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REVIEW ARTICLE
Year : 2017  |  Volume : 3  |  Issue : 1  |  Page : 1-5

Psychological experiences of women regarding menopause


1 MS in Psychology, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 MS in Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Web Publication16-Jan-2017

Correspondence Address:
Rahele Samouei
MS in Psychology, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2395-2296.179065

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  Abstract 

Introduction: Menopause is one of the stages of life for women that cause a wide variety of symptoms, effects, and sometimes limitations. Therefore this study aims to describe the psychological symptoms of postmenopausal women. Method: This is a qualitative study using phenomenological method on postmenopausal women in the city of Isfahan. The sampling was at first carried out using simple sampling and later using snowball sampling method. The data gathering tool as interviews carried out in the office of obstetricians and gynecologists. Data were classified using colaizzi's seven stage data analysis method. Results: Various psychological symptoms were reported in the interviews which can be summarized as irritability, aggression, fatigue, feelings of helplessness, and uselessness. Conclusion: During the interviews, postmenopausal women mentioned a variety of psychological symptoms that can cause limitations and hardships and require suitable support and follow-up.

Keywords: Isfahan, menopause, psychological experiences


How to cite this article:
Samouei R, Valiani M. Psychological experiences of women regarding menopause. Int J Educ Psychol Res 2017;3:1-5

How to cite this URL:
Samouei R, Valiani M. Psychological experiences of women regarding menopause. Int J Educ Psychol Res [serial online] 2017 [cited 2017 Aug 23];3:1-5. Available from: http://www.ijeprjournal.org/text.asp?2017/3/1/1/179065


  Introduction Top


All women experience menopause regardless of culture, race or social, and economical backgrounds.[1] Given the increase of life expectancy to around 85 years and the unchanging menopause age of 51 years since ancient times, now-a-days most women spend around one-third of their lives in postmenopausal stage.[2],[3],[4]

Natural menopause is part of natural aging process that causes a variety of physiological and psychological symptoms and various complaints. Among these symptoms are flushing, mobility, decreased concentration, memory loss, sleep problems, and several other symptoms.[3],[4],[5],[6] When menopause happens simultaneously with great changes in a person's life such as sickness or disability, death or disability of a spouse, retirement, necessity of taking care of elderly family members, separations from children, financial insecurity, or other such happenings it can lead to increased negative feelings.[7] Therefore, menopause creates a special situation by conjugation of various physical, psychological, social, and domestic changes which turns this stage of life to a stage when people have special needs and conditions. The above-mentioned facts illustrate the importance of studies regarding menopause. The results of some of the studies about this stage of life are as follows.

Olofsson and Collins in a study on 148 Swedish women reported the symptoms of menopause as negative mood, vasomotor, decreased sex drive, and memory and sleep problems.[8] Avis et al., in their study on 2565 women in Massachusetts reported that there is no relation between menopause and increase in depression.[9] Bosworth et al. (2001) and Hayden et al., by studying 581 women reported that increased depression rate is related to symptoms of menopause and not menopause itself.[10],[11] Birkhäuser in a study on Irish women reported that depression is more prevalent in postmenopausal women compared to other women.[12] Bloch in a study on 51 Austrian women concluded that negative attitude toward menopause can cause negative psychological symptoms and increased self-confidence can decrease the symptoms.[13] Aaron et al. studies 200 women in India and reported several psychological symptoms during menopause but saw no significant relation between menopause and depression.[14] Danaci et al. in their study on 324 postmenopausal women concluded that menopause has no effect on sexual behavior or psychological characteristics of postmenopausal women.[15] Freeman et al. studies 436 women and reported that there is a possibility for increased depression during menopause and decreased depression after menopause.[16] Polisseni et al. reported that the prevalence of depression after menopause in Brazil is 40%.[17] Ayers et al. in a review of thirty studies from around the world showed that women with a negative attitude toward menopause experience more symptoms and complications.[18] Also, their results showed that postmenopausal women experience a variety of emotional and psychological changes.[19]

Khaledian (2001) in his study of women in different stages of menopause concluded that the highest quality of life belonged to those before menopause and the lowest quality of life belonged to women during and 5 years after menopause.[20] Sadeghani (2004) studies the psychological symptoms of menopause women in Isfahan and Mahshahr and reported these symptoms as depression, frustration, feelings of aging, self-dissatisfaction, anxiety, impatience, desire to be alone, decreased concentration, and insomnia.[21] Shohani et al. (2007) in their study showed that there are significant physical and psychological problems in menopause women the most prevalent of which were depression and anxiety.[22] Yasar et al. (2011) in their study showed that a large percentage of women experience depression during menopause.[23] Afghari et al. (2012) reported that menopause can intensify the symptoms of anxiety and depression in women who had these problems before menopause.[24]

Given the fact that previous studies report different and sometimes conflicting views about symptoms of menopause in women and since most of the previous studies used questionnaires and survey method, this study aims to provide a deeper and more qualitative view about the psychological experiences of women regarding menopause.


