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Representations and Perceived Consequences of Menopause by Peri- and Post-Menopausal Portuguese Women: A Study
– Reported, June 04, 2013
Womens representation of menopause and their response to this period of life rejects both medical and nonmedical perceptions. Given the importance of the support that is rendered by health care providers to menopausal women, in terms of both information and meaning , and also of the psychosocial and cultural contexts in determining the meaning and impact of menopause, the investigation of how peri- (i.e., when women start having a variable cycle length or at least two skipped cycles and an interval of amenorrhea of at least 60 days) and post-menopausal women (that is, who manifest amenorrhea for at least 12 months) represent this process and its consequences, is clinically relevant. Currently 10% of the population of women worldwide is going through menopause or already has gone through this process.
Regarding the positive consequences of menopause, the jury identi?ed three emergent categories: a) cessation of menses (in which were identi?ed seven subcategories, namely, end of the objective experience of menstruation, improvement in hygiene, ability to stop contraception, terminus of premenstrual syndrome, greater sexual freedom, stop buying and using tampons/pads, and freedom to plan vacations), b) psychological changes (divided in nine categories: feeling calmer, feeling less concern, feeling more con?dence, increased assertiveness, increase in the ability to accept lifes aspects, increased maturity, desire to invest in pleasurable things, give more
value to positive experiences, and increased sensitivity), and c) absence of positive consequences.
Regarding the negative consequences of menopause, eight emergent categories were found: a) psychological changes (which had eight subcategories, namely, depressed mood/mood swings, hopelessness regarding the future, irritability/lack of patience, feelings of self-depreciation, anxiety, aggravation of preexisting vulnerability, memory loss, general psychological change); b) physical changes (which had six subcategories, speci?cally, ?accidity in body parts, perception of changes in the body in general, physical constraints in doing certain things, dry skin, hair loss, and tiredness/ decrease of energy); c) concern with disease appearance or aggravation (divided in ?ve subcategories, osteoporosis/osteopenia, high blood pressure, cardiovascular disease, high cholesterol, and worry with health deterioration in general); d) changes in sexual life (which had ?ve subcategories, speci?cally, decreased libido, vaginal dryness, general dif?culties in sex life, estrangement from partner due to sex-related dif?culties and guilt, and insecurity related with her own sexual performance); e) vasomotor symptoms (which had two subcategories, presence of vasomotor symptoms and feelings of shame related to the presence of vasomotor symptoms); f) absence of negative consequences; g) weight gain; and h) perception of loss (which has four subcategories, namely, loss of femininity, loss of the reproductive capacity, quit doing some pleasurable things, and concern with the possibility of
losing an attractive ?gure).
Menopausal process can facilitate the manifestation of depressed mood and sexual changes, which can have an impact on the participants personal life. In the present study, negative psychological and sexual changes were also reported as two negative consequences of
menopause. The MCA suggests that the representation of menopause can be explained by three factors. The ?rst factor is represented by negative experience, negative physical consequences, and aging; therefore, age progression can be viewed as a negative experience by these menopausal women, given the strong relation with two other negative representations. The second factor, which supports the representations of the menopause model, is composed of three independent aspects: the termination of menses, a depreciation (or minimization) of the menopause of the participant, and the menopause as a positive experience.
The third factor evidences menopauses representation as a phase of lifecycle; this means that menopause is seen as a normal or expected transition that is clearly distinct from negative and positive representations. In conclusion, women might represent menopause as being a negative or positive experience or as a life cycle transition. The perceived positive consequences of menopause are explained by two major factors, one clearly psychological (positive psychological changes) and the other of a more physical nature (termination of menses and its absence of positive consequences). The strong association between the emergent categories of cessation of menses and its absence of positive consequences may mean that the termination of menses is not always perceived as a positive consequence, although it accounts for 58.7% of all positive consequences mentioned.
Despite the associations that women establish between menopause and a series of consequences (positive or negative), the menopause process might not be the only variable in?uencing the representations and perceived consequences, since psychosocial and cultural factors can have an impact in the reporting of menopause symptoms and in the way women perceive menopause.
Our results emphasize that, in a group of Portuguese women, representation of menopause may be of a negative, a positive, or a neutral experience, or as a life cycle transition. The perceived positive consequences are cessation of menses or absence of positive consequences on one hand, and positive psychological changes on the other hand. Negative consequences of menopause are of a psychological/sexual nature, a physical nature, include vasomotor symptoms or weight gain, and a perception of loss.
CREDITS.
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