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Laker B, Rowson T. Making the invisible visible: why menopause is a workplace issue we cannot ignore. BMJ LEADER 2024:leader-2023-000943. [PMID: 38782569 DOI: 10.1136/leader-2023-000943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Benjamin Laker
- University of Reading Henley Business School - Greenlands Campus, Henley-on-Thames, UK
| | - Tatiana Rowson
- University of Reading Henley Business School - Greenlands Campus, Henley-on-Thames, UK
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Walkden SM. "So It's Like a Painful Period?" Living with Endometriosis: My Journey. HEALTH COMMUNICATION 2023:1-5. [PMID: 38111219 DOI: 10.1080/10410236.2023.2296189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
This essay details the author's personal process of being diagnosed with endometriosis, including her experience of medical gaslighting and societal attitudes toward "period pain." Many people who experience excessive menstrual pain report dismissive attitudes and/or trivialization of their symptoms, from both the public and health professionals. The author recalls conversations from throughout her diagnostic journey, which evidence the ingrained beliefs and attitudes of gendered observations of pain. Ultimately, the author contends that the "burden of proof" is with the patient, being forced to continually fight for their right to be heard in an archaic medical system. The people experiencing this condition are experts-by-experience, who are continually providing knowledge about endometriosis, and self-advocating to rewrite the societal narratives concerning menstrual pain. The goal of this essay is not to blame or cause discomfort, but rather to raise awareness and encourage everyone to talk more openly about menstrual related issues. The following prose is written as a first-person account of my experience with this condition, drawing on appropriate support from academic literature.
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Affiliation(s)
- Samantha Marie Walkden
- School of Psychology, Faculty of Social Sciences and Education, Leeds Trinity University
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Nelson LM. The truth about 17-beta estradiol: menopause beyond "old wives' tales". Front Endocrinol (Lausanne) 2023; 14:1229804. [PMID: 37766693 PMCID: PMC10520270 DOI: 10.3389/fendo.2023.1229804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Affiliation(s)
- Lawrence M. Nelson
- Digital Women's Health Initiative, Mary Elizabeth Conover Foundation, Inc., Tysons, VA, United States
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Backonja U, Taylor-Swanson L, Miller AD, Jung SH, Haldar S, Woods NF. "There's a problem, now what's the solution?": suggestions for technologies to support the menopausal transition from individuals experiencing menopause and healthcare practitioners. J Am Med Inform Assoc 2021; 28:209-221. [PMID: 33582820 DOI: 10.1093/jamia/ocaa178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/17/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To elicit novel ideas for informatics solutions to support individuals through the menopausal transition. (Note: We use "individuals experiencing menopause" and "experiences" rather than "symptoms" when possible to counter typical framing of menopause as a cisgender women's medical problem.). METHODS A participatory design study was conducted 2015-2017 in the Western US. Two sessions were held with individuals experiencing menopause recruited from the general public; and 3 sessions with healthcare practitioners (HCPs) including nurses, physicians, and complementary and integrative health (CIH) practitioners were held. Participants designed technologies addressing informational needs and burdensome experiences. HCPs reflected on designs from participants experiencing menopause. Directed content analysis was used to analyze transcripts. RESULTS Eight individuals experiencing menopause (n = 4 each session) and 18 HCPs (n = 10 CIH, n = 3 nurses, n = 5 physicians) participated. All participants provided ideas for solution purpose, hardware, software, features and functions, and data types. Individuals experiencing menopause designed technologies to help understand and prevent burdensome menopause experiences. HCPs designed technologies for tracking and facilitating communication. Compared to nurses and physicians, CIH practitioners suggested designs reframing menopause as a positive experience and accounted for the complex lives of individuals experiencing menopause, including stigma; these ideas corresponded to comments made by participants experiencing menopause. Participants from both populations were concerned about data confidentiality and technology accessibility. CONCLUSIONS Participant generated design ideas included novel ideas and incorporated existing technologies. This study can inform the development of new technologies or repurposing of existing technologies to support individuals through the menopausal transition.
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Affiliation(s)
- Uba Backonja
- School of Nursing & Healthcare Leadership, University of Washington Tacoma, Tacoma, Washington, USA.,Department of Biomedical Informatics & Medical Education, University of Washington School of Medicine, Seattle, Washington, USA
| | | | - Andrew D Miller
- Department of Biomedical Informatics & Medical Education, University of Washington School of Medicine, Seattle, Washington, USA.,School of Informatics and Computing, IUPUI (Indiana University-Purdue University Indianapolis), Indianapolis, Indiana, USA
| | - Se-Hee Jung
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Shefali Haldar
- Department of Biomedical Informatics & Medical Education, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Communication Studies, Northwestern University, Chicago, Illinois, USA
| | - Nancy Fugate Woods
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA
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Abstract
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.
