Women's midlife confusion: "why am I feeling this way?"

Context-dependent sexual changes during women's midlife transitions

For women, midlife represents an important stage of transition, including shifts in physiological, social, and sexual experiences. Prior research demonstrates that women's sexuality is more dynamic and context-dependent than men's. Most research focused on women's sexuality in mid- to later-life emphasizes physiological changes, while largely ignoring changes stemming from social, psychological, and relational contexts. The present study examined midlife women's diverse sexual experiences within the context of their lives. We conducted semi-structured interviews with 27 women, ages 39-57, and used interpretative phenomenological analysis to investigate perceptions and interpretations of midlife sexual experiences and changes. Themes included changes in sexual engagement, unwanted sexual experiences, body image, and sexual healthcare. Participants reported changes in the frequency of sex and sexual desire within the context of their diverse social roles and identities, prior intimate relationships, and sexual health. Women contrasted perceptions of their own bodies with societal perceptions of sexiness. Frequently reported negative experiences with sexual healthcare informed a distrust of healthcare systems. The diverse and changing nature of participants' experiences supports prior evidence of sexual fluidity and context-dependence. By questioning societal expectations around sexuality and body image, participants illustrated the potential of counternarratives to combat dominant beliefs and stereotypes about midlife women's sexuality. To improve sexual health and education, psychoeducational interventions for women in midlife are needed.

"We're Just Tired": Influences on Sexual Activity Among Male-Partnered Women in Midlife; A Mixed Method Study

Studies into decline in sexual activity among women in midlife produce equivocal findings, some implicating hormonal and physiological changes, others psycho-social and environmental factors. Women's perspectives rarely inform interpretation of the data. Associations between sexual satisfaction, activity and function, and health and lifestyle factors were explored using data from 2133 female participants in the third British National Survey of Sexual Attitudes and Lifestyles (2010-2012). Semi-structured interviews (2012-2015) with 23 women aged 45-59 reporting sexual dissatisfaction in Natsal-3 explored their perceptions of the influences on their sexual activity. Analysis of the survey data showed sexual dissatisfaction to be less common than low frequency and function. Neither menopausal stage nor age was independently associated with any of the dimensions of sexual experience. Only relationship unhappiness was independently associated with all three and communicational difficulty with two (dissatisfaction and lower function). In-depth interviews identified influences on sexual activity not captured in the survey. Tiredness attributed to contemporary challenges of midlife was a dominant theme. Relationship quality mediated its adverse impact. Sexual experience in midlife must be interpreted in light of both life-stage and era, notably, the increasing demands on women in contemporary society and their impact on vitality. Efforts to address sexual wellbeing should take account of the wider social context.

Menopause uncertainty: the impact of two educational interventions among women during menopausal transition and beyond

Introduction

Menopause is a natural part of women's lives, which is associated with physical and mental changes and can lead to uncertainty and consequent undesirable effects in the lives of menopausal women. The present study was conducted to compare the impact of multimedia and booklet educational methods on the uncertainty about menopause during this transition period.

Materials and methods

In a cluster randomized trial 68 women aged 45-55 years were randomly allocated into two groups: multimedia and booklet. Data were collected using knowledge and uncertainty questionnaires about menopause in three stages, i.e. before intervention, immediately after intervention (two weeks later), and one month later. Repeated-measures analysis of variance (rANOVA) was used to compare knowledge and uncertainty scores between two groups for the duration of the study. Data were analysed using SPSS software and p values < 0.05 were considered as statistically significant.

Results

The results of the study indicated a high level of uncertainty in both groups before the implementation of the educational program. There was no significant difference between groups in terms of knowledge and uncertainty about menopause over time (p > 0.05). However, we found a significant increase in knowledge and a significant decrease in uncertainty scores in both groups (p < 0.001) after the interventions.

Conclusions

Although the findings of this study did not show a significant difference between the effect of multimedia and booklet educational methods in postmenopausal women, the high level of uncertainty of women before intervention and its significant reduction after the implementation of the educational programs indicated the importance of education throughout this period.

Migraine in the post-menopausal period is associated with higher levels of mood disorders, disability, and more menopausal symptoms

Objective

To assess the prevalence of headache in post-menopausal women.

