms, but not with MNP state itself.
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Affiliation(s)
- Mildren Del Sueldo
- Healthy heart program, Municipalidad de Villa María, Córdoba, Argentina
- Cardiology Division and Cardiovascular Prevention, Specialty Clinic, Villa María, Córdoba, Argentina
| | - Nieves Martell-Claros
- Hypertension Unit, Internal Medicine Service, Hospital Clínico San Carlos, Madrid, Spain,
- School of Medicine, Complutense University, Madrid, Spain,
- Research Institute of the San Carlos Clinical Hospital, Madrid, Spain,
| | - María Abad-Cardiel
- Hypertension Unit, Internal Medicine Service, Hospital Clínico San Carlos, Madrid, Spain,
- School of Medicine, Complutense University, Madrid, Spain,
- Research Institute of the San Carlos Clinical Hospital, Madrid, Spain,
| | - Judith M Zilberman
- Physiology Course at the School of Pharmacy and Biochemistry, University of Buenos Aires, IQUIMEFA-CONICET, CABA, Argentina
- Department of Cardiovascular Prevention, Hypertension Unit, Cardiovascular Institute, Buenos Aires (ICBA), CABA, Argentina
- Cardiology Service, Hypertension Unit, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina
| | - Raul Marchegiani
- Healthy heart program, Municipalidad de Villa María, Córdoba, Argentina
- Cardiology Division and Cardiovascular Prevention, Specialty Clinic, Villa María, Córdoba, Argentina
| | - Cristina Fernández-Pérez
- Unit of Epidemiology and Clinical Methodology, Preventive Medicine Service, Research Institute of the San Carlos Clinical Hospital, UCM, Madrid, Spain
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Bio Psychosocial Risk Factors of Depression in the Menopausal Transition: A Narrative Review. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.12928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Efficacy of a biobehavioral intervention for hot flashes: a randomized controlled pilot study. Menopause 2018; 24:774-782. [PMID: 28266949 DOI: 10.1097/gme.0000000000000837] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The need for effective nonhormonal treatments for hot flash management without unwanted side effects continues. The primary aim of this pilot study was to evaluate the effect of combining a nonhormonal pharmacologic agent with a behavioral treatment for hot flash reduction. METHODS Seventy-one postmenopausal women were randomized to one of four groups: venlafaxine 75 mg + hypnosis (VH) versus venlafaxine 75 mg + sham hypnosis (VSH) versus a placebo pill + hypnosis (PH) versus placebo pill + sham hypnosis (PSH). Women recorded hot flash severity and frequency in a daily diary, in real time. The intrapatient difference in hot flash score (frequency × severity) at 8 weeks was analyzed using a General Estimating Equation model, using VSH as the referent arm, controlling for baseline hot flashes. RESULTS The active arms including PH or VH were not statistically significantly different than VSH (P = 0.34, P = 0.05, respectively). Women in each active arm reported hot flash reductions of about 50%, with the PSH group reporting a 25% reduction. Women receiving the PSH reported statistically significantly smaller reductions in hot flash score than women in the referent VSH arm (P = 0.001). There were no significant negative side effects during the course of the study. CONCLUSIONS Hypnosis alone reduced hot flashes equal to venlafaxine alone, but the combination of hypnosis and venlafaxine did not reduce hot flashes more than either treatment alone. More research is needed to clarify whether combining hypnosis with a different antidepressant would provide synergistic benefits.
