Menopause: Life Event or Medical Disease?

Abstract

Women throughout the world experience menopause, but it is often difficult to determine what it means and how it is perceived by women. A dilemma exists as to whether menopause should be medicalized or treated as a normal life event. The effects of this decision on the woman and the role of the advanced practice nurse in assisting the woman through this time of change are presented.

Perimenopause: More Than Hot Flushes and Night Sweats for Some Australian Women

“…This stage is characterized by many complex biological, psychological, and sociocultural changes (Masi & Fattorini, 1996;Rasmussen, 2000). Lasting on average 7 to 10 years (Rousseau, 1998) and spanning up to 25 years (Blackwell & Blackwell, 1997), perimenopause is the time that estrogen levels decline, follicle-stimulating hormone (FSH) levels increase, and ovarian follicles are depleted (Nachtigall, 1998;Sulak, 1996). Defined as "a few years before and one year after the permanent cessation of menses" (Li et al, 1997, p. 64), perimenopause is marked by FSH level >30 mIU/ml (Bachmann, 1994).…”

The menopausal experience-confounding factors

“…The transition begins, on average, at age 47 and takes approximately 4 years 1 ; however, perception of the effects of menopause often last far beyond the final cessation of menses. 2 These physiological changes are also accompanied by a complex array of psychological, social, and emotional effects. How women experience the menopausal transition is highly variable in that some women are debilitated by their symptoms and others have only minimal complaints.…”

“…One is the perception of menopause as a medical condition requiring treatment rather than a natural process. 2 For example, substantial attention and research are directed toward potential therapies that alleviate the symptoms associated with the menopausal transition. However, when considering hot flashes, one of the most common and disruptive symptoms, 41% of women worldwide are estimated to report hot flashes, with only 10% to 30% reporting severity that potentially interferes with daily life.…”

“…However, when considering hot flashes, one of the most common and disruptive symptoms, 41% of women worldwide are estimated to report hot flashes, with only 10% to 30% reporting severity that potentially interferes with daily life. 2,5 Although menopause is far more than simply the experience of hot flashes, it is one of the most common menopausal experiences for which women seek medical treatment.…”

“…2,9 For this, among other reasons, the infertile population is a group that deserves special attention. 9 Very little has been published describing the effect of infertility on the menopausal experience.…”