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Cortés YI, Altemus M, Reame NE. From maca to marijuana: cultural influences on joint pain symptoms and management in urban perimenopausal and early postmenopausal Latinas. Menopause 2024; 31:756-763. [PMID: 39078653 PMCID: PMC11469668 DOI: 10.1097/gme.0000000000002396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/24/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVE The purpose of this qualitative study was to explore the symptom experience and coping strategies for managing joint pain during the menopause transition in urban Latina women. METHODS We conducted focus groups with 13 English-speaking peri and early postmenopausal Latinas living in Upper Manhattan in New York City in 2014. Eligible participants were self-identified Latinas aged 45 to 60 years with new onset or worsening joint pain and spontaneous amenorrhea, recruited through flyers and snowball sampling. Focus group interviews conducted in English were audiotaped, transcribed, and analyzed by a bilingual research team, using NVivo software (QSR International) to organize and code themes. RESULTS On average, participants were aged 51.7 ± 4.8 years and overweight (body mass index of 29.3 ± 6.7 kg/m 2 ); 10 (76.9%) were Puerto Rican, and the last menstrual period was 1 month to 5 years ago. The following four themes emerged: 1) menopause and joint pain are an alarming package; 2) pain disrupts life and livelihood; 3) medical management is unsatisfactory and raises worries about addiction; and 4) home remedies for coping with pain-from maca to marijuana. Despite access to a world-class medical facility in their neighborhood, women seeking pain relief preferred to self-manage joint pain with exercise, over-the-counter products, and other culturally valued home remedies. Many suffered through it. CONCLUSIONS For midlife Latinas, joint pain symptoms may emerge or worsen unexpectedly as part of the menopause transition and carry distressing consequences for daily activities and quality of life. There is a need to develop more culturally specific approaches for menopause-related pain management in this underserved population.
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Gerber LM, Sievert LL. Neighborhood disorder, exposure to violence, and perceived discrimination in relation to symptoms in midlife women. Womens Midlife Health 2018; 4:14. [PMID: 30766724 PMCID: PMC6297945 DOI: 10.1186/s40695-018-0043-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 09/21/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Some symptoms at midlife are associated with stress, such as hot flashes, trouble sleeping, headaches, or depressed mood. Hot flashes have been studied in relation to laboratory stressors, physiological biomarkers, and self-reported stress, but less is known about hot flashes in relation to the larger context of women's lives. This study examined the risk of symptoms in relation to neighborhood disorder, exposure to neighborhood violence, social cohesion and perceived discrimination. We hypothesized that women exposed to more negative neighborhood characteristics and discrimination would be more likely to report hot flashes and other midlife symptoms. METHODS Participants were black and white women, aged 40 to 60, drawn from a cross-sectional investigation of race/ethnicity, socioeconomic status, and blood pressure in New York City (n = 139). Demographic information, medical history, menopausal status, and symptoms were measured by questionnaire. Likert scales were used to measure neighborhood characteristics, specifically, the Neighborhood Disorder Scale, the Exposure to Violence Scale, the Perceived Violence Subscale, the Neighborhood Social Cohesion and Trust Scale, and the Everyday Discrimination Scale. Ten symptoms were included in analyses: lack of energy, feeling blue/depressed, backaches, headaches, aches/stiffness in joints, shortness of breath, hot flashes, trouble sleeping, nervous tension, and pins/needles in hands/feet. Each scale with each symptom outcome was examined using logistic regression analyses adjusting for significant covariates. RESULTS Black women reported higher scores on all negative neighborhood characteristics and discrimination, and a lower score on the positive Neighborhood Social Cohesion and Trust. Neighborhood Disorder was associated with feeling blue/depressed, aches/stiffness in joints, and hot flashes, and Perceived Violence was associated with aches/stiffness in joints, after controlling for model-specific covariates. There was a lower risk of backaches with increasing Neighborhood Social Cohesion and Trust score. The Everyday Discrimination Scale was associated with lack of energy. Lack of energy, feeling blue/depressed, aches/stiffness in joints, and hot flashes appeared to be most vulnerable to negative neighborhood context and discrimination. CONCLUSIONS This study adds to the literature linking neighborhood environments to health outcomes. The associations between negative neighborhood contexts and discrimination with diverse symptoms, and the association between social cohesion and back pain, point to the need to expand analyses of stress to multiple physiological systems.
