How the Menopause Life Course Stage Contributes to Understandings of Health and Illness

3684 words (15 pages) Nursing Essay

20th May 2020 Nursing Essay Reference this

Tags: healthHRTmenopause

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Write an essay explaining how and to what extent a particular life course stage can add to the understandings of health and illness provided by sociology, biology and psychology. This can be done either in relation to a single area of health and illness chosen from the subjects covered in Block 3 or across the range of those subjects. Follow the instructions below and use no more than 1500 words:

Explain how your chosen life course stage, working alongside the perspectives of biology, psychology and sociology, shapes our understanding of health and illness; how does it help us to understand experiences of health and illness?

The focus of this essay is to explain how my chosen life stage Menopause contributes to understanding of health and illness.  I have chosen to explore Menopause by explaining the life course perspective and how the five principles relate to menopause.  Focus will be placed on the biological, psychological and social health needs and what physical and emotional symptoms the changes menopause brings. I will discuss with evidence any changes in strategies or legislation and how these can help facilitate the health professional meet the needs of the individual across their mid-life span.  I will evaluate how to obtain optimum health and wellbeing by focusing on Health Promotion as my criteria.

Evidence and explanation (750 words)

Explain both your choice of life course stage and how that stage, working alongside the perspectives of biology, psychology and sociology, shapes our understanding of health and illness. How does it help us understand experiences of health and illness?

I have chosen for this essay “Menopause” the middle age life course to understand the stages of menopause as it proceeds through changes of woman’s emotions such as a sense of loss due reproductive years ending, loss of identity and feeling of uselessness to their family or society and explore how the menopause is related to the changes often known as “the change of life” and how women feel about these changes and their opinion on “body image” by their experiences and whether or not it is a positive or negative experience (Watson, 2019c).

The life course perspective defines age categories as people progress from birth to death.  It is broken down into life course stages and it is important to highlight women’s course varies and are shaped by the society and culture they habitat.  Similarly, this shapes the role, responsibility and experiences for women giving a better understanding of any factors that contribute to their health and wellbeing during this stage of their life (Rogers, 2019).

The Life Course Theory consists of five principles and is defined as a theory developed in the 1960’s to focus on a person from birth, middle age and adulthood and further on to ascertain the historic, social and cultural surroundings in an individual’s life.  Bengtson et al. (2005) highlights the importance of the cultural and historical context, the importance of kinship and friendship in that family or friends may influences a person which ultimately changes a person’s attitude or  behaviour which can make our health care job more difficult to treat. He explains historical time and place will interact with age and geographical location such as economy which can disrupt family life (Rogers, 2019a).  It is important to recognise that menopause is a stage of life woman pass through with five live course principles to consider, linked lives such as “health before birth”, historical time and place, transitions and their timings, agency and planfulness and biographical process and the role of the individual which are important in the reporting and preventing any illness menopause may present by considering the life course principles (Rogers, 2019b).

Having established menopause as a life course perspective it happens as a natural biological event in which the ovaries do not producing eggs and the hormones oestrogen and progesterone which usual occurs normally in woman in their early 50’s but can happen at an earlier age.  Menopause is when the function of the ovary’s ceases, the ovary (female gonad), is one of a pair of reproductive glands in women and produce eggs (ova) and female hormones such as oestrogen.  Subsequently during menopause, the low and changing degrees of ovarian hormones especially oestrogen is the reason for menopausal events and health outcomes and menopause experiences can be different depending on how each individual coping mechanism depending on their physical, emotional and mental health (Melissa Conrad Stöppler, 2019).  Some women may be induced by medical intervention known as bilateral oophorectomy, undergo a hysterectomy or receive chemotherapy for breast cancer or pelvic radiation therapy which causes ovarian damage resulting in loss of fertility and the end of menstrual periods and very much depend on sex and age, hormones are pertinent with behaviour and fitting to the social aspect (Anon, 2019).  Change in menstrual cycle causes women to have hot flushes, night sweats, headaches or dizziness, vaginal dryness, difficulty sleeping, mood swings, memory problems, loss of interest in sex and weight gain being symptoms experienced (Healthtalk.org, 2019).