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Erikainen S, Couturier A, Chan S. Marketing Experimental Stem Cell Therapies in the UK: Biomedical Lifestyle Products and the Promise of Regenerative Medicine in the Digital Era. SCIENCE AS CULTURE 2019; 29:219-244. [PMID: 33716572 PMCID: PMC7905833 DOI: 10.1080/09505431.2019.1656183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Stem cell research has attracted much public and biomedical anticipation centred on the possibility of using stem cells to treat various diseases and conditions, but the number of evidence-based therapies is currently limited. Numerous commercial direct-to-consumer (DTC) businesses are nonetheless marketing experimental stem cell therapies online for myriad medical conditions and aesthetic ailments, which has attracted critique due to safety and efficacy concerns. Existing research has largely focused on the problem of unproven therapies and regulatory pathways for addressing it. The proliferation of these experimental products must also be examined, however, in the broader socio-technological context of consumer culture and changing practices of knowledge-making in the digital era. DTC stem cell therapies have emerged as a new biomedical 'lifestyle' product that blurs the boundaries between 'science,' 'medicine,' and 'consumer culture.' In using, conceptualising and marketing stem cells, commercial businesses build on and commercially co-opt alternative epistemic and ontological frames that challenge scientific medicine. They advance promissory narratives about their potential that tap on cultural aspirations around the future of medicine and health. This is key, not only for understanding how and why these therapies have proliferated but also in conceptualising what the 'problem' around them actually is.
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Affiliation(s)
- Sonja Erikainen
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Anna Couturier
- EuroStemCell, Scottish Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, UK
| | - Sarah Chan
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
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Affiliation(s)
- Bharti Kalra
- Department of Gynaecology, Bharti Hospital and BRIDE, Karnal, Haryana, India. E-mail:
| | - Sonia Malik
- Southend Fertility and IVF Centres, National Capital Region, India
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Harris AL, Vitzthum VJ. Darwin's legacy: an evolutionary view of women's reproductive and sexual functioning. JOURNAL OF SEX RESEARCH 2013; 50:207-246. [PMID: 23480070 DOI: 10.1080/00224499.2012.763085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
On the Origin of species, published just over 150 years ago, has deeply influenced thinking in both scientific and wider communities. Darwin's legacy includes recognition of the fact that all organisms evolve; that variation within and between species is natural and normal; and that an evolutionary approach to understanding the sources and consequences of this variation comprises theoretical frameworks, testable hypotheses, and rigorously collected evidence. With an eye toward facilitating communication and productive collaboration among researchers from different intellectual traditions who nonetheless share a common interest in women's reproductive and sexual functioning, we discuss evolutionary concepts and models, summarize the known variability in ovarian functioning and consider the implications of this variability for conducting sex research, and evaluate the relative merits of various biomarkers that serve as proxy measurements of a woman's reproductive and hormonal status. With these perspectives and methods from reproductive ecology at hand, we examine several contentious issues: the links between hormones and sexuality in premenopausal and perimenopausal women, the causes of premenstrual syndrome, and the existence (or not) of menstrual synchrony. In none of these cases is as much known as is often claimed. In each, there are abundant opportunities for innovative, albeit challenging, research.
