Stressful life events, psychological appraisal and coping style in postmenopausal women

Menopause as a window of opportunity: the benefits of designing more effective theory-driven behaviour change interventions to promote healthier lifestyle choices at midlife

Menopause is a natural developmental phase that all women go through from their early forties to mid-fifties, marking the transition from the reproductive to the non-reproductive years. This is characterised as the permanent cessation of menses due to progressive ovarian failure. Each woman's experience of the menopause is unique. Biopsychosocial changes occur during this time with some symptoms affecting up to 80 % of women and lasting for 4-5 years from the peri- to post-menopause. Reduced oestrogen may predispose some women to health issues following menopause, such as heart disease, diabetes, stroke and cognitive decline. It is vital to understand how to promote health and well-being to reduce the risk of developing chronic conditions in later life. Increased symptoms and concerns about health during the menopausal transition can be cues to action for some women to actively maintain their health. Menopause represents a window of opportunity to promote health, and to support women to make healthier lifestyle choices, part of the National Institute for Clinical Excellence guidelines for menopause management. Identifying appropriate strategies to change behaviour is less clear. Theories of behaviour change can provide frameworks to gain more insight into the facilitators and barriers to behaviour and can inform the researcher on what needs to change. This information can be used to inform the design, content, implementation and evaluation of a lifestyle intervention. This review paper will explore the impact of menopause on health and well-being generally, and the benefits of designing more effective theory-driven behaviour change interventions for menopause.

Relationships between menopausal symptoms, sense of coherence, coping strategies, and quality of life

OBJECTIVES

The aims of this study were to examine the relationships between menopausal symptoms, sense of coherence (SOC), coping strategies, and quality of life, and to test the mediating effects of SOC and coping strategies on the relationships between menopausal symptoms and quality of life among Chinese women during menopausal transition.

METHODS

Two hundred one women aged 40 to 60 years and currently undergoing menopausal transition were recruited at community centers between June and August 2017. Menopausal symptoms, SOC, coping strategies, and quality of life were assessed by the Menopause Rating Scale, the Sense of Coherence Scale, the Brief COPE Inventory, and the Medical Outcomes Study Short-Form-36, respectively. Data were analyzed by path analysis.

RESULTS

Menopausal symptoms were associated with poorer quality of life, and both SOC and maladaptive coping were found to mediate the effects of menopausal symptoms on quality of life. The results suggest that SOC might alleviate the adverse effects of menopausal symptoms on quality of life, whereas maladaptive coping strategies might aggravate the adverse effects of menopausal symptoms on quality of life.

CONCLUSIONS

The results provide new insights into the importance of considering SOC and coping strategies and their interactions with menopausal symptoms and quality of life in the situation of menopausal transition.

Women Coping Strategies towards Menopause and its Relationship with Sexual Dysfunction

BACKGROUND

Paying attention to sexual dysfunction and its coping strategies is essential owing to its impact on mental health in postmenopausal women and their families. This study aimed to determine the relationship between women coping strategies toward the process of menopause and sexual dysfunction in menopausal women.

MATERIALS AND METHODS

This is a cross-sectional study in which 233 married menopausal women were sampled in the first 5 years after cessation of menstrual cycle using health records in the health centers in Isfahan in 2015. The method of data collection was a demographic characteristics form, sexual function questionnaire of Rosen et al., along with a researcher-made coping strategies questionnaire. The validity and reliability of these instruments were assessed, and the resulting data were analyzed utilizing inferential statistical tests (t-test and Chi-square test) and SPSS 16 software.

RESULTS

According to the results of this study, the relative frequency of sexual dysfunction in menopausal women is 67.42%. The mean score of the avoidance strategy in people with overall sexual dysfunction was significantly higher than the group without disorder (P < 0.001). The mean of coping strategies of social support seeking (P < 0.001), problem-solving (P = 0.016), and target replacement strategy (P = 0.004) were significantly lower than that in the group without disorder.

CONCLUSIONS

In line with the findings of this study, problem-oriented strategies such as social support, problem solving, and target replacement are the best strategies for decreasing sexual dysfunction or increasing sexual satisfaction. These results emphasize the reinforcement of health personnel skills in teaching approach of these strategies to this group of women.

'Its all part of the big CHANGE': a grounded theory study of women's identity during menopause

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.

Predictors of intentions to use hormone replacement therapy in clinical postmenopausal women

OBJECTIVES

To investigate the contribution of components of the Health Beliefs Model (perceived susceptibility, perceived severity, health motivation, perceived risk and benefits of hormone replacement therapy (HRT) use), sociodemographic variables (age, duration of postmenopause, hysterectomy and social class) and psychological stress to intentions to use HRT for the first time.

METHODS

A quasi-experimental design was used to recruit a clinical sample of 180 postmenopausal women, attending a menopause clinic, with a mean age of 50.74 years (standard deviation 4.75 years). Data were collected using self-report questionnaires. A regression analysis was carried out to establish what predicts intentions to use HRT in this sample; sociodemographic variables were entered in the first step of the regression, followed by health motivation and perceived stress in step two, the third step involved the addition of perceived severity measures, and in the final step susceptibility and perceived risks and benefits were added.

RESULTS

The main predictor of intentions to use HRT, after controlling for all other variables, was the belief that the benefits outweigh the risks associated with taking HRT.

CONCLUSIONS

This information should be used to develop interventions and health awareness materials about HRT in clinical postmenopausal women.