  Method Top


This qualitative study was carried out in order to determine the psychological experiences of menopause women in Isfahan using phenomenological method. The minimum number of samples for this study was 6 people according to Morse and 10 according to Polite and Hunger. In the current study and by considering information saturation during interviews, the participation of 20 menopause women in the study was predicted. The sampling was at first carried out using simple sampling and later using snowball sampling method. The information was gathered using open, unstructured interviews with a volunteer participant visiting office of an obstetrician and gynecologist. Other participants were introduced by the previous ones. Each interview lasted at least 45 min and at most 90 min. The exact phrases spoken by the participants were written down and recorded during the interview. In order to endure the suitability and feasibility of information classification process, each interview form was reviewed by two researchers in order to ensure the uniformity and credibility of information. Data were classified using colaizzi's seven stage data analysis method. To this end, after the initial extraction of information, the main concepts were sorted, the relations between sentences and statements were determined and the general description of the phenomenon was provided.

Research findings

In this section, psychological characteristics of menopause women along with the some codes and reports are provided.

  • Anxiety: "I was anxious because I thought menopause will reduce ability and I will not be able to work well"
  • Depression
  • Increased self-esteem
  • Decreased self-esteem
  • Dizziness
  • Inclination toward loneliness: "I had not in the mood for anyone and wanted to be alone all the time"
  • Feeling death from loneliness
  • Not wanting to be alone: "I was feeling that I'm getting older and so I didn't want to be alone at all"
  • Feeling old: "I was feeling old and ugly and though I had an intolerable face"
  • Feeling impatient
  • Tension caused by flushing
  • Feelings of disability
  • Increased expectations
  • Need for vacation and rest
  • Inability in decision making
  • Dissatisfaction from job situation and job environment
  • Paying more attention to appearance: "By taking more care of my appearance, I suggested to myself that I'm young and attractive"
  • Desire to attract attention: "Before I didn't like guests but now I wanted to have guests over so that I could attract their attention and show myself to them"
  • Reduced vitality
  • Irritability: "I was too irritable; a small comment from by husband or children would make me cry"
  • Crying: "I was crying most nights for no reason and afterward I'd feel refreshed"
  • Feeling ugly and undesirable
  • Increased screaming and fighting
  • Forgetfulness: "I was soon to forget many of the things they told me"
  • Reduced concentration: "Often I would lose sight of conversation and forget what I was saying"
  • Fearing being sent to retirement homes: "I was feeling that my children will leave me at a retirement home"
  • Stubbornness: "I had become too stubborn and wanted to have the final say in everything"
  • Fatigue
  • Inability to work: "I felt that I am unable to do the most simple works and that I can't do anything"
  • Reduced memory
  • Hearing a buzzing sound in the head
  • No changes in emotions: "My emotions didn't change during menopause because I was married"
  • Happiness: "I was happy when I entered menopause because I felt that after a short while I'll be alone and will return to God's side in a few years"
  • Fear: "I had become a coward, for example I started fearing the dark," "Sometimes I have unreasonable fears like I fear the sound of wind then I'm home alone"
  • Nagging
  • Staring into the space
  • Aggression
  • Laziness.


Family experiences of menopause women

  • Anger toward children
  • Fighting with children
  • Being angry toward husband: "My husband at first tried to convince me about menopause but when I kept insisting on my opinion, he would become angry and say yeah, you are right, I hate you"
  • Bad family relations
  • Hating the spouse
  • Feeling misunderstood by the family members: "I wanted my husband and children to understand me but I felt that they don't and that they don't care about me"
  • Increased support from others
  • Great understanding by the family
  • Support from husband: "My husband never let me feel alone or disabled and always encouraged me to work with more strength which was very helpful."


A summary of description and psychological characteristics of participants at the final stage of the interview

The summary of the psychological experiences of postmenopausal women from menopause is as follows: Feeling old (10 people), feeling alone and introvert (10 people), depression (7 people), anxiety and rapid heart rate (7 people), boredom (6 people), aggression (5 people), tiredness (5 people), crying without reason (4 people), becoming demanding (4 people), inability in carrying out certain works (4 people), feeling useless (3 people), irritability and sensitivity (2 people), feeling senile (2 people), lying, fear, reduced memory, reduced self- esteem, and increased self-esteem (1 person each).

The family relations of postmenopausal women are as follows: Suitable relationship with husband (6 people), lack of suitable relation with husband (5 people), pessimism toward husband (2 people), feeling unattractive for husband (2 people), and lack of suitable relation with children (6 people).


  Discussion Top


In the interviews carried out in order to describe the psychological experiences of postmenopausal women, most participants reported psychological symptoms such as feeling old, feeling alone, depression, anxiety, and irritability during menopause.

There are several studies about psychological symptoms of menopause that each has different views about these symptoms. Some of these are mentioned below.