The biological lens is particularly important and is highlighted in the biomedical model of healthcare and seen as a medical issue or disease, the medical profession see it as “a deficiency disease needing to be treated or cured with the use of hormone replacement therapy” focusing on diseases like bone density decreasing, risk of osteoarthritis increasing (Anon, 2019), hormone balances changing and the risk of cardiovascular diseases (SAGE Journals, 2019).

Subsequently we need to consider the psychological aspect to understand the biology aspect better using theoretical models and expectation on normal day to day functioning of each woman experiencing menopause and what can alleviate these biological changes such as exercise and lifestyle changes (McFadden and Rawson Swan, 2012).  GP’s prescribe HRT treatment such as tablets or skin patches which replaces oestrogen to control symptoms taking into consideration bone protection to avoid osteoporosis (Menopausematters.co.uk, 2019) and vaginal oestrogen creams for vaginal dryness or alternative therapies such as Cognitive Behavioural Therapy (CBT) to help with low mood or feelings of anxiety.  Information can be given on nutrition and exercise to improve symptoms (nhs.uk. 2019).

Psychological and emotional symptoms occur during the menopause such as anxiety, depression, sadness, difficulty concentrating and anger and irritability as examples, positive mental health and wellbeing avoids deteriorating health however deteriorating health affects menopausal women psychologically as their thoughts, feelings and coping mechanisms are altered significantly due to life experiences and their ability to cope with same and how critical the role of family relationships can play in health and illness.  McFadden and Swann’s review of the research available identify and evidence that poor concentration, night sweats, disturbed sleep pattern equals poor daily performance at work or at home (McFadden and Rawson Swan, 2012).   The psychological lens is important in relation to how each woman embraces the menopause, for many women they can have very few symptoms and others experience very negative symptoms which affects their lives and health.  These can be characterised as psychosocial and environmental therefore society, family and how a woman perceives menopause will portray how they cope physically and mentally (Bhutani, Bhutani and Bhutani, 2019).   There is evidence in recent studies Campbell (2003) states that poor family relationships can be negative to health and illness impacting on depression, negative environments such as a smoking environment impacts on health however Campbell (2003) says family support is important and helps improve health, education and support (Rogers, 2019d).  Therefore, developing resilience and being happy is important qualities to good health and happiness, resilience is defined as ‘The ability of a substance or object to spring back into shape; elasticity’ (Oxford Dictionaries, 2014) therefore woman going through menopause need good psychological resilience to cope with stress and anxiety (Rogers, 2019e).

Another point to consider is the sociology lens of menopause.  Many women’s symptoms include, depression, forgetfulness, mood swings, stress, hot flushes and vaginal dryness.  Therefore, it is understandable that this would affect a women’s social life or work life.  Due to severe symptoms this creates poor overall health status for woman and will interfere with their day to day living.  Due to the drop in oestrogen levels during menopause this can lead to hot flushes that disturbs sleep that can lead to anxiety, fears and mood swings and will impact on woman’s concentration during the day which leads ultimately to poor work performance and in some cases women may have to leave their employment leading to financial difficulties which contributes to mood alterations such as depression  (Relationship-affairs.com, 2019).   The earlier the menopause due to induced menopause will socially affect a couple and impact on their sex life.  Woman feel they have lost their womanliness and sexual attraction perhaps due to vaginal dryness or feeling unattractive.  Others will suffer other health issues for example sore painful joints, headaches, anxiety or urinary incontinence and would have to be managed by HRT Treatments, support groups or CBT counselling (Bhutani, Bhutani and Bhutani, 2019.  Using a sociological lens aids understanding of the social aspect be it cultural, social and group influences women may choose to manage the menopause such as nutritional needs are important in alleviating several health problems like obesity or anorexia.  Woman now juggle full time employment with family life and therefore this pace of life is very different to a woman in the 1920’s.  Fast food and convenience foods are to hand and are convenient but high in fat and sugar content.  Nutrition is also seen as a customary behaviour in families which influences food choices which increases diseases such are obesity, heart disease or diabetes (Rogers, 2019f).