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Prevalence and severity of menopause symptoms among perimenopausal and postmenopausal women aged 30-49 years in Gulele sub-city of Addis Ababa, Ethiopia. BMC WOMENS HEALTH 2017; 17:124. [PMID: 29216870 PMCID: PMC5721600 DOI: 10.1186/s12905-017-0484-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 11/28/2017] [Indexed: 12/24/2022]
Abstract
Background Menopause is a natural phenomenon occurring as women approach middle-age. It is characterized by declining of ovarian function and onset of the last menstrual period and subsequent 12-month cessation of menstruation. Due to a growing aging population and longer life expectancies, sub-Saharan African women will spend a significant portion of their lives in postmenopause. Menopausal symptom research has been primarily conducted on Caucasian women from high-income countries. Understanding menopause symptom prevalence and perceptions among diverse women in Ethiopia will better inform reproductive health care. Methods We conducted a multi-stage, cross-sectional study on 226 perimenopausal and postmenopausal women aged 30-49 years in Gulele sub-city of Addis Ababa, Ethiopia. Data on socio-demographic characteristics, menopausal status and an 11-item Menopause Rating Scale (MRS) were collected using interviewer-administered questionnaire. Statistical analyses consisted of descriptive data and chi-squared analyses. Results Study participants were 40.4 ± 5.9 years, on average, with the majority married, educated at secondary school level, and comprised different ethnicities and wealth tertiles. The most prevalent types of menopausal symptoms reported from the MRS were from somatic subscale (65.9%) while psychological (46.0%) and urogenital subscale symptoms (30.5%) were also prevalent. The most commonly reported individual symptoms were: hot flushes (65.9% (95% CI: 59.4%–72.1%)), difficulty falling asleep (49.6% (95% CI: 42.9%-56.3%)), depressive mood (46.0% (95% CI: 39.4%-52.8%)), irritability (45.1% (95% CI: 38.5%-51.9%)), and anxiety (39.8% (95% CI: 33.4%-46.5%)). Each of the somatic, psychological, and urogenital MRS subscale scores were higher among postmenopausal women compared to perimenopausal women. Women self-reported differing severity levels of symptoms with high severity reported in 8.4% of total MRS, 1.3% of somatic, 10.6% of psychological, and 8.4% of urogenital scales. Conclusions Our study provides the first presentation of menopausal symptoms among perimenopausal and postmenopausal women in the Gulele sub-city of Addis Ababa, Ethiopia. We capture the prevalence of menopausal symptoms experienced as well as self-rated severity through the MRS. Our findings reflect menopausal symptoms in our specific study population and have been found to be consistent with previous international research. Electronic supplementary material The online version of this article (10.1186/s12905-017-0484-x) contains supplementary material, which is available to authorized users.
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Guérin E, Goldfield G, Prud'homme D. Trajectories of mood and stress and relationships with protective factors during the transition to menopause: results using latent class growth modeling in a Canadian cohort. Arch Womens Ment Health 2017; 20:733-745. [PMID: 28707156 DOI: 10.1007/s00737-017-0755-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Abstract
The menopause transition is characterized by significant hormonal changes that may predispose women to psychosocial maladjustment. Prospective studies to date have focused primarily on negative mood states and show equivocal findings. The primary goal of this study was to identify patterns of change with respect to positive and negative mood states (vigor, depression, tension, and stress) over a 5-year period in a cohort of women undergoing the transition to menopause. A secondary aim was to determine whether the identified trajectories were associated with menopause status as well as baseline health-related and psychological characteristics. This longitudinal study observed 102 healthy Canadian women who were premenopausal at baseline (age 47-55 years). Analyses consisted of latent class growth modeling. Mood states were predominantly normal and stable, raising doubts regarding the notion that psychosocial distress is a common and natural occurrence during the transition to menopause. Neither time spent in perimenopause nor BMI had a significant influence on levels of mood indicators. However, higher scores on body image, self-esteem, and general health perceptions were predictive of more positive psychological outcomes over the 5-year period. Targeting improvements in self-perceptions may promote a healthier psychological adjustment during this natural transitional period in a women's lifespan.
