Menopausal experiences and hormone replacement therapy use among women with physical impairments

A qualitative study of menopause among women with disabilities

Few studies have examined the way women with disabilities understand and make decisions regarding menopause. This report is a qualitative descriptive study detailing how women with varying mobility impairments view the menopausal transition. Nineteen women aged 42 to 64 years were interviewed regarding their menopausal experiences. Results described their experiences as minority groups of women with disabilities using a women's ways of knowing framework. Overall, most women described menopause as a back burner issue, but maintained the need for accurate information from which to make informed decisions that might impact future health and functional outcomes.

Menopause Health Decision Support for Women With Physical Disabilities

Menopausal women with disabilities present health care providers with unique and challenging health issues. Many women with disabilities already face an ongoing struggle to promote their health and prevent secondary disabling conditions, which may be exacerbated by menopause. This article highlights some of the special health concerns of this population and to suggest ways in which a health care professional might tailor general clinical guidance to meet these women's needs.

Menopause characteristics of women with physical disabilities from poliomyelitis

OBJECTIVE

To describe menopause characteristics of women with physical disabilities from poliomyelitis.

METHODS

Nine hundred and nine women with a history of poliomyelitis completed a survey on health, physical functioning, emotional well being and menopause.

RESULTS

The majority of the sample was postmenopausal having had a natural menopause around the average age of 50.3 years; 34.7% of the sample had had hysterectomies. Thirty-nine percent were using some form of hormone replacement therapy (HRT). Menopause symptoms were clustered into psychological, somatic-sensory, somatic-sleep and vasomotor factors. Among never and past HRT users, there were significant differences in menopause factor severity by menopause status. Somatic/sleep symptoms were lowest in never users; past users had significantly higher vasomotor symptoms; desire for sexual activity and painful intercourse did not vary by HRT use. Compared to population estimates, post-polio women had similar rates of hysterectomies overall, but among some age cohorts they had significantly lower rates, contrary to expectations. However, they used HRT at significantly higher rates than expected.

CONCLUSIONS

This study suggests that basic menopause characteristics of women with polio are generally similar to those of their non-disabled peers. There were few substantial differences in severity of menopause symptoms by HRT use, which is critical in light of the dearth of studies examining its risk-benefit ratio among women with physical disabilities. Until such studies provide some evidence of the specific risks or benefits to women with physical disability, each woman should carefully weigh the known risks and benefits with her physician.

Hormone replacement therapy and health behavior in postmenopausal polio survivors

OBJECTIVES

Little is known about menopause and hormone replacement therapy (HRT) use in women with disabilities. The objectives of this study were to explore the health behaviors, health outcomes, and efficacy of HRT in a group of postmenopausal polio survivors and to compare selected outcomes to nationally representative cohorts.

METHODS

One hundred and thirty-one postmenopausal polio survivors completed self-report surveys on health behaviors, HRT use, functional status, and psychosocial well-being. During a physical examination, fasting cholesterol and body mass index (BMI) were collected. Independent sample t-tests and Chi-square analysis were used to compare HRT users and non-users on health behaviors and health outcomes; logistic regression was used to predict HRT use.

RESULTS

Prevalence of HRT use was 58%. Only BMI predicted HRT use (OR = 0.30, CI: 0.11-0.81). HRT users had better high density lipoprotein (HDL), low density lipoprotein, total cholesterol/HDL ratios, lower BMIs, were more confident when communicating with their physicians, more likely to discuss menopause with their physician, and experienced greater overall stress. HRT was not associated with health behavior, health-related quality of life, mood, or life satisfaction. Compared to non-disabled women, more of these women had higher total cholesterol, obesity, more sleeping problems, and were less likely to vigorously exercise or smoke.

CONCLUSIONS

HRT did not confer substantial benefits in these postmenopausal polio survivors to warrant them using HRT at a higher rate than their non-disabled peers. Comparisons to their non-disabled peers suggested they may be at higher risk for adverse health problems associated with postmenopause.