Voices from the Hilo Women's Health Study: talking story about menopause

The Multiple Pharmacologic Functions and Mechanisms of Action of Guizhi Fuling Formulation

Objectives

Guizhi Fuling Formulation (GZFL), a traditional Chinese medical formulation, consists of Cinnamomi Ramulus, Paeoniae Radix Alba (or Paeoniae Radix Rubra), Moutan Cortex, Persicae Semen, and Poria, with multiple therapeutic functions such as sedation, antitumor activity, anti-inflammation, and neuroprotection. However, its clinical applications remain relatively fragmented, and the underlying mechanisms of GZFL in different diseases are still not very certain. Further research and summary in both application and mechanisms remain to be needed for human health and the best use of GZFL. Therefore, we summarized the multiple pharmacologic effects and possible mechanisms of action of GZFL according to recent 17 years of research.

Methods

We retrieved four English and two Chinese databases using these keywords (the formulation name or its synonyms) and searched articles written in English from January 2006 up to February 2022. Key Findings. GZFL exhibits multiple pharmacologic advantages in gynecologic diseases and other expanding diseases such as cancer, blood, and vascular disease, renal failure, inflammation, and brain injury. Possibly due to its diverse bioactive components and pharmacologic activities, GZFL could target the multiple signaling pathways involved in regulating blood circulation, inflammatory and immune factors, proliferation, apoptosis, and so on.

Conclusion

This review suggests that GZFL displays promising therapeutic effects for many kinds of diseases, which have been beyond the scope of the original prescription for gynecologic diseases. In this way, we wish to provide a reference and recommendation for further preclinic and clinic studies.

Age at menopause among rural and urban women in the state of Campeche, Mexico

OBJECTIVE

The purpose of this study was to examine age at natural menopause among women of Maya and non-Maya ancestry living in urban and rural communities in the state of Campeche, Mexico.

METHODS

Women ages 40 to 60 (n = 543) participated in semi-structured interviews and anthropometric measures. The last names, languages spoken, and the birthplace of the woman, her parents, and her grandparents were used to determine Maya or non-Maya ethnicity. Recalled age at natural menopause was compared across four communities; analysis of variance was used to compare means and Kaplan-Meier analyses were used to compare medians. Probit analysis was also used to estimate median ages at menopause. Cox regression analyses were applied to identify variables associated with age at menopause.

RESULTS

Mean recalled age at natural menopause across all sites was 46.7 years, ranging from 47.8 years in the city of Campeche to 43.9 years in the rural Maya communities in the municipality of Hopelchén. Median ages at menopause across all sites were 50.55 years by probit analysis and 50.5 years by Kaplan-Meier. Variables associated with a later age at menopause included higher socioeconomic status, higher parity, and a later age at menarche.

CONCLUSIONS

The early mean recalled age at menopause in southern Hopelchén was consistent with previous studies in the Yucatán peninsula. As expected, probit and Kaplan-Meier analyses demonstrated later ages at menopause. Contrary to our expectations, Maya/non-Maya ethnicity was not associated with age at menopause. Demographic and reproductive factors were more important than ethnicity in explaining variation in age at menopause within the state of Campeche, Mexico.

A meta ethnography of the cultural constructs of menopause in indigenous women and the context of Aotearoa/New Zealand

The researchers aim in this synthesis is to interpret the cultural constructions of menopause in Indigenous women and apply these interpretations to the context of Māori women in Aotearoa/New Zealand. There is a lack of research about Indigenous women's interpretations of health, and how culture mediates understandings and experiences of menopause. There is even less research regarding Māori women's understandings and experiences of menopause, as the discourse is dominated by Western ideology. Using meta ethnography methodology, the researchers selected eight studies, that provided the foundations to enable the interpretation of the cultural constructions of menopause in Indigenous women. The findings were then translated into four metaphors- natural, cultural protection, freedom and idiomatic and then were subsequently translated to Māori concepts mana wahine, Mātauranga Māori, tikanga and pepeha. We suggest that broader mainstream understandings of the cultural constructions of menopause for Indigenous women are necessary to provide equitable health outcomes for Māori and other Indigenous women. The researchers further developed a model that can be used to represent the foundations of Māori women's conscious understandings and experience of menopause.

Centrality of family bonds in the experience of middle-aged women

OBJECTIVE

To analyze meanings attributed to middle-aged women from their experience in their family relationships.

METHOD

Qualitative study of the Convergent Care Research method. Gender was used as an analytical category, developed with a total of thirteen middle-aged women from the coverage area of the Family Health Strategy program in a city in the southwest of Bahia state, through reflection workshops and interviews. Data were analyzed using discourse analysis.

RESULTS

They express the affective relationship with children and grandchildren as the greatest highlight of middle age in overlap with the relationship with partners and other bonds, which makes their uniqueness and identification of demands for health care unfeasible.

CONCLUSION

Female middle-aged are marked by conceptions of femininity that emerge from their condition as a woman-mother, from her complete donation. The research points to an urgent need to add gender as a reference for the care of middle-aged women, in order to consider the biopsychic and social interlaces in their life experience and that outline demands for care.

#Menopause on Instagram: a mixed-methods study

OBJECTIVE

The aims of this study were to: (1) characterize the menopause transition (MT) on social media and (2) determine if concordance or discordance exists when comparing MT-focused social media posts and biomedical research literature.