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Affiliation(s)
- Amy L Harris
- Anthropology Department, Indiana University, Bloomington 47405, USA
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Wu CY, Wu SL, Lin SJ, Chu CMY. Changes in Hormone Therapy Prescriptions Among Middle-Aged Women in Taiwan: Implications for Health Needs at Menopause. Womens Health Issues 2011; 21:153-9. [DOI: 10.1016/j.whi.2010.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2010] [Revised: 08/25/2010] [Accepted: 09/06/2010] [Indexed: 11/30/2022]
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Press coverage of hormone replacement therapy and menopause. Eur J Obstet Gynecol Reprod Biol 2010; 153:56-61. [PMID: 20702017 DOI: 10.1016/j.ejogrb.2010.07.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 04/12/2010] [Accepted: 07/16/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the information reported by Italian press articles about hormone replacement therapy (HRT) and menopause, in terms of completeness, clarity of language and transparency. STUDY DESIGN In the framework of the Consensus Conference Informing women about hormone replacement therapy, 225 articles published from 2000 to 2007 in Italian lay press were evaluated. Health magazines, weekly news magazines, newspapers, women's magazines and medical practitioners' journals were selected. A form covering graphic layout, completeness of information, clarity of language and transparency was applied to each article by a reviewer. The form was tested in a pilot phase. RESULTS HRT was recommended to treat menopausal symptoms in more than half of articles (56%) and was described as a preventive measure in almost half (48%). Risks related to HRT were under-reported (58% of the articles). Information on conflicts of interest was lacking (88%). Opinions of experts were the main source of information cited in the articles (66%). CONCLUSIONS The information reported by the articles is lacking in several aspects. Many women are likely to receive unbalanced information from the press. Qualified sources of information delivered on the scientific knowledge available are needed, reporting advantages and disadvantages of HRT, pharmacological and non-pharmacological alternative treatments and their effectiveness. Scientific journalism needs to grow through training. The role of researchers and clinicians is discussed.
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Vitzthum VJ. The ecology and evolutionary endocrinology of reproduction in the human female. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2009; 140 Suppl 49:95-136. [DOI: 10.1002/ajpa.21195] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ringa V, Fritel X, Varnoux N, Zins M, Quelen C, Bouyer J. Discontinuation of hormone therapy in the French GAZEL cohort 1990-2006. Fertil Steril 2009; 94:1387-1391. [PMID: 19748086 DOI: 10.1016/j.fertnstert.2009.07.1001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 07/09/2009] [Accepted: 07/15/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To analyze changes in hormone therapy (HT) use after the publication of the Women's Health Initiative (WHI) results, in a country (France) where HT is different from that assessed in the WHI. DESIGN Longitudinal study. SETTING Women in the GAZEL cohort of employees of the French national power company. PARTICIPANT(S) One thousand six hundred five postmenopausal women ever-users of HT. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Discontinuation of HT. RESULT(S) Rates of discontinuation were higher after 2002: 65% of users who began HT in 1998 were still using it after 5 years. In contrast, >90% of those who began before 1994 were still using it after 5 years. Discontinuation was associated with women's social and medical characteristics and with factors related to side effects and expectations concerning HT. After adjustment for these factors, women were twice as likely to stop HT after publication of the WHI. CONCLUSION(S) Even in France, publication of the WHI has led to a decline in HT use.
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Affiliation(s)
- Virginie Ringa
- Institut National d'Etudes Démographiques (INED), Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Le Kremlin-Bicêtre, France; University Paris-Sud 11, Faculté de médecine Paris-Sud, Bicêtre Hospital, Le Kremlin-Bicêtre, France.
| | - Xavier Fritel
- INSERM, U953, IFR69, Villejuif, France; University Pierre-et-Marie-Curie Paris 6, Paris, France
| | - Noëlle Varnoux
- Institut National d'Etudes Démographiques (INED), Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Le Kremlin-Bicêtre, France; University Paris-Sud 11, Faculté de médecine Paris-Sud, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Marie Zins
- INSERM, U687, Saint-Maurice, France; Equipe Risques Post-Professionnels-Cohortes (RPPC) du Centre technique d'appui et de formation des centres d'examens de santé (CETAF), Saint-Maurice and Institut Fédératif de Recherche (IFR69), Villejuif, France
| | - Céline Quelen
- Institut National d'Etudes Démographiques (INED), Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Le Kremlin-Bicêtre, France; University Paris-Sud 11, Faculté de médecine Paris-Sud, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Jean Bouyer
- Institut National d'Etudes Démographiques (INED), Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Le Kremlin-Bicêtre, France; University Paris-Sud 11, Faculté de médecine Paris-Sud, Bicêtre Hospital, Le Kremlin-Bicêtre, France
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Markovic M, Manderson L, Warren N. Endurance and contest: women's narratives of endometriosis. Health (London) 2008; 12:349-67. [PMID: 18579632 DOI: 10.1177/1363459308090053] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endometriosis is an often painful medical condition in which, in response to hormones associated with the menstrual cycle, the uterine lining grows in the peritoneum and other organs, bleeding into the surrounding organs and tissues. Diagnosis is not always straightforward, and women and health professionals alike may have difficulties recognizing period pain as a sign of anomaly, considering it instead as an inevitable part of menstruation. This article describes the illness narratives of Australian women with endometriosis, drawing on data collected during a study conducted in Victoria in 2004-5. Thirty women (aged 20-78 years) from various socio-demographic backgrounds participated in in-depth interviews. We explore the influence of socio-demographic background and social and family norms on women's illness narratives of endurance and contest. Narratives of endurance are characterized by the normalization of period pain by young women, their families and health professionals, and, with diagnosis, long-term exposure to biomedical treatments. In contrast, narratives of contest are dominated by how women's subjective experience is challenged by doctors, their requirements for a patient-centered approach, and their desire to have access to complementary treatments.