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Affiliation(s)
- Eva Guérin
- Institut du Savoir Montfort - Recherche, 202-745A Montréal Rd, Ottawa, ON, K1K 0T1, Canada
| | - Gary Goldfield
- Healthy Active Living and Obesity (HALO) Research group, Children's Hospital of Eastern Ontario (CHEO) Research Institute, 40 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Denis Prud'homme
- Institut du Savoir Montfort - Recherche, 202-745A Montréal Rd, Ottawa, ON, K1K 0T1, Canada. .,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Pr, Ottawa, ON, K1N 1A2, Canada.
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Perich T, Ussher J, Parton C. "Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder. BMC WOMENS HEALTH 2017; 17:110. [PMID: 29145856 PMCID: PMC5689207 DOI: 10.1186/s12905-017-0467-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/07/2017] [Indexed: 12/25/2022]
Abstract
Background Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Methods Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Results Themes identified included ‘Constructions of mood change: menopause or bipolar disorder?’,‘ Life events, bipolar disorder and menopause coming together’; ‘Treatment choices for mood change during menopause’. Conclusions The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices. Electronic supplementary material The online version of this article (10.1186/s12905-017-0467-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia. .,School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Chloe Parton
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Perich T, Ussher J, Meade T. Menopause and illness course in bipolar disorder: A systematic review. Bipolar Disord 2017; 19:434-443. [PMID: 28796389 DOI: 10.1111/bdi.12530] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/06/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Menopause may be a time of increased mood symptoms for some women. This systematic review aimed to examine the severity of symptoms and prevalence of mood changes in women with bipolar disorder during peri-menopause and post-menopause. METHODS A systematic review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The two primary outcomes assessed were relapse rates and symptom severity during menopause. Databases searched were MEDLINE, EMBASE, PsychInfo, CINAHL and SCOPUS from January 1980 until December 2016. RESULTS Nine studies, including a total of 273 participants diagnosed with bipolar disorder and who reported menopause, were included in the narrative synthesis. Menopause was reported to be associated with increased symptoms overall, and with depression in particular (range of 46%-91%). The collection of self-reported retrospective data was the most commonly used method to record menopause status. CONCLUSIONS The impact of menopause on illness course for women with bipolar disorder is largely under-explored. Preliminary evidence suggests that it may be associated with increased bipolar symptoms. Further work is needed to explore how menopause may interact with bipolar disorder over time and the nature of these symptom changes, and if and how menopause may differ from other reproductive stages.
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Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jane Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Tanya Meade
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia.,School of Medicine, University of Sydney, Sydney, NSW, Australia
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Sergeant J, Rizq R. 'Its all part of the big CHANGE': a grounded theory study of women's identity during menopause. J Psychosom Obstet Gynaecol 2017; 38:189-201. [PMID: 28067092 DOI: 10.1080/0167482x.2016.1270937] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
This study explores the impact of menopause on women's identity and considers the effect of sociocultural factors on their experience of this stage of life. Semi-structured interviews were conducted with 11 women and analysed following constructivist Grounded Theory methods. Women described uncertainty produced by their changing bodies. Menopause was interpreted as marking transition to another phase of life, which necessitated renegotiation of role and status in the face of menopause narratives questioning women's relevance, vigour, attractiveness and emotional stability. We discuss results with reference to what appears to be an unspoken social "rule" keeping menopause hidden, something that enables dismissive menopausal narratives to persist. Our study suggests this resulted in some sense of emotional strain for participants as they negotiated a continuing narrative of their lives through a period of change. However, results also indicate that menopause may provide an opportunity for women to refocus on their goals and wellbeing. We conclude by considering the implications of the study for healthcare professionals working with menopausal women.