METHODS

We analyzed 440 sequential Instagram posts with the hashtag #menopause over 2 weeks from January to February 2019. Posts were composed of 299 unique accounts, resulting in an average of 1.7 posts per account (standard deviation [SD] 1; range 1-9; median 1 and interquartile range [IQR] 1-2). Each account had an average of 2,616 followers (SD 11,271; range 3-129,000; median 421.5 and IQR 177-1,101). Content and thematic analyses were completed for posts, images, and videos to identify codes related to the MT. The top 15 codes were then searched along with the key term "menopause" in PubMed to ascertain the level of concordance between Instagram content and peer-reviewed literature on the MT.

RESULTS

We identified 69 codes in our corpus of Instagram content, resulting in 9 categories: physical health, mental health, complementary and integrative health, advertising, social, advice, self-care, nature, and self-expression (kappa 0.95-1.00). The most prevalent codes were related to weight loss/fitness (20.5%) and hormones (18.4%). The majority of frequent codes identified in Instagram posts were infrequently listed in biomedical literature related to menopause. However, there were two codes, Weight loss/Fitness and Hot flashes, that were frequently discussed in Instagram posts and the biomedical literature.

CONCLUSIONS

The examination of #menopause on Instagram provides novel insights for researchers and clinicians. Our findings provide a better understanding of the experiences and support needs of individuals experiencing menopause. Furthermore, codes related to menopause have low prominence in the biomedical literature, suggesting key topics that could be explored in the future.

Experiencing menopause in the UK: The interrelated narratives of normality, distress, and transformation

We investigated the experience and perspectives of menopause among 48 UK mothers through qualitative in-depth interviews. Interviews were analyzed thematically then explored using social science theories. Three interdependent narratives emerged: menopause as a normal, biological process, distinct from self and social transitions; menopause as struggle, an "idiom of distress" expressing upset, identity loss, shame, and social upheaval; and menopause as transformative and liberating, arising from biopsychic and relational changes. Some women followed a predictable "rite of passage" trajectory with transformation emerging from distress, but not all: Menopause arises from a complex interplay of personal predicament, somatic change, and sociocultural context.

Rise and fall: two sides of a coin of middle aged women's perceptions of reproductive: a qualitative study

The present study was conducted to determine the perceptions of middle-aged women of reproductive changes. The present study was a qualitative research with a content analysis approach. The participants were 30 middle-aged women whose perceptions of reproductive changes had been collected on in-depth semi-structured interviews. The data were analyzed using the Graneheim and Lundman's inductive content analysis method. The main themes extracted from the data were a sense of "fall" and "the beginning of a new life cycle." A feeling of fall was formed from the subthemes "deterioration of youth," "the dusk of femininity," and "fade-out of the gender roles." The theme "beginning of a new life cycle" was formed from the subthemes of "acceptance," "sophistication," and "maturity." Middle-aged women had a wide range of emotions experienced from the reproductive changes ranging from a feeling of decline to that of excellence and rise.

Identifying self-care behaviors in middle-aged women: A qualitative study

Background

Women in their middle-age enjoy abilities that affect their health promotion and improvement. Throughout their entire lifetime, women strive to maintain and improve their health through benefiting from behaviors that come from experience.

Objective

This study was carried out with the aim of identifying self-care behaviors that middle-aged women consider as far as maintaining and promoting their health are concerned.

Methods

The study was conducted using a qualitative approach in conventional content analysis. Participants comprised of 20 middle-aged women from Zahedan, Iran in 2016 that were invited to enter the study using purposive sampling, and were given semi-structured interviews. After data collection, all interviews were transcribed, reviewed and then the subcategories were extracted.

Results

The findings of this study include a main category “preventive self-care behaviors” and three subcategories of “understanding health and disease”, “health knowledge” and “awareness of the health threats”.

Conclusion

The findings suggest that preventive self-care behaviors of women are associated with features such as understanding health and disease, health knowledge and awareness of the associated health risks. As a matter of fact, preventive behaviors encompass strategies that women apply to improve their physical and mental health.

Understanding the Contextual Factors Affecting Women's Health in Sistan and Baluchestan Province in Iran: A Qualitative Study

BACKGROUND

Contextual factors impact health the same way social and cultural conditions do. Women's health, with its varying dimensions, is also under the influence of biological, societal, and cultural contexts. This typical condition has been developed along the continuum of their life cycle, bearing close correlation with their lif style. Therefore, identifying those marices within which women's health behaviors are formed is important.This study aims at exploring the contextual factors affecting women's health in Sistan and Baluchestan in Iran.

METHODS

This study was carried out using a qualitative method, on a content analysis approach. Participants were 20 middle-aged women from Zahedan who entered the study with purposive sampling method. The method of collecting data was face-to- face and through conducting semi-structured interviews. After data collection, all interviews were transcribed, andreviewed, from which categories were extracted. The semantic similarities were revised and subcategories were identified, and then the related subcategories were arranged under one category.

RESULTS

Two main categories of "features of context-based structure" and "changes in the cultural context" prove to be the basis for health behaviors in women. As for the category of "characteristics of context-based structure", individual, familial and environmental characteristics were identified, and regarding the category of "changes in the cultural context", the context-based cultural features were identified.

CONCLUSION

The findings of the study suggest that effective contextual factors influencing women's living conditions had a decisive role in their health behaviors. In fact, the context- based structure in association with the cultural changes that have occurred in the beliefs of men and women, have had a decisive role in the women's health behaviors.