Alice in menopauseland: the jabberwocky of a medicalized middle age

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.

The nocebo effect for women in waiting

This paper, drawn from a larger phenomenological study, critiques the effects of "waiting" for women when they have an abnormal Pap test result. The hurt and injury incurred by women who perceive they have no choice but to become patient waiters in a health system that seemingly values the time of the health care provider over the health care recipient is discussed. These iatrogenic, unintended, harmful consequences are referred to as the nocebo effect. The participants provide the principal voices and their stories are dialogued to a lesser degree with the literature and the discourse of critical theorists who question power relationships in health professional practice. The purpose of this paper is served when the women's stories strip away some of the taken-for-granted, invisible aspects of the health professional's power.

An application of the theory of life's lesions to the study of the menopausal transition

The aim of this article is to shed light on the experiential and contextual sources influencing menopausal manifestations, or discomforts. To do so, I propose the concept of life's lesions, suggesting that women's experiences of physiological changes occurring during the menopausal transition may be heightened by specific aspects of their lives embedded in society and culture. The concept of life's lesions advances the notion that the lived experience tends to order a person's life and shape a person's experience of his or her body, including during menopause. Indisputably, menopausal discomforts will be due to inexorable biological changes that take place when a woman reaches a certain age, but they will also be promoted by external factors that prevail in a given society, such as economic scarcity, malnutrition and public health deficits, environmental or political upheavals, civil wars, forced migration, and racism, especially in developing nations; most important, they will be furthered by irresolvable contradictions, irreconcilable incongruities, and moral indignations in their lives that lead to anger and anguish. Rooted in the notion of life's lesions is the fundamental assumption that human beings the world over exist in a moral and ideological universe, that they engage in moral evaluations by distinguishing between right and wrong in the social environment. All these factors become part of their physiology and amplify the experience of bodily changes. By pointing to the moral domain and the existence of irresolvable conundrums in human life, which could also be felt as moral affronts and injustice, the concept of life's lesions introduces an important new dimension to our understanding of the extrasomatic causality of discomforts that may occur during the menopausal transition. Although the concept of life's lesions must be studied qualitatively, requiring us to attend to the cultural and experiential characteristics of women during the menopausal transition, the article proposes several ways of applying this concept to the study of menopause that will also generate new hypotheses, which could then be tested using quantitative methodologies.

A Voice of Their Own: Women Moving Into Their Fifties

This purpose of this qualitative study was to illuminate the developmental journey experienced by women moving into their fifties. A purposive sample of 23 women was asked to document any changes they perceived in themselves as they moved from their forties into their fifties. Themes identified included stepping out of the mold, letting go, walking in balance, moving in new directions, redefining relationships, and experiencing a freedom "to be". Understanding the patterns of meaning experienced by healthy women at midlife can provide clinicians with a blueprint for enabling women to become all they can be during late midlife and thereafter.

A sodium-rich carbonated mineral water reduces cardiovascular risk in postmenopausal women

This study was designed to investigate the possible beneficial effects of consuming a sodium-rich carbonated mineral water on lipoprotein metabolism and to determine whether consumption of this water influences endothelial dysfunction (ED) in postmenopausal women. Women included in the study were amenorrheic (>1 y), healthy, and not obese (BMI < 30 kg/m(2)). The subjects did not take estrogen replacement therapy; supplements of vitamins, minerals, and phytoestrogens; or other medications known to affect bone and lipid metabolism. The study consisted of 2 intervention periods of 2 mo each, during which women drank 1 L/d of a control mineral water (low mineral content) for 2 mo followed by the carbonated mineral water, rich in sodium, bicarbonate, and chloride, for 2 mo. Body weight, height, and blood pressure were measured, and BMI was calculated. Blood samples were taken from fasting subjects and serum was analyzed for total cholesterol, HDL-cholesterol, LDL-cholesterol, triacylglycerols, apolipoprotein AI, apolipoprotein B, soluble intercellular cell adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and glucose. Blood pressure levels did not change throughout the study. Carbonated water intake decreased total cholesterol and LDL-cholesterol levels by 6.8% (P = 0.001) and 14.8% (P < 0.0001), respectively, whereas HDL-cholesterol concentration increased by 8.7% (P = 0.018), compared to the control period. Therefore, cardiovascular disease (CVD) risk indexes (total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol) were markedly reduced (both P < 0.0001). Soluble ICAM-1 and sVCAM-1 levels decreased by 8.4% (P = 0.007) and 14.8% (P = 0.015), respectively. Fasting serum glucose concentration decreased by 6.7% (P < 0.0001). Triacylglycerol levels did not change. Consumption of this sodium rich carbonated water can play a beneficial role in the prevention of CVD and the metabolic syndrome.