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KNOWLEDGE, ATTITUDE AND EFFECTS OF MENOPAUSAL CHALLENGES AMONG OLDER WOMEN IN ISEYIN LOCAL GOVERNMENT.
CHAPTER ONE
INTRODUCTION
Background of the study
The experience of menopause varies among women as they age. Adolescent females between the age range of 45 to 55 years are naturally affected by this phenomenon (Faubion et al., 2015; Laven et al., 2016; World Health Organisation [WHO], 2022). Menopause is the process by which ovarian function declines and menstruation stops (WHO, 2022). The absence of a monthly menstrual cycle for a duration of 12 months, without any identifiable biological or physiological cause, is often acknowledged (World Health Organisation, 2022). Menopause, sometimes referred to as the transitional phase in a woman’s life, denotes the conclusion of her reproductive phase and the start of the ageing phenomenon (Hatice et al., 2016).
The onset of menopause may be attributed to the inefficiency of DNA repair mechanisms, which contribute to the ageing process of the soma. This ageing process ultimately leads to the inability to reproduce and the subsequent manifestation of natural menopause (Laven et al., 2016). Therefore, menopause is an inherent phase in a woman’s life that warrants comprehension, assistance, and self-preservation.
Comprehension, assistance, and self-preservation during menopause are particularly crucial due to the potential physical and psychological changes and challenges that may arise during this period. During the menopausal phase, women may encounter a range of physiological manifestations, such as hot flashes, irregular menstrual cycles, and dyspareunia (World Health Organisation, 2022). In addition, it seems that the occurrence and severity of these symptoms are impacted by several factors, including education, self-esteem, anxiety, and low levels of blood oestrogen (Zhang et al., 2020).
In addition to these factors, age has a substantial influence on psychological concerns during menopause. Multiple studies have shown that natural menopause does not have any detrimental impact on the mental well-being of middle-aged women who are in good health (Busch et al., 2016). Nevertheless, it has been shown that women who deviate from the expected age patterns in terms of the initiation of natural menopause, whether it occurs sooner or later, tend to have more pronounced symptoms of sadness and psychological distress (Faubion et al., 2015). In due course, women may navigate this transition with more ease and comfort if they possess knowledge about the many elements that influence menopausal symptoms. However, formal education for women often does not include coverage of menopause, and a significant number of general practitioners possess insufficient expertise in the management of menopause (Harper et al., 2022; WHO, 2022). Furthermore, it is worth noting that menopause has often been seen as a deficient ailment and a detrimental encounter throughout a woman’s lifespan by both the media and the medical community (Harper et al., 2022).
Similarly, Brewis, Beck, Davies, and Matheson (2017) emphasised that previous research has shown menopause as a medical ailment that elicits more negative emotions, rather than presenting it as an inherent aspect of the ageing process or a process of life transition (Arseneau et al., 2021; Hickey et al., 2022). Although menopause is significant, there is a lack of adequate formal knowledge on this topic. Consequently, women may possess incorrect perspectives about menopause, which might impact their perception and readiness for this phase of life. Hence, it is crucial to do research that perceives menopause as an inherent phase, with a specific emphasis on its beneficial outcomes. It is crucial to present menopause in a more optimistic light, since attitudes about menopause seem to impact the intensity of menopausal symptoms and the overall experience of menopause (Arseneau et al., 2021).
According to Beck, Brewis, Davies, Fish, and Garlick (2016), an attitude refers to an individual’s emotional response and evaluation of an item or event. Hence, menopausal attitudes may be defined as the evaluation and position on the occurrence of menopause. Numerous research conducted so far have shown that women’s perspectives on menopause may be shaped by a range of characteristics, including their menopausal state, social background, educational attainment, and self-perceived mental and physical well-being. An instance of enhanced attitudes towards menopause may be seen via the acquisition of information and readiness for this physiological process (Liao & Hunter, 1998). The correlation between information and menopausal attitudes is substantiated by the observation that women tend to have more favourable perspectives about menopause subsequent to their own experience with the condition.
According to a recent research conducted by Dashti et al. (2021), postmenopausal women exhibit more favourable views compared to women in pre- or perimenopausal stages. These findings are consistent with previous research indicating that the majority of women, particularly those who have reached menopause, have neutral or positive views regarding menopause and do not see it as as stressful as they first believed. Research substantiates this claim by demonstrating a slight decrease in menopausal anxiety as individuals get older. The drop in question may be attributed to the variability in the perception of experiences, which is contingent upon an individual’s life stage (Brewis, Beck, Davies, & Matheson, 2017). Due to the multitude of physiological changes that often occur during menopause, younger women tend to have more unfavourable views about menopause compared to middle-aged women. Middle-aged women often see menopause as a normal occurrence with less apprehension around the loss of reproductive capacity. Hence, elderly women do not see menopause as a critical or extreme occurrence, but rather as an inherent phase of gradual metamorphosis. This finding illustrates that age has a substantial influence on individuals’ thoughts regarding menopause. Hence, it is essential to provide education to younger women on the symptoms associated with menopause, as well as to equip and assist them in preparing for the start of their menopausal transition.
