Menopause And Practice Of Menopausal Coping Strategies

Project and Seminar Material for Sociology

Menopause And Practice Of Menopausal Coping Strategies


Abstract


The study was designed to investigate the perception of menopause by women in UDI Educational Zone of Enugu State, and how they cope with the stage. Four specific purposes of the study, four research questions and three null hypotheses were formulated and tested at the probability of 0.05 levels of significance. A descriptive survey research design was adopted for the study. A structured questionnaire was developed and used for data collection. The population of the study consists of all the women in Udi educational zone who are within menopause age. The sample for the study was 600 women purposively selected, 600 questionnaire copies were distributed but only 583 were collected. Mean was used to analyse the research questions. The questionnaire was validated by two experts in guidance and counselling and one expert in Measurement and Evaluation all in University of Nigeria, Nsukka. The result revealed that both married and unmarried women perceive menopause as beginning of old age and the end of reproductive life, that lack of sexual arousal, decrease in sex are the reproductive health behaviour of women in the study area. The finding of the study further revealed that women in menopausal age have strained relationship with husband and children. They equally have loss of sexual enjoyment and the coping strategies they adopt are resigning to faith, discussing with people who have passed menopausal state and seeking medical attention. The study highlighted the implications of the study and made recommendations, suggestions for further studies were made bearing in mind the importance of guidance and counselling to women who are in menopausal stage.


Table of Content


Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Purpose of the Study
  • 1.4 Objectives of the Study
  • 1.5 Research Questions
  • 1.6 Hypothesis
  • 1.7 Significance of the Study
  • 1.8 Scope of the Study
  • 1.9 Definition of Terms
  • 1.10 Limitation of the Study
  • 1.11 Organization of the Study

Chapter Two:

Review of Related Literature

  • 2.1 Conceptual Review
  • 2.2 Theoretical Review
  • 2.3 Empirical Review
  • 2.4 Summary

Chapter Three:

Research Methodology

  • 3.1 Design of the Study
  • 3.2 Area of the Study
  • 3.3 Population of the Study
  • 3.4 Sample and Sampling Technique
  • 3.5 Instrument for Data Collection
  • 3.6 Validity of the Instrument
  • 3.7 Reliability of the Instrument
  • 3.8 Method of Data Collection
  • 3.9 Method of Data Analysis
  • 3.10 Ethical consideration

Chapter Four:

Data Analysis and Result Presentation

  • 4.1 Data Presentation
  • 4.2 Summary of Findings

Chapter Five:

Discussion, Implication and Recommendation

  • 5.1 Discussion of Findings
  • 5.2 Recommendation
  • 5.3 Suggestion for Further Studies
  • 5.4 Summary of the Study
  • 5.5 Conclusion
  • REFERENCES
  • APPENDIX

Chapter One


Introduction

1.1 Background of the Study

Human growth and development passes through different significant stages from infancy through childhood to puberty and adolescent to adulthood. Each of these stages is marked by certain characteristics that manifest in human beings. A lot of studies have been carried out on some of these stages while some others are yet to receive attention. One of such stages that is yet to receive considerable attention is the period of adulthood especially the menopausal stage of adult life.

Menopause is a transition caused by gradual decline in the body production of female hormones called estrogen and progesterone (Odunukwie 2011). Estrogen and progesterone are hormones produced in the bodies of women which prepares the body to become pregnant and is also used for contraception. As this hormonal decline occurs women can experience a variety of physiological and emotional changes. Menopause therefore, is the point at which menstruation ceases (Bobak 1990). Menopause is the period in a woman‟s life in which certain hormonal changes occurs little by little, modifying her reproductive life. According to Lauritzen (1993) menopause is the period that begins after at least twelve months without any menstrual episode .It is also regarded as the point along the aging process that is marked by ceassation of menstruation. Menopause usually occurs when a woman is advancing in age hence Davis (1986) writes that the mean age of menopause is 51 years although this varies from person to person. Menopause is the end of the menstrual flow and fertility in women and marks the end of the productive era in women. (Cox,1983). Menopause is a term used to describe the permanent cessation of the primary function of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uttering [the menses].

