"One of the greatest investments we can make is to invest in wellness; for there is no other investment like it... Health is life insurance, success, and happiness." - Mahatma Gandhi.
The wise women tradition emphasizes holistic healing through storytelling, simple rituals, and herbal remedies. It acknowledges that various stages of a woman's body – puberty, menstruation, pregnancy, lactation, and menopause – present chances for empowerment and personal development. Menopause is seen as an opportunity for deliberate transformation rather than a curable ailment, signifying the conclusion of fertility.
The commencement of liberation is referred to as climacteric, an individual and distinct occurrence for every grown woman. The enigma of climacteric remains concealed by the universe. To encounter this ecstasy, a woman must possess the willingness to surpass the barriers that protect its entrance. Although standin...
g at the brink may seem engulfed in obscurity, peril, and postponement; countless women from diverse cultures across time have confided in one another that it is the most exhilarating transformation a woman ever experiences.
The postmenopausal period is important for women as it constitutes a significant part of their lives. Puberty and climacteric are phases that all women go through, with puberty marking the transition to fertility and climacteric representing the end of motherhood and the start of wisdom in older age. Both stages involve growth and loss, birth and death, and bring about physical, emotional, and spiritual changes. Nonetheless, some people question the benefits or healthiness of using extra hormones during these phases.
The wise woman tradition reframes the role of women in menopause, moving away from victimhood and acknowledging it as a natural and sacred process that has benefits for individual
and society. This philosophy emphasizes holistic nurturing for women, enabling them to produce essential hormones without relying on artificial replacements. As a result, menopausal women are encouraged to embrace their bodily changes and use this time for introspection and personal development. Moreover, postmenopausal women are recognized as vital contributors to our culture's overall health. Instead of being seen as an illness, menopause is considered a survival advantage.
Menopause, which refers to the permanent stoppage of menstruation as a result of decreased ovarian follicular function, signifies the conclusion of a woman's ability to conceive. This phase has physical, psychological, and social effects on women. Upon reaching this significant reproductive stage, women may face negative attitudes and perceptions related to getting older.
During the climacteric stage, women's social status and sexual desire decline with age, while they also face disadvantages in income, status, and power compared to men. The physical and mental health of women during this phase significantly affects their later years (David & Norman, 2000). Various factors including career, changes in home life, diet, physical activity, economic status, society, and the environment impact women's health as they age. The well-being of women is influenced by the normal aging process and hormonal changes in the reproductive system. According to a study conducted by David and Norman (2000) in 1990, there were 476 million postmenopausal women worldwide with 40% residing in industrialized countries.
By 2030, it is predicted that there will be around 1.2 billion postmenopausal adult females worldwide, with approximately 76% of them living in underdeveloped regions. In the East Asian region, data from 1989 to 1992 shows that the percentage of people aged 45 and above ranged from
15.3% to 24%. According to WHO (2002), menopause in India is similar to other parts of the world. Historically, women's health concerns, including menopause, have been neglected in India; however, significant changes are now taking place.
Indian adult females encounter numerous societal and cultural challenges throughout their lives. The symptoms of menopause can differ among women, with the average age at which Indian women experience menopause being 47.5 years, according to the Indian Menopause Society (2008). In rural areas of India, body aches and pains are experienced by 72% of women, greatly affecting their quality of life. Gynecological disorders and postmenopausal issues are two main health problems that significantly impact the wellbeing of women in the final three decades of their lives, as indicated by various studies.
Women living in rural areas, especially those experiencing menopause, lack sufficient support for their overall well-being (Bhattacharya, 2006). Unfortunately, healthcare services primarily focus on women of reproductive age and neglect them after they go beyond the childbearing stage. Menopause brings significant health challenges and is a crucial phase in a woman's life. Given the increasing impact of aging and menopause on women's health, it is essential to prioritize this specific group. In the past, these symptoms were not considered life-threatening due to women having shorter lifespans.
The public healthcare system is facing a growing challenge in providing care to single women in this age group who lack a partner. These women live alone and have untreated health issues. There has been a recent societal effort to address concerns related to life after menopause, focusing on the factors that affect both the physical and mental aspects of menopause and aging. In today's
society, it is expected that women will spend a significant part of their adult lives beyond their reproductive years. Therefore, it is crucial to prioritize preventive healthcare and develop healthy lifestyle habits to improve quality of life during these later years (Young kin; A; Davis, 2004).
SIGNIFICANCE AND NEED FOR THE STUDY
Menopause is a critical phase in a woman's life as it signifies the end of her reproductive capacity. The physical transformations and aging process that accompany menopause can be overwhelming for certain women, leading to feelings of depression and anxiety (Kessenich, 2007). In societies in the Western world, where women have longer lifespans, they can expect to live approximately one-third of their lives after experiencing menopause. As women get older, they face various transitions and confront challenges related to health, work, and marriage that require them to adapt. These challenges are particularly pronounced during the period of menopause.
Most adult females in the United States experience climacteric around 51 years of age (Andersons 2007). In India, women's average life expectancy increased from 31 years in 1951 to 61 years by 1991. Thus, women will spend about a quarter to a third of their life in the postmenopausal stage. It is projected that by 2025, over 165 million women will be aged above 60.
