Academic journal article Journal of Counseling and Development : JCD

Menopause Symptoms and Attitudes of African American Women: Closing the Knowledge Gap and Expanding Opportunities for Counseling

Academic journal article Journal of Counseling and Development : JCD

Menopause Symptoms and Attitudes of African American Women: Closing the Knowledge Gap and Expanding Opportunities for Counseling

Article excerpt

Menopause is a universal female midlife transition that remains poorly understood (Huffman & Myers, 1999). Most of the research concerning women's experiences of menopause has focused on biological and psychological changes, or "symptoms" according to the medical model (Neugarten & Kraines, 1965). The types, incidence, and severity of symptoms have been shown to vary among women both within the same culture and between different cultures (Kaufert & Syrotuik, 1981).

Although the available literature provides clear support for the relationship between attitudes and perceptions, behaviors, and experiences, studies of women's attitudes toward menopause have primarily involved Caucasian, middle-and upper-class, well-educated women (Mansfield & Voda, 1993; Rousseau & McCool, 1997; Theisen, Mansfield, Seery, & Voda, 1995). Only a few recent studies have attempted to include minority women, but they have had only marginal success recruiting participants (Kaufert & Lock, 1997). One exception to the problem of sampling minority populations is the ongoing Study of Women Across the Nation (DeAngelis, 1997). Launched in 1994 and continuing until 1999, this study was designed to investigate the variations of menopausal experiences among ethnic groups in the United States. Preliminary findings suggest that attitudes toward menopause vary among different ethnic groups, which supports conclusions of other investigators that results from one population of women cannot be generalized to another population (Tang, 1994; Theisen et al., 1995). Because of the lack of empirical evidence on the menopausal experiences of minority women, professional interventions are based on research on the symptoms experienced by Caucasian women, as well as on the attitudes of these women toward their menopausal experiences.

Symptoms attributed to menopause affect every body system, making it difficult to differentiate coincidental pathological changes or other age-related changes from those purely related to menopause (Neugarten & Kraines, 1965). More than 100 menopausal symptoms have been identified (Ditkoff, Crary, Cristo, & Lobo, 1991; Perz, 1997), with some of the most common ones including hot flashes, night sweats, vaginal dryness, reduced libido, sleep disturbance, irritability, depression, anxiety, tension, palpitations, headaches, poor concentration, forgetfulness, and fatigue (Ballinger, 1990; Morse et al., 1994). Several longitudinal studies of nonclinical populations indicate that hot flashes and night sweats are the only symptoms that women universally and consistently report (Kaufert & Syrotuik, 1981). Approximately 50% to 85% of women experience hot flashes with varying degrees of frequency and intensity (Bowles, 1990).

Consistently, women who are seeing physicians for menopausal and related health and mental health concerns have reported more psychological and physiological problems than menopausal women from the general population who are not seeing physicians (Dennerstein, Smith, & Morse, 1994; Morse et al., 1994). In nonclinical studies, only 10% of women report significant physical symptoms (Ford, 1996; Oldenhave & Netelenbos, 1994). Such findings support Ballinger's (1990) suggestion that if symptom reporting from clinic populations is considered representative of the general population of menopausal women, the presence of symptoms will be overestimated.

Neugarten, who pioneered general population studies of symptomatology, was also instrumental in turning the attention of researchers to the study of attitudes toward menopause (Kaufert & Syrotuik, 1981). Numerous studies of attitudes reveal that they are influenced by sexist and ageist stereotypes (Leiblum & Swartzman, 1986). Positive attitudes toward menopause are associated with positive experiences of menopause, whereas negative attitudes are associated with both negative symptoms and negative experiences (Dennerstein et al. …

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