The presence of unfavourable views regarding menopause has the potential to impact the overall well-being of young women. According to Kopenhager and Guidozzi (2015), the level of well-being is at its lowest among young women. It then has a mild increase from age 18 to midlife, which typically occurs around the age of 50, and then slightly decreases thereafter. According to Kopenhager and Guidozzi (2015), the improvement in women’s self-reported mental health may be attributed to their changing expectations for their health as they approach adulthood, as well as their reorientation of values around midlife, which leads to psychological enhancements. Furthermore, research findings from the early 1990s suggest that women who had a generally high level of well-being had favourable views regarding menopause. This corroborates the hypothesis that younger women have diminished well-being due to unfavourable evaluations of menopause and the process of ageing. According to Brewis, Beck, Davies, and Matheson (2017), there exists a negative correlation between well-being and many factors such as psychosomatic and respiratory symptoms, prior premenstrual problems, and interpersonal stress. Moreover, there exists a favourable correlation between it and the current state of general health and the overall appraisal of health (Brewis, Beck, Davies, & Matheson, 2017). The findings of this study indicate that middle-aged women exhibit elevated levels of well-being due to favourable assessments of life stage problems, such as menopause, notwithstanding the developmental obstacles associated with the ageing process. Therefore, the researcher aims to assess the knowledge, attitude and effects of menopausal challenges among older women in Iseyin Local government.
Statement of the problem
Menopause is a crucial period of change in a woman’s life, characterised by the end of menstrual periods and the loss of reproductive ability. Menopause, while a normal occurrence, often presents a range of medical, psychological, and social difficulties that may greatly affect a woman’s overall well-being. Although menopause is an unavoidable process, there is still a lack of comprehension about how older women view and handle the difficulties linked to it (Brewis, Beck, Davies, and Matheson, 2017). Hence, the objective of this study is to examine the understanding, beliefs, and impacts of menopausal difficulties among elderly women. Nevertheless, there exist several obstacles that restrict women’s comprehension of menopause, including but not limited to the dearth of complete information pertaining to older women’s knowledge of menopause, its physiological alterations, and the accompanying health hazards.
This lack of awareness may lead to misunderstandings and insufficient readiness for handling menopausal symptoms. Women’s perceptions and coping mechanisms towards menopause are significantly influenced by their attitudes towards it. An investigation of the perspectives of elderly women on menopause may provide insights into the cultural, societal, and personal elements that impact their encounters and methods of dealing with it (Brewis, Beck, Davies, and Matheson, 2017).
Moreover, the manifestation of menopausal symptoms, such as hot flashes, mood swings, sleeplessness, and vaginal dryness, may have a substantial influence on several dimensions of a woman’s existence, encompassing her bodily well-being, emotional state, interpersonal connections, and occupational pursuits. Comprehending the magnitude and characteristics of these impacts is crucial in order to build effective treatments and support structures.
According to Brewis, Beck, Davies, and Matheson (2017), women’s experiences of menopause may be greatly influenced by sociocultural variables such as society norms, cultural beliefs, and healthcare practices. This analysis may provide valuable insights into the contextual elements that impact the process of acquiring information, attitudes, and coping strategies among elderly women. Hence, the need to assess the knowledge, attitude and effects of menopausal challenges among older women in Iseyin Local government.
1.3 Objective of the study
The broad objective of the study is to assess the knowledge, attitude and effects of menopausal challenges among older women in Iseyin Local government. The specific objectives is as follows
Examine the level of knowledge among older women regarding menopause.
Find out the attitudes of older women towards menopause, and how do these attitudes influence their perceptions and coping strategies.
Assess the physical, psychological, and social effects of menopausal challenges on the lives of older women.
Analyze how sociocultural factors influence older women’s experiences of menopause.
1.4 Research Questions
The following questions have been prepared to guide the study
What is the level of knowledge among older women regarding menopause?
What are the attitudes of older women towards menopause, and how do these attitudes influence their perceptions and coping strategies?
What are the physical, psychological, and social effects of menopausal challenges on the lives of older women?
How do sociocultural factors influence older women’s experiences of menopause?
1.5 Research hypotheses
The hypotheses have been formulated for the study
H01: The level of knowledge among older women regarding menopause is low
H02: The attitudes of older women towards menopause does not influence their perceptions and coping strategies.
