Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Women's Experience of Being Well during Peri-Menopause: A Phenomenological Study

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Women's Experience of Being Well during Peri-Menopause: A Phenomenological Study

Article excerpt

BACKGROUND

Menopause has been shown to be a highly individualised experience. Qualitative research studies examining the experience of menopausal symptoms have shown that the experience of symptoms is subject to a variety of contextual and personal influences, and that menopausal changes are not differentiated from midlife changes (Arpanantikul 2004; Hvas 2006).

In Buck and Gottlieb's (1991) study examining the meaning women attached to the experience of menopause, the participants' experiences were dominated by changes in the structures of their lives, particularly their social roles and personal relationships and menopause appeared only as a background event in the midlife experience. Participants expected changes at midlife and they were more disturbed when expected changes did not occur on time, than by the changes themselves. Buck and Gottlieb (1991) found that the expectation that the events of life would unfold On-time' was an important influence on the way menopause was experienced. In her research on menopause and psychological distress, Lennon (1982) found women whose menopause occurred earlier or later than expected showed more symptoms of distress than women whose menopause occurred on-time. Menopause which occurs too early, or off-time, especially if it is before the age of 40, has been shown to be strongly disruptive in women's lives (Boughton 1997).

In their qualitative study examining women's perceptions of and response to menopausal changes, Kittell, Mansfield and Voda (1998) found women responded to symptoms at menopause according to whether they saw them as a normal feature of menopause. Analysis revealed that when women experienced changes they felt were normal for menopause, the changes were not perceived as disruptive. Symptoms were considered to be disruptive if they were unexpected or unusually intense participants referred in particular to unexpected heavy bleeding, hot flushes and emotional outbursts.

In Choi's (1993) grounded theory study of women's choices regarding HRT, the extent to which menopausal changes were deemed disruptive was found to be significantly influenced by the coherence between expectations and actual experience, particularly physical experience. 'When a woman's body experience turned out to be more troublesome than she expected ... feelings of betrayal, inadequacy or even selfabnegation might occur' (Choi 1993: 89). Similarly, in her qualitative study of menopausal experience, Walter (2000: 121) found that those women who reported the greatest uncertainty and sense of unfamiliarity regarding their bodies at the time of menopause reported feeling Out of control or vulnerable in ways they had not experienced prior to menopause'.

In Capozzoli's (1990) phenomenological study, menopause was characterised as a relief, from both menstruation and the possibility of pregnancy. Participants' experiences of menstrual irregularities, hot flushes, night sweats and dryness of the vagina were anticipated and understood as normal aspects of menopause. While these symptoms may have caused some discomfort for participants, they did not feel incapacitated by them. They viewed menopause as just one event within many occurring concurrently which had greater importance for them than did menopause, including illness of loved ones, death of a parent, return to the workforce and children leaving home.

In an Australian study, DaIy (1994: 34) described the positive menopausal experience of some participants as 'gliding through' menopause, because they only noticed they were menopausal when they stopped menstruating. Although they did experience some menopausal symptoms, they were not distressed or disturbed by them, and some women also described feelings of enhanced well-being f ollowing menopause.

The literature exploring the experience of menopause shows that women's experience of change which is unexpected, unfamiliar or unexplainable may be linked to the experience of greater distress at menopause. …

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