Hunter, Avis et al., and Avis et al., reported that there is a relation between history of depression and depression during menopause. Matthews et al., Avis et al., Bosworth et al., and Hayden et al., reported that natural menopause has no negative effects on health situation of women. Avis and McKinlay, Dennerstein et al. (1993), Avis et al. (2001), Dennerstein et al. (1999), Bloch, Danaci et al., and Ayers et al. concluded that a negative attitude toward menopause increases the negative symptoms of menopause. Avis et al. reported that long menopause can lead to depression symptoms. According to Freeman et al., it is possible for depression to increase at the onset of menopause but it will decrease afterward. Sadeghani (2004), Shohani et al. (2007), Yasar et al. (2011), Afghari et al. (2012), and Polisseni et al. introduced and described some of the psychological symptoms of menopause such as depression, hopelessness, feeling old, dissatisfaction, anxiety, boredom, and loneliness on the other hand, Brikhauser and Khaledian (2001) reported lower quality of life during menopause.[25],[26],[27],[9],[8],[11],[28],[29],[30],[31],[13],[15],[18],[26],[9],[16],[21],[22],[23],[24],[17],[12],[20]

First of all, it is necessary to remember that menopause is a culture related phenomenon. In other words, it appears that women in different cultures have different attitudes toward menopause and show different psychological symptoms. For example in some African cultures, women believe that menopause is a sign of higher social station and an easier future life. This attitude helps these women to accept this stage of life with open arms and easily accept the changes. On the other hand, women in United States, Germany and Italy have negative attitudes toward menopause. They believe menopause to be synonymous to getting old and weak. These cultural differences show that attitudes of women toward menopause can greatly affect the psychological symptoms of menopause. A study by Olofsson and Collin showed that 51% of women had a positive attitude toward menopause and considered this stage to be about relaxation and comfort while Aaron et al. reported this number to be 59%.[14],[32]

The awareness of women about menopause and its symptoms can somewhat predict how they deal with stage. Most women enter menopause without knowledge about this stage of life and are therefore faced with various fears such as fear regarding end of sexual life, fear regarding looking unattractive to the spouse, fearing becoming old or unattractive, fearing disability, and many such fears. Due to these fears and negative emotions, when dealing with this stage a woman first needs to deal with her personal feelings. Relationships with spouse, children and relatives will undergo changes and due to increased sensitivity, there will be a constant feeling of criticism, blame, and resentment which will either be displayed overtly or held back. These conflicts can lead to feelings of incompetence, insecurity, and feeling dismal. Continuation of such feelings can lead to sadness, depression, feeling lonely, increased crying, and other such symptoms. If the depth of unawareness is great enough, these experiences can be transferred to younger female members of the family such as daughters who need to deal with menopause in the future which will create a negative mental image of menopause for the next generation. In general women that think they have no control over their situation during menopause and are only controlled by biochemical changes in their bodies are more vulnerable during menopause.

Most women reported negative experiences in their relations with their family and spouse during and after menopause. Given the fact that menopause happens in the age when women are starting to live lonelier lives, which can be due to retirement or independence of children, one of the factors that can provide them with support, and security during this stage of life is continued marital life with their spouse. The role of spouse in this stage of life is stronger and more important than other stages. In this stage of life, both men and women start to feel lonely, old or disabled and they can reduce these feelings by increasing their attention and affection toward each other. Regarding the role of spouse in menopause symptoms, Avis et al. (1997), Dennerstein et al. (1999), and Aaron et al., have reported results similar to those found in this study.[14],[31],[30]

In this study and during the interviews, it was evident that women with positive healthy relations with their spouses, reported more satisfaction, and security and had a better attitude toward menopause. In other words women that receive attention and strength from their spouses during this stage have higher self-esteem and were better at dealing with menopause. Even some of the participants felt that they had moved beyond female limitations during this stage of life and led a more comfortable and carefree life with their spouses. On the other hand many negative attitudes toward menopause were strengthened when women felt ugly, disabled, or sexually impotent in their relationship with their spouses.

Regarding the relation between women and their children, one must remember that husband can have an important role in determining the relation between children and their spouse. If husband respects his spouse and cares about her, children will follow his example. Therefore spouses that are aware about changes in menopause can predict some of the changes and help in accepting the new circumstances by helping women understand and accept these changes.


  Conclusion Top


The psychological experiences of women regarding menopause can greatly vary from person to person. However feelings of anxiety, depression, loneliness, and disability are reported with more frequency. These changes in physiological and psychological characteristics of women can in turn change marriage and quality of life of women.

Despite all of these negative and positive experiences, the fact remains that menopause like onset of menstruation is an unavoidable and natural stage of life for all women and the way they adapt to these natural changes depends on their quality of life, awareness, attitudes, and physical and mental health. Women with positive attitudes that received support from their family members were those that better dealt with menopause and its symptoms.

Suggestions

Providing the possibility of visiting credible counselors and psychologists for menopause women and providing them with necessary tips and solutions can help them to better deal with this phenomenon. Also creation of consultation - treatment teams consisting of psychologists, midwives, specialist physicians, fitness and nutrition, and planning expert can help support women during menopause.

Acknowledgment

This study was carried out with the support of Isfahan University of Medical Science. The researchers wish to thank all women participating in this study for their cooperation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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