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Affiliation(s)
- Linda M Gerber
- Department of Healthcare Policy & Research, Division of Biostatistics and Epidemiology, Weill Cornell Medical College, 402 E. 67th St., LA-231, New York, NY 10065 USA
- Department of Medicine, Division of Nephrology and Hypertension, Weill Cornell Medical College, New York City, NY USA
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Abshirini M, Siassi F, Koohdani F, Qorbani M, Khosravi S, Hedayati M, Aslani Z, Soleymani M, Sotoudeh G. Dietary total antioxidant capacity is inversely related to menopausal symptoms: a cross-sectional study among Iranian postmenopausal women. Nutrition 2018; 55-56:161-167. [PMID: 30086485 DOI: 10.1016/j.nut.2018.04.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/12/2018] [Accepted: 04/21/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to assess the association between dietary total antioxidant capacity (DTAC) and menopausal symptoms (MS) in postmenopausal middle-aged women. METHODS A cross-sectional study was conducted with 400 postmenopausal women who referred to municipality health houses and health centers in south Tehran, Iran. Sociodemographic data and anthropometric measures such as body weight, height, and waist circumference were determined. Dietary intake was assessed using a 147-item validated food frequency questionnaire. Energy-adjusted DTAC was calculated using the US Department of Agriculture database. Individual MS was measured by the Menopause Rating Scale questionnaire. RESULTS Multivariable linear regression analyses indicated that DTAC was negatively associated with total Menopause Rating Scale score, somatic and psychological score, which was independent of confounding variables such as age, education, waist circumference, total physical activity, dietary intake of fiber, tea and coffee intake, total energy intake, and dietary supplement use (P < 0.001). Additionally, in logistic regression, a negative association between MS and DTAC was observed, which was independent of confounding variables (Ptrend = 0.002). Logistic regression for each symptom indicated that higher DTAC was associated with reduction in hot flashes and sweating, sleep problems, anxiety, exhaustion, and difficulty concentrating. However, a significant positive association was observed between DTAC and sexual problems. CONCLUSION DTAC is inversely associated with MS, which could be of particular significance for somatic and psychological symptoms. These findings indicate that DTAC could be an important basis for developing an effective dietary measure for reducing MS.
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Affiliation(s)
- Maryam Abshirini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Koohdani
- Department of Cellular, Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Shahla Khosravi
- Department of Social Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Aslani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Soleymani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Mazor M, Lee K, Dhruva A, Cataldo JK, Paul SM, Melisko M, Smoot BJ, Levine JD, Elboim C, Conley YP, Miaskowksi C. Menopausal-Related Symptoms in Women One Year After Breast Cancer Surgery. J Pain Symptom Manage 2018; 55:1138-1151.e1. [PMID: 29221848 PMCID: PMC5856592 DOI: 10.1016/j.jpainsymman.2017.11.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 11/18/2022]
Abstract
CONTEXT Approximately 60% to 100% of women with breast cancer experience at least one menopausal-related symptom. Little is known about associations between menopausal status and symptoms in women 12 months after breast cancer surgery. OBJECTIVES The purpose of this study was to evaluate for differences in occurrence, severity, and distress of symptoms between pre- and postmenopausal women 12 months after breast cancer surgery. METHODS Women with breast cancer (n = 327) completed the Menopausal Symptoms Scale, which evaluated the occurrence, severity, and distress of 46 common menopausal-related symptoms. Regression analyses were used to evaluate between-group differences in the seven symptoms that occurred in 30% and more of the sample (i.e., hot flashes, night sweats, depression, daytime sweats, joint pain or stiffness, wake during the night, and numbness or tingling). RESULTS Of the 327 patients with breast cancer, who completed the 12-month assessment, 35.2% were premenopausal and 64.8% were postmenopausal before surgery. In the conditional models, when significant interactions were found, the differences in symptom occurrence rates between pre- and postmenopausal patients depended on their age. CONCLUSION Regardless of menopausal status, women reported relatively high occurrence rates for several menopausal symptoms. Associations between symptom occurrence rates and menopausal status depended on the patient's age. During the development of a survivorship care plan, clinicians need to assess symptom burden within the context of a woman's menopausal status and salient demographic and clinical characteristics. This approach will assist with the prescription of more effective interventions.