Evaluation of the perspectives (550 words)

Evaluate how much effect your chosen life course stage has in shaping our understanding of health and illness; you will need to outline the criteria – for example, its ease of application to your own practice – that you have used to come to this judgement.

As a health care practitioner, we are trained to offer interventions that can improve health, education, information and support to provide personal centred care.  Applying a holistic and reductionist approach to menopausal woman incorporating all three lenses (biological, psychological and sociological) can be difficult and specialist information is required for the entire holistic picture and address menopausal woman as a whole identity that is physically, mentally, emotionally and socially.  The need to understand all the arguments in order to support women to make the right informed choices for them (Watson, 2019g).

Therefore, the criteria I am using to evaluate and has good potential to empower menopausal woman on the implications, symptoms and support available to them is “health promotion”. As a future nurse I need to provide informed care to service users if they need advice and guidance and what available evidence is there to assist.  NICE Guidelines are continually making recommendations to improve on the individuals care and gives advice and information too family members so menopausal women can feel supported in their symptoms, lifestyle choices, treatments available which ultimately eases their symptoms and manages their general health and wellbeing.   Considering HRT or CBT can alleviate low mood and educate women they are not “mad or abnormal”, they have voices and are being listened too helps with health-related illnesses (Nice.org.uk, 2019).  Health Promotion advertises and encourages menopausal woman to attend support groups for woman to feel connected, share their experiences and manage lifestyle changes such as dietary information, exercise, support on giving up smoking and reducing alcohol intake.   Menopausal women feel socially isolated which increases their levels of stress and anxiety, joining groups such as yoga, mediation or attending for acupuncture are among several resources available for women suffering from menopause (Mysecondspring.ie, 2019).

There are medications or remedies for menopausal women like antidepressants, HRT, CBT, Mindfulness or Counselling however it does come down to a person preferred choice (Menopausematters.co.uk, 2019) and researchers are continually promoting and researching what is best for each individual.  Feminist research will influence the menstrual cycle such as the randomised controlled trial Schierbeck and colleagues reported that woman who were given HRT showed a decline in cardiovascular activity therefore they believe HRT is a positive treatment in improving death rates.  Results also indicated that HRT did not increase the risk of breast cancer or stroke.  However, this was debated with Loppie and Keddy who argue menopause is not a medical condition rather a natural occurrence and they believe woman are misled with inconsistent information (Watson, 2019g).  Even though the topic is controversial we must understand that evidence and health promotion are key to understanding both sides of the arguments taking into consideration the three lenses and a holistic approach to support woman in their own decision making as health care professionals.

Conclusions (100 words)

In summary combining medical research and all three perspectives will give a better focus on how the middle life stage of menopause evolves, from symptoms, illnesses and experiences.  By applying a holistic and reductionist approach and incorporating all three lenses can be difficult and specialist information is required for the entire holistic picture and address menopausal woman as a whole identity.  The need to understand all the arguments in order to support women to make the right informed choices.  As discussed the NMC Guidelines support not only the menopausal women but their family and carers also and advocate being more proactive in their recommendations so we all receive clearer guidelines to share and communicate accordingly, this in return encourages woman to be more proactive in their health care choices for example nutrition or medication (HRT).  Understanding health and illness during menopause is complex and it is evitable occurrence for all woman bringing with it health implications which in turn adds challenges for services.  Research tends to be focusing on factors that completely influence the physical and psychological aspects of menopause such as health lifestyle changes to support and improve a woman’s quality of life during and after menopause.

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