Methods

Women attending gynecology outpatient services in the coastal region of the state of Sao Paulo, Brazil were invited to participate in this study. Only those with non-surgical menopause and no hormone replacement therapy were included. Prevalence and characterization of headaches were assessed, as well as the burden of migraine, traits of anxiety and depression, and menopausal symptomatology.

Results

One hundred and three women were included in the study. Migraine affected 14.7% of them. Some previous type of headache was reported by 86.2% of the women, most of whom improved during menopause but still presented with headache attacks. There was a correlation between higher migraine disability and depressive traits.

Conclusions

Many women believe that their headaches, particularly migraine, will end after menopause. This is, unfortunately, not the case for many of them.

Physical activity, evaluation of menopause, life satisfaction and influence tactics in marriage of perimenopausal women

<b>Background</b><br /> Domination of the biomedical approach to menopause may imply creation of negative attitudes to the phenomenon, and at the same time negatively affect women’s life satisfaction and behaviour in the family. It is assumed that physical activity may be a defensive factor, as this type of activity may reduce the intensity of menopause symptoms. The aim of the research was to determine the relation between menopause evaluation, life satisfaction and tactics of influence employed in marriage by women who differ in involvement in physical exercise.<br /> <br /> <b>Participants and procedure</b><br /> The research was conducted among 90 women, at the age of 45-55: 45 physically active women and 45 women who do not engage in any physical activity. The following research methods were used: the Menopause Evaluation Scale, the Satisfaction With Life Scale (SWLS) and the Questionnaire of Influence in Close Relations of Women and Men.<br /> <br /> <b>Results</b><br /> Positive evaluation of menopause was related to involvement in physical exercise as well as to a stronger tendency to use positive strategies of exerting influence on one’s spouse. The research also showed a slight correlation between life satisfaction and involvement in physical exercise. Negative evaluation of menopause was related to avoiding physical activity. <br /> <br /> <b>Conclusions</b><br /> Physical activity is more frequently related to a positive attitude towards menopause and the use of more positive tactics of exerting influence on one’s spouse, and slightly positively conducive to one’s life satisfaction level.

Uncertainty during perimenopause: perceptions of older first-time mothers

AIM

This article is a report of a study exploring older first-time mothers' perceptions of health during their transition to menopause.

BACKGROUND

Increasing numbers of women world-wide are delaying motherhood, yet little is known about the unique phenomenon created when midlife motherhood is closely followed by the transition to menopause. A literature search revealed that the effect of these overlapping life transitions on women's health was unknown.

DESIGN

A hermeneutic phenomenological approach utilizing Gadamer's philosophical underpinnings guided the study.

METHOD

A purposive sample of thirteen women aged 45-56 years who were mothering children aged 12 years or younger and experiencing symptoms of perimenopause was recruited. Two in-depth interviews were conducted with each woman and meaning was mutually negotiated through participative dialogue with the women, ongoing construction and thematic analysis of data collected between 2004 and 2007.

FINDINGS

The key theme 'Perimenopause as a State of Uncertainty' is an interpretation of older first-time mothers' perceptions of health during perimenopause and is the focus of this article. Hermeneutic interpretation culminated in the construct 'uncertainty' as theoretical embodiment of the women's lived experience. An uncertain temporality, projection of the lifespan and valuing health as precious enabled these women to transform uncertainty into opportunities for health promotion to 'be there' for their children.

CONCLUSION

Nurses, nurse practitioners and midwives will increasingly be caring for midlife mothers and need to understand the unique issues of older mothers to offer education and health promotion that support healthy transitions to menopause.

The menopausal transition: does it induce women's worries about aging?

OBJECTIVE

This study examines whether patterns of worries about aging change in women during the menopausal transition.

DESIGN

A population-based sample of 261 Australian-born women aged 45-55 years at baseline participated in a longitudinal study. Data were collected at baseline and in the 5th year of annual follow-up interviews. Measures included the Attitudes to Aging Scale which is based on a scale developed by Kaufert and Syrotuik and contained the six-item version which examines worries about specific losses. Menopausal status was determined by menstrual status as follows: late reproductive, early menopausal transition, late menopausal transition, and postmenopause.

RESULTS

Data analysis carried out by cross-tabulation found that 36% of participants did not change their attitudes over the 5-year follow-up period, 30% became more worried and 33% became less worried and there was no significant difference between those who had or had not experienced the menopausal transition. There was no significant association between the scores on the Attitudes to Aging Scale and changes in the self-rated health, work status and marital status.