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Affiliation(s)
- Judith Sergeant
- a Community Health Psychology , Surrey and Borders Partnership NHS Trust , Guildford , UK
| | - Rosemary Rizq
- b Department of Psychology , University of Roehampton , London , UK
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Factors associated with different symptom domains among postmenopausal Saudi women in Riyadh, Saudi Arabia. Menopause 2017; 24:1392-1401. [PMID: 28697042 DOI: 10.1097/gme.0000000000000931] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine factors associated with different symptom domains among postmenopausal Saudi women in Riyadh, Saudi Arabia. METHODS In a cross-sectional study, interviews were conducted with 542 postmenopausal Saudi women, comprising sociodemographic history, social support, and the Menopause-specific Quality of Life questionnaire. RESULTS The mean age of participants was 58 (±7.0) years, and the mean age at menopause was 49 (±4.7) years. We found that 41% (n = 224), 14.4% (n = 78), 57% (n = 307), and 12.7% (n = 69) of women reported severe/moderate impact of vasomotor, psychosocial, physical, and sexual symptoms, respectively. Multivariate logistic regression revealed that lacking emotional support was associated with severe/moderate vasomotor (adjusted odds ratio [aOR] 1.5, 95% confidence interval [CI] 1.1, 2.3), psychosocial (aOR 2.0, 95% CI 1.2, 3.4), and physical (aOR 1.7, 95% CI 1.2, 2.6) symptoms. Lack of tangible social support was associated with severe/moderate sexual symptoms (aOR 1.9, 95% CI 1.0, 3.4). In addition, women who worked (aOR 1.8, 95% CI 1.1, 3.2), were obese (aOR 2.0, 95% CI 1.0, 4.1), lived in rented accommodations (aOR 3.9, 95% CI 1.2, 13.1), or had a retired spouse (aOR 1.6, 95% CI 1.0, 2.4) had higher odds for moderate/severe menopausal symptoms. CONCLUSIONS Establishing educational and counseling programs for postmenopausal women, their spouses, and other family members could improve social support and hence quality of life of postmenopausal women. Effective preventive strategies to deal with modifiable risk factors, such as obesity and work stress, should also be implemented.
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Parton C, Ussher JM, Perz J. Experiencing menopause in the context of cancer: Women’s constructions of gendered subjectivities. Psychol Health 2017; 32:1109-1126. [DOI: 10.1080/08870446.2017.1320799] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Chloe Parton
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Jane M. Ussher
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Quiroga A, Larroy C, González-Castro P. Climacteric symptoms and their relation to feminine self-concept. Climacteric 2017; 20:274-279. [PMID: 28398825 DOI: 10.1080/13697137.2017.1310192] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To investigate women's subjective experiences in the climacteric transition, especially the impact of self-concept, quality of life and depression on the severity of climacteric symptoms. METHOD Non-experimental, cross-sectional study, purpose sampling. To analyze the results, we proposed a three-way interaction, in which the direct effect of depression on the severity of climacteric symptoms would be buffered by perceived sexual quality of life, and mediated by self-concept. RESULTS As hypothesized, depression significantly predicted self-concept, which in turn mediated the severity of climacteric symptoms. In a second stage of the model, sexual quality of life moderated the direct effect of depression on climacteric symptoms, such that women with a better sexual quality of life would perceive less severity of climacteric symptoms than those with a less favorable sexual quality of life. Physical quality of life did not significantly buffer the direct effect of depression on climacteric symptoms, nor did vasomotor or psychosocial quality of life. CONCLUSIONS Our study confirmed the impact of subjective factors such as satisfaction, self-concept, and quality of life on climacteric symptoms; specifically, we observed the moderating effect of the sexual quality of life on the previously established correlation between depression and aggravation of climacteric symptoms.