This period which can be found in very few men according to some studies [Tindal, 1987, Robert, and Learler, 1950], mainly concern the women folk. The period seriously affects their health status and consequently their role performance at that stage. For instance, the period is marked with health problem such as fatigue, headache, depression, anxiety, nervousness, and loss of appetite, shrinkage of vagina, hot flushes, constipation and marks the end of reproductive era. These health problems definitely will affect their function in the home as women. They may find it difficult to carry out their routine household chores, they may no longer be able to satisfy their husbands sexually due to their vaginal shrinkage. Managing their household generally may be a problem to them and the family and children will suffer. Studies have shown that of all the health-related problems in the whole world, physiological and psychological problems associated with menopause is an important determinant of the health of aging women [Friendman and Moshy, 1986]. However, little work has been carried out on the contribution of menopause and menopausal perception to the health recent studies indicate that menopause is associated with physiological and psychological health problem in women (Jacobson 1993). The psychological health impact of menopause has different Connotations or influences on single women, married women with children and childless women and family life as a whole [Cox, 1983; Smith and Reynrd, 1991].

Many women approach menopause with fear, insecurity, loss of fertility, obesity and loss of their husbands‟ affection (Cox, 1983). Some associate the menopause with development of cancer, emotional depression and anxiety (Tindal, 1987). A fundamental reason for emotional upset is that the menopause represents the end of reproductive era and this means a lot to women ; even those who have as many children as they want. It inevitably may mean more to the barren and unmarried who had previously lived on hope; especially in our cultural context where a woman‟s nobility is counted mainly on marital status, and number of children.

Menopause typically (but not always) occurs in women on midlife, during their late 40s or early 50s and signals the end of the fertile phase of a woman‟s life. The transition from reproductive to non-reproductive is the result of a major reduction in female hormonal production by the ovaries. This transition is normally not sudden or abrupt, tends to occur over a period of years, and is a natural consequence of aging.

However for some women, the accompanying signs and effects that occurs during the menopause transition years can significantly disrupt their daily activities and their sense of well-being. In addition, women who have some sort of functional disorder affecting the reproductive system [i.e. endometriosis, polycystic ovary syndrome, cancer of the reproductive organs can go into menopause at a younger age than the normal time- frame; the functional disorders often significantly speed up the menopausal process and create more significant, for the affected woman.
Menopause can seem like the end of a woman‟s life. She could lose interest in her existence, in her companion and in her family. She may seem to adjust to the situation but she may complain or exaggerate and certainly suffer. The symptoms mentioned above are not necessarily permanent and sometimes they are not wholly real. That is, they may be physiological fear and may not be actually what will happen to the woman. They can be as a result of lack of information and the exaggeration of the event that accompany the hormonal changes that occur in the woman‟s body.

The most difficult task in menopause –health associated problem, is the way to prevent and/or manage the stress, depression, emotions and other health problems that accompany menopause in women. The coping strategies therefore have a serious health implications for the aging woman‟s health status and consequently counseling
implications for the guidance counselor. At a personal level, menopause is a stage in a woman‟s life which comes naturally or could be caused by other factors like surgical operations, several abortions etc affecting the reproductive organ in which a woman stops seeing her monthly period.

Perception determines attitude; the way women perceive menopause goes a long way to determine their behavior during this period as well as how they cope with it. It was against this background that this study menopausal perception and coping strategies among women in Udi Educational Zone and its implications for their health status and to guidance counselor was conceived.