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Affiliation(s)
- Melissa Mazor
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Kathryn Lee
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Anand Dhruva
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Janine K Cataldo
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Michelle Melisko
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Betty J Smoot
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Charles Elboim
- St. Joseph Health Medical Group, Santa Rosa, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christine Miaskowksi
- School of Nursing, University of California at San Francisco, San Francisco, California, USA.
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Waterer G. Recovery from community acquired pneumonia: the view from the top of the iceberg. Eur Respir J 2017; 49:49/6/1700571. [DOI: 10.1183/13993003.00571-2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 03/20/2017] [Indexed: 11/05/2022]
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Tonob D, Melby MK. Broadening our perspectives on complementary and alternative medicine for menopause: A narrative review. Maturitas 2017; 99:79-85. [PMID: 28364873 DOI: 10.1016/j.maturitas.2017.01.013] [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] [Received: 01/19/2017] [Accepted: 01/26/2017] [Indexed: 12/20/2022]
Abstract
Complementary and alternative medicine (CAM) is widely used for menopause, although not all women disclose use to their healthcare providers. This narrative review aims to expand providers' understanding of cross-cultural approaches to treating and managing menopause by providing an overarching framework and perspective on CAM treatments. Increased provider understanding and awareness may improve not only provider-patient communication but also effectiveness of treatments. The distinction between illness (what patients suffer) and disease (what physicians treat) highlights the gap between what patients seek and doctors provide, and may help clarify why many women seek CAM at menopause. For example, CAM is often sought by women for whom biomedicine has been unsuccessful or inaccessible. We review the relevance to menopause of three CAM categories: natural products, mind-body practices including meditation, and other complementary health approaches including traditional Chinese medicine (TCM) and Japanese Kampo. Assessing the effectiveness of CAM is challenging because of the individualized nature of illness patterns and associated treatments, which complicate the design of randomized controlled trials. Because many women seek CAM due to inefficacy of biomedical treatments, or cultural or economic marginalization, biomedical practitioners who make an effort to learn about CAM and ask patients about their CAM use or interest may dramatically improve the patient-provider relationship and rapport, as well as harnessing the 'meaning response' (Moerman, 2002) imbued in the clinical encounter. By working with women to integrate their CAM-related health-seeking behaviors and treatments, providers may also boost the efficacy of their own biomedical treatments.
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Affiliation(s)
- Dunia Tonob
- Department of Anthropology, University of Delaware, USA
| | - Melissa K Melby
- Department of Anthropology, University of Delaware, USA; College of Health Sciences, University of Delaware, USA.
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Whole plant foods intake is associated with fewer menopausal symptoms in Chinese postmenopausal women with prehypertension or untreated hypertension. Menopause 2015; 22:496-504. [DOI: 10.1097/gme.0000000000000349] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Our purpose for this study was to identify clusters of midlife women by menopausal symptoms in a multiethnic sample, and to determine ethnic differences in the clusters. This was a secondary analysis of data from 501 women in a larger Internet study on menopausal symptom experiences. The data were analyzed using factor analysis, hierarchical cluster analysis, and multinominal logistic analysis. A three cluster solution was adopted (F = 575.71, p <.01). The clusters differed significantly in the country of birth and ethnicity (p <.05). Only in the low symptomatic cluster were there significant ethnic differences in menopausal symptoms.