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Affiliation(s)
- A Quiroga
- a Departamento Académico de Psicología , Universidad of Monterrey , Garza García , Mexico
| | - C Larroy
- b Clinic Psychology Department , Universidad Complutense de Madrid , Madrid , Spain
| | - P González-Castro
- a Departamento Académico de Psicología , Universidad of Monterrey , Garza García , Mexico
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Muslić L, Jokić-Begić N. The experience of perimenopausal distress: examining the role of anxiety and anxiety sensitivity. J Psychosom Obstet Gynaecol 2016; 37:26-33. [PMID: 26821968 DOI: 10.3109/0167482x.2015.1127348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The hormonal changes that occur in perimenopause can result in distress for a significant proportion of women years before reaching menopause. Previous studies have suggested that various biopsychosocial characteristics and personality traits contribute to more intense reactions to these hormonal changes. In the present study, we examined the contribution of trait anxiety and anxiety sensitivity in predicting the experience of perimenopausal distress in pre- and early perimenopausal women while controlling for some menstrual experiences. METHOD A sample of 660 women aged 35-52 years was selected from a broader online survey of biopsychosocial changes in middle-aged women that considered age, menstrual cycle pattern, physical and mental health, and childbearing experience. Three hierarchical multiple regression analyses were conducted for different age subgroups: women aged 35-40, women aged 41-45 and women aged 46-52. RESULTS Results indicated that anxiety and anxiety sensitivity, along with a number of features of the menstrual experience, explained 56-66% of the perimenopausal distress variance. Different personality trait predictors were found to be important in different age subgroups. In the youngest and middle subgroups (45 years and younger), trait anxiety was found to be more significant, whereas anxiety sensitivity was found to be more important in explaining perimenopausal distress experienced by women older than 40. CONCLUSION Anxiety sensitivity (dimension of psychological concerns) might be an important vulnerability factor in the experience of perimenopausal distress among women closer to menopause, whereas the predisposition to an anxiety response might contribute to perimenopausal distress near the beginning of reproductive hormonal changes. Implications for better understanding the development of perimenopausal distress and psychological intervention are discussed.
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Affiliation(s)
- Ljiljana Muslić
- a Department of Mental Health Promotion and Addiction Prevention , Division of Health Promotion, Croatian Institute of Public Health , Zagreb , Croatia , and
| | - Nataša Jokić-Begić
- b Department of Psychology , Faculty of Humanities and Social Sciences, Clinical and Health Psychology Unit, University of Zagreb , Zagreb , Croatia
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The effects of menopausal health training for spouses on women's quality of life during menopause transitional period. Menopause 2016; 23:183-8. [PMID: 26783984 DOI: 10.1097/gme.0000000000000588] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Spouses' support during menopausal transition has an important role for improving the quality of life in postmenopausal women. Since the first step in providing support is having adequate knowledge, this study aimed to investigate the effects of an educational program on menopause health for spouses on women's quality of life during the menopausal transition. METHODS This clinical trial was conducted in Yazd, Iran. A hundred healthy women aged 45 to 60 years were recruited by random sampling. The spouses in the intervention group (n = 50) attended three training sessions about the management and health of menopausal transition. The spouses in the control group (n = 50) did not receive any intervention. Knowledge and performance about menopausal health were assessed in all spouses before and 3 months after intervention. All women were assessed by the Menopause Rating Scale, and the Menopause Quality of Life questionnaire before and 3 months after educational intervention. Analyses were carried out using SPSS 16 software. The level of significance was set at P less than 0.05. RESULTS The knowledge and performance of spouses in the intervention group were significantly higher 3 months after intervention (P < 0.0001). The quality of life in women in the intervention group was higher 3 months after intervention (P < 0.0001). The mean scores of psychological and physical domains were significantly lower in the intervention group (P = 0.002 and P = 0.001, respectively). CONCLUSIONS The training of menopausal health for spouses improves the quality of life in women during menopausal transition. We suggest integrating such educational programs in menopausal management programs.
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Attitudes Towards Menopause Among Iranian Women: A Systematic Review and Meta-Analysis. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.31012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Genuis SK, Bronstein J. Looking for “normal”: Sense making in the context of health disruption. J Assoc Inf Sci Technol 2016. [DOI: 10.1002/asi.23715] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shelagh K. Genuis
- School of Public Health; University of Alberta; 3-094 ECHA, 11405 87 Avenue Edmonton AB T6G 1C9 Canada
| | - Jenny Bronstein
- Department of Information Science; Bar-Ilan University; Ramat Gan 52900 Israel
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