According to the Indian Climacteric Society (2006), women encounter difficulties in their later years as life expectancy rises. The notion that early menarche results in a postponed menopause lacks supporting evidence. Contrary to menarche, the average age of menopause has remained unchanged throughout history. The climacteric period encompasses both the pre-menopausal phase when ovarian activity alters and the post-menopausal years characterized by no
Menopause is a significant event for adult females that universally and inevitably marks the end of menstruation, typically occurring between ages 45 and 55. The hormonal changes during this phase are primarily caused by reduced estrogen production in the ovaries. As menopause approaches, menstrual cycles become irregular, indicating unpredictable ovulation and resulting in fluctuating hormone levels of estrogen and progesterone. These changes lead to symptoms associated with menopause (Krantz, 2007). Although all women experience similar hormonal changes during menopause, factors such as age, cultural background, health status, type of menopause, desires regarding childbearing, and relationships can influence each woman's individual experience. Women may perceive menopause as positive due to relief from painful periods or no longer needing contraception; however, it can also be seen negatively as it may make them feel "old" and result in infertility.
A study conducted in Gujarat by a non-governmental organization revealed that many adult females lack awareness and disregard climacteric. Bhavadam (1999) suggests that for some women, climacteric signifies liberation from societal and religious constraints as well as sexual challenges. Cultural factors also shape women's perception of climacteric, with certain individuals embracing it while others associate it with the onset of aging and experiencing reduced attractiveness, physical capabilities, and energy levels.
Not only do menopausal women undergo physical changes, but they also face societal and psychological shifts that can impact their well-being. In certain cultures such as India, the Far East, and the south Pacific Islands, where postmenopausal women attain status, depression is absent among them (Shifren ; Schiff, 2007). A study by Sivakami ; Shyamala (2005), using data from the National Family Health survey - 2, reveals varying ages at which
menopause occurs in different states of India. Unlike developed countries where menopause typically happens in one's fifties, about 11% of Indian women experience it before reaching forty. This exposes Indian women to a longer period of postmenopausal time and its associated challenges. Thus, prioritizing the health of menopausal women becomes crucial for enhancing their quality of life. With an increasing average life expectancy for women, both the number of women experiencing menopause and those living in the postmenopausal stage are on the rise.
The postmenopausal period, occurring after menopause (Curran & Bachmann, 2006), is a significant phase for adult females. They are projected to spend more than one-third of their life in this stage. Surprisingly, many women go through menopause without experiencing any troublesome symptoms. These women can maintain their active lifestyles and good health without much disruption to their daily routines.
Kessenich (2007) states that the ability header with any emphasis consists of three factors: the individual's perceptual experience of the event, support systems, and coping mechanisms. Nurses can support menopausal women by providing education and counseling on disease prevention options, treatment for menopausal symptoms, and promoting health during the menopausal transition. Dr. Meeta Singh emphasized during a World Menopause Day event in New Delhi that although awareness about menopause is increasing, many Indian women tend to deny or neglect its significance. A booklet containing information on menopause was distributed to women in India, and feedback revealed that most were not well-informed about it and held misconceptions such as considering it a 'disease' rather than a natural process. Even educated women believed that poor health was associated with menopause (as cited in Lal, 2006). Healthcare professionals
should be mindful that postmenopausal women may hesitate to spontaneously raise questions about certain problems.
During climacteric, women should prioritize themselves and their needs. It is important to help them understand the physical and emotional changes they may experience (Borrego et al., 2005). Therefore, it is crucial to address the health concerns of menopausal women, urging them to adopt healthy lifestyles and seek medical help to take charge of their well-being. In celebration of World Menopause Day on October 18, the International Menopause Society (IMS) and the World Health Organization (WHO) collaborate in promoting policies that support research in menopausal health within affiliated menopause societies.
The public healthcare system does not recognize the specific health needs of older women, despite extensive research on menopause in Western countries. Only a few institutes in India have acknowledged its potential for study (as mentioned by Bhavadam, 1999). By conducting research on the postmenopausal period's quality of life, we can enhance and sustain women's well-being. As menopause aligns with a decrease in social support for women, it is vital to examine if preventive healthcare can significantly affect their quality of life.
Women in rural areas may hesitate to seek medical assistance, have limited access to private healthcare services, or neglect their postmenopausal health. Therefore, a research study was conducted in 2010 in specific rural areas of Madurai territory. The goal was to evaluate and improve the quality of life for these women by assessing their quality of life and examining its relationship with demographic variables such as age, household income, household type, and occupation. Additionally, a self-instructional module on coping strategies was created. The hypothesis stated that there would be a significant
correlation between quality of life and the mentioned demographic variables.
Quality of Life
This survey defines quality of life as the satisfaction level experienced by postmenopausal adult females across various aspects including physical, psychological, environmental, and social factors. The assessment of quality of life is done using the standardized scale called WHOQOL-BREF.
Survey and Self-Instructional Program for Postmenopausal Adult Females
This research is centered on the climacteric stage and the last menstrual period experienced by adult females within 1 to 5 years. The study aims to include participants aged between 45 and 55 years old, providing them with a self-instructional program consisting of carefully planned written information tailored specifically for postmenopausal women. The aim is to empower women to independently understand information about the climacteric phase, health concerns, and managing menopausal issues.
- The experience of menopause varies for each individual.
- Having a satisfactory quality of life in all aspects is important for overall well-being.
- Postmenopausal women are more likely to encounter changes in their quality of life.
- Community health nurses can identify menopausal issues and provide coping guidelines.
- This study focused on adult females who were unable to verbally express all their problems.
- This study only included adult females who were willing to receive written information.
- This study specifically targeted adult females over the age of 55 years old.
The survey will evaluate the quality of life among postmenopausal women living in rural areas, enhancing understanding in this demographic.The results will assist in creating a self-instructional module about coping strategies for postmenopausal women. Nurses can utilize these findings to determine the necessary support, counseling, guidance, and education required by women during menopause.
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