CONCLUSION

The menopausal transition does not induce an overall increase in worries about aging.

Challenging social myths and stereotypes of women and aging: heterosexual women talk about sex

Cultural representations of aging and sexuality combine to paint a particular picture of mid and later life for women: menopause is constructed as a time when women either lose or renew their interest in sex, and later life a time when sexual activity no longer assumes importance yet remains vital to healthy aging. This article examines the importance of sexual activity to "older" women, paying particular attention to how they negotiate such representations. In-depth interviews were conducted with 19 women aged 50 and older recruited from Sheffield, UK. A material-discursive analysis revealed that whilst participants rejected the asexual discourse of aging they accepted it for women older than themselves. They constructed women per se as sexually complex, in comparison to men, making sexual activity "risky business" for women, and positioned their own sexual desire as responsive, either to a man's sexual desire or to their own hormones. Finally, sexual activity was constructed as having psychological and physiological benefits for couples within committed relationships. The findings are discussed in terms of their implications for research, theory and clinical practice.

O climatério: a corporeidade como berço das experiências do vivido

Estudo qualitativo de abordagem fenomenológica, realizado a partir do depoimento de mulheres entre 48 e 55 anos, que haviam apresentado menopausa espontânea há 12 meses ou mais. Os resultados evidenciaram cinco categorias temáticas que foram analisadas e interpretadas à luz do referencial teórico filosófico de Maurice Merleau-Ponty. Dentre as categorias que emergiram dos depoimentos destacou-se o tema: "Conscientiza-se do mundo por meio do seu corpo no tempo e no espaço", que será apresentado com o objetivo de estimular a reflexão sobre aspectos existenciais da vivência desta fase do ciclo reprodutivo e fazer considerações sobre a assistência à saúde da mulher climatérica.

"Feeling frumpy": the relationships between body image and sexual response changes in midlife women

This study investigated the relationships between self-rated attractiveness and self-reported sexual response changes (over the past decade) and current sexual satisfaction in 307 heterosexual, midlife women. Results indicated that regardless of the woman's specific age, she was more likely to consider herself more attractive when she was 10 years younger and her self-perceived attractiveness did not significantly differ based on her menopausal status. The more a woman perceived herself as less attractive than before, the more likely she was to report a decline in sexual desire or frequency of sexual activity. The more she perceived herself as attractive, the more likely she was to experience an increase in sexual desire, orgasm, enjoyment, or frequency of sexual activity. There were no significant statistical relationships between a woman's perception of her own attractiveness as she aged and her current sexual satisfaction.

Psychological aspects of menopause management

The influence of endocrine function on the mood of the menopausal woman continues to be debated and researched. While many women present at the menopause with depression and anxiety, the reasons for these mood disorders cannot be attributed to menopause status alone. The influence of psychological factors, lifestyle, body image, interpersonal relationships, role, and sociocultural factors in predicting levels of depression and anxiety in the menopausal patient cannot be ignored. This chapter discusses the research to date on menopause and depression and anxiety. Included is a discussion of the role of psychosocial factors in the symptomatology of perimenopausal, post-menopausal and prematurely menopausal women. The importance of understanding the individual menopausal experiences of women within the context of their lives while offering support, education, and validation is highlighted. The need for a multidimensional approach to treating the menopausal woman who presents with mood disorders is examined. Finally, this chapter makes it clear that psychosocial aspects of menopause management require further research, particularly on the experiences of women who enter menopause prematurely.

Now you see it, now you don't--the confusing case of confusion as an emotion: commentary on Rozin and Cohen (2003)

P. Rozin and A. B. Cohen (2003) contend that confusion is an emotion because it is valenced, it has a distinct facial expression, and it has a distinct internal state. On the basis of these criteria, they call for further study of this unstudied stateand challenge emotion researchers to consider "confusion" to be an emotion. The author agrees with Rozin and Cohen (2003) that confusion is an affective state, is valenced, has an (internal) object, may be expressed facially, and that laypersons may, under certain circumstances, consider it an emotion. However, its expression is likely to be an expressive component of emotions for which goal obstruction is central. Further, confusion may also not be as commonly considered an emotion by laypersons, as Rozin and Cohen contend. Finally, confusion is not unstudied, only most of the time it is not emotion researchers who do the researching.