1.6 Significance of the study
The study will be significant to the following
Ministry of health: Understanding the knowledge and attitude towards menopause among older women is crucial for promoting awareness about this natural transition in a woman’s life. Many women lack accurate information about menopause, leading to misconceptions and anxiety. This study can contribute to filling this knowledge gap and empowering women to make informed decisions about their health.
Healthcare Provision: Findings from the study can inform healthcare providers about the specific challenges and concerns faced by older women during menopause. This can lead to improved healthcare provision tailored to the needs of menopausal women, including better counseling, support, and treatment options.
Policymakers: Findings from the study may have implications for healthcare policies related to women’s health, aging, and menopause. Policymakers can use this information to advocate for better healthcare services, research funding, and public health campaigns aimed at promoting menopausal health and well-being.
Academia: the study will be beneficial to the academic community as it will contribute to the existing literature.
1.7 Justifications of the study
Menopause marks a significant transition in a woman’s life, accompanied by various physiological and psychological changes. Despite its universal nature, there exists a noticeable gap in understanding and addressing the challenges faced by older women during this phase. Investigating their knowledge and attitudes towards menopause, as well as the effects of these challenges, is crucial for bridging this healthcare gap. Menopausal symptoms can significantly impact the quality of life of older women. By exploring their knowledge and attitude towards menopause, we can identify areas where education and support interventions are needed. Understanding the effects of menopausal challenges on various aspects of life such as physical health, mental well-being, social relationships, and professional life can inform strategies to improve the overall quality of life for this demographic. Effective allocation of healthcare resources requires an understanding of the prevalence and impact of menopausal challenges. By elucidating the knowledge, attitudes, and effects among older women, policymakers and healthcare providers can tailor resources to meet the specific needs of this population. This may involve implementing educational programs, providing access to support groups, or developing specialized healthcare services targeting menopausal health. In addition, Menopausal transition is associated with an increased risk of certain health conditions such as osteoporosis, cardiovascular diseases, and mood disorders. Examining the knowledge and attitudes of older women towards menopause can shed light on their awareness of these health risks and their willingness to adopt preventive measures. This information is invaluable for designing targeted preventive health interventions to mitigate the long-term health consequences of menopause.Menopausal challenges not only have physiological ramifications but also significant psychosocial implications. Older women may experience feelings of isolation, anxiety, or depression as they navigate through this life stage. Understanding the effects of menopausal challenges on their mental health and social well-being can guide the development of support networks and mental health interventions tailored to their specific needs. Investigating the knowledge, attitudes, and effects of menopausal challenges among older women is essential for enhancing healthcare provision, improving quality of life, and addressing the psychosocial and preventive health needs of this demographic. By shedding light on these aspects, this study seeks to pave the way for targeted interventions and support mechanisms tailored to the unique experiences of older women during menopause.
1.8 Scope of the study
The study focuses on the knowledge, attitude and effects of menopausal challenges among older women in Iseyin Local government. Hence, the study will examine the level of knowledge among older women regarding menopause, find out the attitudes of older women towards menopause, and how do these attitudes influence their perceptions and coping strategies, assess the physical, psychological, and social effects of menopausal challenges on the lives of older women and analyze how sociocultural factors influence older women’s experiences of menopause. The study is delimited to Iseyin Local government.
1.9 Limitation of the study
Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint are:
Time: The researcher encountered time constraint as the researcher had to carry out this research along side other academic activities such as attending lectures and other educational activities required of her.
Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process.
Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study
1.10 Definition of terms
Knowledge:
Knowledge refers to the awareness, understanding, and familiarity that older women possess regarding menopause, its physiological processes, associated symptoms, and potential management strategies. This includes factual information, acquired through various sources such as healthcare providers, literature, personal experiences, and cultural beliefs.
Attitude:
Attitude pertains to the psychological predisposition or perspective of older women towards menopause and its challenges. It encompasses their feelings, beliefs, opinions, and emotional responses regarding menopausal experiences, including their perceptions of its impact on their physical health, emotional well-being, social interactions, and overall quality of life.
Menopausal Challenges:
Menopausal challenges denote the array of physiological, psychological, and social difficulties encountered by older women during the transition into menopause and the postmenopausal period. These challenges may encompass a spectrum of symptoms such as hot flashes, mood swings, sleep disturbances, vaginal dryness, changes in libido, cognitive changes, osteoporosis, cardiovascular risks, and challenges related to body image, self-esteem, and identity. They may also include broader societal attitudes, cultural perceptions, and healthcare-related issues impacting women’s experiences of menopause.
1.11 Area of the study
Ibadan is the capital and most populous city of Oyo State, in Nigeria. It is the third-largest city by population in Nigeria after Lagos and Kano, with a total population of 3,649,000 as of 2021, and over 6 million people within its metropolitan area. It is the country’s largest city by geographical area.