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Affiliation(s)
- Eun-Ok Im
- a School of Nursing, University of Pennsylvania , Philadelphia , Pennsylvania , USA
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Ferrand F, Hajri S, Benzineb S, Draoui DM, Hassoun D, Delanoë D, Zins M, Ringa V. Comparative study of the quality of life associated with menopause in Tunisia and France. Menopause 2013; 20:609-22. [DOI: 10.1097/gme.0b013e318278b0ce] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Reed SD, Lampe JW, Qu C, Gundersen G, Fuller S, Copeland WK, Newton KM. Self-reported menopausal symptoms in a racially diverse population and soy food consumption. Maturitas 2013; 75:152-8. [PMID: 23562010 DOI: 10.1016/j.maturitas.2013.03.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/01/2013] [Accepted: 03/05/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Evaluate the association of self-reported vasomotor symptom (VMS) frequency with race/ethnicity among a diverse midlife US population and explore menopause symptom differences by dietary soy isoflavone (genistein+daidzein) consumption. STUDY DESIGN Cross-sectional population-based study of peri- and postmenopausal women, ages 45-58. OUTCOMES Recent VMS frequency, VMS ever; recent symptom bother (hot flashes, night sweats, headache and joint-ache). RESULTS Of 18,500 potentially eligible women, 9325 returned questionnaires (50.4% response); 3691 were excluded (premenopausal, missing data, taking hormones). Of 5634 remaining women, 82.1% reported hot flashes ever, 73.1% reported night sweats ever; 48.8% and 38.6% reported recent hot flashes or night sweats, respectively. Compared with White women, Chinese, Japanese, Vietnamese, other Asian (each p<0.001) and Filipino (p<0.01) women less commonly reported ever having hot flashes; Asian women less commonly reported recent VMS bother (p<0.001). Black women more commonly reported hot flashes ever (p<0.05) and recent VMS bother (p<0.05). Compared with non-Hispanic White women, Hispanic women were less likely to report hot flashes (p<0.05) or night sweats (p<0.001) ever. Women were classified by isoflavone consumption: (1) none (n=1819), (2) 0.01-4.30 mg/day (n=1931), (3) 4.31-24.99 mg/day (n=1347) and (4) ≥ 25 mg/day (n=537). There were no group differences in recent VMS number/day: (1) 7.0 (95% CI 6.5, 7.5); (2) 6.4 (95% CI 6.0, 7.1); (3) 7.0 (95% CI 6.3, 8.2); and (4) 6.8 (95% CI 6.1, 7.7). CONCLUSIONS Menopausal symptoms, independent of isoflavone intake, varied considerably by race/ethnicity and were least common among Asian races.
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Abstract
With increasing interests in oppressed groups, the number of feminist studies in nursing has steadily increased. Despite the increasing number of feminist studies, very few articles have been written to provide practical guidelines for feminist research in nursing. In this article, guidelines for feminist research in nursing are proposed on the basis of 3 previous feminist studies. First, characteristics of feminist research are concisely described. Then, the 3 studies that are the basis for the guidelines are described. Finally, practical guidelines for feminist nursing research are proposed on the basis of 10 idea categories related to issues/concerns from the 3 studies.
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Detecting cross-cultural differences in somatization. Menopause 2012; 19:121-2. [DOI: 10.1097/gme.0b013e318240bfbf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Melby MK, Sievert LL, Anderson D, Obermeyer CM. Overview of methods used in cross-cultural comparisons of menopausal symptoms and their determinants: Guidelines for Strengthening the Reporting of Menopause and Aging (STROMA) studies. Maturitas 2011; 70:99-109. [DOI: 10.1016/j.maturitas.2011.07.011] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 07/13/2011] [Accepted: 07/14/2011] [Indexed: 11/27/2022]
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