Transcript CHAPTER 18: Rethinking Menopause

CHAPTER 18:
Rethinking Menopause
Introduction
• Menopause is associated with many health
issues.
– Intertwined with personal, societal, and
biomedical appraisals of midlife, femininity, and
aging
• The experience of menopause is
biopsychosocial.
Definitions
• Menopause refers to the final menstrual
period.
• Perimenopause refers to the transitional time
surrounding the end of menstruation.
• Premenopause precedes perimenopause.
• Postmenopause is the time following the final
menstrual period.
Biology of Perimenopause/Menopause
• Physiology
– Involves feedback relationships among ovarian,
pituitary, and hypothalamic hormones, as well as
other chemicals and brain structures
Biology of Perimenopause/Menopause
• Biomedical Model
– Menopause is natural, healthy, and overly
medicalized.
• Alternative Perspectives
– Evolutionary theories
Perimenopause/Menopause
and Life Stage
• Need for positive personal definitions of what
it means to be menopausal
– It is a Period of introspection and developmental
change
• No cultural consensus about what it means to
be a midlife or mature woman
– In United States, cultural attitudes toward older
women have been negative.
Perimenopause/Menopause
and Life Stage
• Loss of fertility may be an important issue for
women who have delayed childbearing.
• Women’s ideas and experiences of sexuality
may change during menopause.
Normal Course of
Perimenopause/Menopause
• Average age of menopause is 51 in Western
cultures.
• Menopause is the end of fertility.
– There is a typical sequence to changes in
menstrual flow, but not all women progress
through each stage in the same way.
Signs and Symptoms
• Hot flashes
– Transient feelings of heat, sometimes
accompanied by visible reddening or sweating
• Cross-cultural and social class variations
– Great variations among social class, racial, and
cultural groups
Coping With Distress
• Facilitated by a positive self-concept and
sense of mastery
• Proactive health-promoting behaviors (e.g.,
diet, exercise, supplements)
• Cognitive-behavioral and other psychological
approaches
Postmenopausal Hormone Therapy
• Complex issue of use of hormone therapy (HT)
– HT vs. hormone replacement therapy (HRT)
– Method of managing of symptoms?
– Increase in breast cancer risk?
– Decrease in coronary heart disease (CHD) risk?
Conclusion
• Menopause is associated with a wide range of
health issues, including:
– Understanding normal course of aging
– Coping with uncomfortable physical symptoms
– Forming a self-concept as a menopausal woman
Conclusion
• Key Points:
– Menopause differs among women.
– Women should not expect a predictable course.
– Women should not expect that they will be unable
to cope with distress if it occurs.
– Cultural stereotypes have encouraged negative
views of menopause and midlife.
– A woman’s own definition of her life stage is key.