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Affiliation(s)
- Milica Markovic
- School of Psychology, Psychiatry and Psychological Medicine, Monash University, Victoria, Australia.
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Genuis SK, Genuis SJ. Exploring the continuum: medical information to effective clinical practice. Paper I: the translation of knowledge into clinical practice. J Eval Clin Pract 2006; 12:49-62. [PMID: 16422780 DOI: 10.1111/j.1365-2753.2005.00608.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper investigates the translation of medical information into clinical practice and the role of thoughtful dissent by exploring the influence of sociological factors on change, the impact of evidence-based medicine (EBM), and the role of industry. Changing practice related to hormone therapy for menopausal and post-menopausal women provides context for this discussion. Medical change involves diffusion of ideas to potential users and ongoing reconciliation of new information with old ideas; this process is influenced by sociological factors including values and experiences, interpersonal relationships and local context. While EBM has alerted doctors to the importance of high quality research and theoretically provides a tool for translating research into practice, there are important problems with its application: (1) it has resulted in a reductionist approach to research and illness; (2) there is a considerable gap between research findings and the complex environment of clinical practice; and (3) EBM has been appropriated by experts, thus corporately developed 'standard-of-care' documents have become instruments of external regulation, and EBM has ceased to be a tool in the hand of individual clinicians. In addition, industry impacts the translation of knowledge by significantly influencing academia, researchers, medical publications, consensus conferences, and practising doctors. While questioning doctrinaire practices or directives is a daunting prospect for individual clinicians, the translation of knowledge into practice and evolution of medical thought is dependent on the progressive role of thoughtful dissent.
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Affiliation(s)
- Shelagh K Genuis
- School of Library and Information Studies, University of Alberta, Alberta, Canada
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Genuis SK. Exploring the role of medical and consumer literature in the diffusion of information related to hormone therapy for menopausal women. ACTA ACUST UNITED AC 2006. [DOI: 10.1002/asi.20370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
The world's older population has been growing for centuries; however, the pace of this growth is accelerating rapidly. According to the U.S. Census Bureau, by 2030, more than 60 countries will have 2 million or more older people. Population aging represents a "success story," with increasing numbers of people worldwide enjoying additional years of life. However, the sustained increase in numbers of older people (usually defined as persons over the age of 65) poses many challenges to policy makers and health care providers around the world. As the world population ages, we are just beginning to understand the social, economic, and political implications of the "age wave." The majority of older people are women, thus the implications of population changes for women and women's health are astounding. Nurses can take a national and world leadership role to adequately address the health care needs of increasing numbers of older women.
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Affiliation(s)
- Patricia A Tabloski
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467-3812, USA.
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McLeod JD, Pescosolido BA, Takeuchi DT, White TF. Public attitudes toward the use of psychiatric medications for children. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2004; 45:53-67. [PMID: 15179907 DOI: 10.1177/002214650404500104] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Psychiatric medication use for children has increased dramatically over the past three decades. Despite substantial media attention to the issue, little is known about how the lay public feels about the use of psychiatric medications for children. Drawing on theories of medicalization, we describe and analyze Americans' attitudes towards the use of psychiatric medications generally and Prozac specifically for children described as having three types of behavioral problems. Using data from the 1998 General Social Survey's Pressing Issues in Health and Medical Care Module, we find that more Americans (57%) are willing to use psychiatric medications for children who have expressed suicidal statements than for "oppositional" behaviors (34.2%) or for hyperactivity (29.5%). Across the board, respondents are less willing to give Prozac than the general class of psychiatric medications. While socio-demographics do little to identify Americans with differing positions, the strongest and most consistent correlates of willingness to give psychiatric medications to children are trust in personal physicians, general attitudes towards psychiatric medications, and the respondent's expressed willingness to take psychiatric medications herself or himself.
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Affiliation(s)
- Jane D McLeod
- Department of Sociology, Indiana University, Ballantine Hall 744, 1020 E. Kirkwood, Bloomington, Indiana 47405, USA.
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