1.2 Statement of the Problem

Menopause is associated with some health related problem such s fatigue, headache, vaginal dryness, hot flushes etc. these health related problems affect menopausal women‟s‟ function in the home. The vaginal dryness for instance brings about decrease in sexual responsiveness and loss of sexual enjoyment in women. Some women may not be able to perform their sexual functions with their husbands due to the pain they feel during intercourse as a result of the vaginal dryness. Others may not deem it necessary to have sexual intercourse with their husband since they have gotten the number of children they want leaving the men with no other option than getting involved in extra-marital affairs in order to get sexual satisfaction. This particular problem has exposed so many couples to sexually transmitted diseases and can equally lead to divorce when not properly handled

Women these days tend to marry late due to education, high bride price, economic crisis and some other social factors eventually, such women marry when their menopause is fast approaching. Due to the high regard Africans and Igbos in particular place on children, women tend to negate all the rules of family planning [child spacing] so as to make the required number of children they wanted if they had married early. This has a serious health implication for women especially in our context where health services have not yet adequately developed. For a childless woman who cannot find peace and joy in a culture that places high premium on children menopause means a lot. This is because menopause is associated with infertility; when a woman can no longer bear children. Indeed the status of a Nigerian woman seems to depend on the number and sex of children she has. Menopausal period may also mean a lot to women with same sex children especially female children.

Worse still, the anxiety, depression and stress that accompany menopausal perceptions are enormous. In addition, most women have not only perceived menopause in different ways but also have not developed appropriate strategies for handling such situation. As a result their psychological problems are always aggravated.
Based on this therefore the problem of this study is to investigate the perception of menopause by women in the study area and how they cope with it, with a view to providing/recommending counseling.


1.3 Purpose of the Study

Broadly, the purpose of this study is to investigate the perception women have about menopause and how they cope with it.


1.4 Objectives of the Study

Specifically, the study intends to;

  1. Ascertain the perception of menopause by women in the study area.
  2. Ascertain the reproductive health behaviours of women approaching menopause in the study area.
  3. Examine the perceived influence of menopause on family life of women
  4. Examine the coping strategy used by these women who are already in menopausal age.

1.5 Research Questions

  1. The research questions that will guided this study are as follows;
  2. How do women perceive menopause?
  3. What is the reproductive health behavior of women already in menopause?
  4. How does menopause influence the family life of women?
  5. What are the coping strategies adopted by menopausal women in the study area?

1.6 Hypothesis

The following hypothesis were tested at 0.05 level of significance

  1. There is no significant difference in the mean perception of menopause between married and unmarried women in menopause.
  2. There is no significant difference in the mean perception of menopause between married women with even
    distribution of sex of children and married women with only one sex of children.
  3. There is no significant difference in the mean perception of menopause between married women without children and married women with children.

1.7 Significance of the Study

The problem associated with menopause is a major health concern to women and the society at large. The findings of this study will be beneficial to women, health workers, counsellors and nongovernmental organizations. It will help enlighten women on the influence of menopause on family life. This will also help for a better family living and better health for women.

This study will equip the counsellors with information that will help them educate women on menopausal issues. Health workers will also use the information from this study to guide women as regarding their reproductive health behavior. This will thus bring to an end their idea of conceiving almost yearly to have their desire number of children before menopause.

Furthermore, it will help the nongovernmental organizations in their pursuit for peace in families and invariable peace in the nation.


1.8 Scope of the Study

The study is focused on the menopausal perceptions and coping strategies of women in Udi educational zone of Enugu state. The study includes barren women, married women with even distribution of sex of children, married women with only one sex of children and unmarried women who are already in menopause.

Reproductive health behaviour, family life, and coping strategies adopted by the women in the above categories as they relate to menopause.


1.9 Definition of Terms

Menopause

Is a stage in life when you stop having your monthly period. It’s a normal part of aging and marks the end of your fertile, reproductive years. Menopause typically occurs in your late 40s to early 50s. However, people who have their ovaries surgically removed undergo “sudden” surgical menopause usually involves adjusting to or tolerating negative events or realities while you try to keep your positive self-image and emotional equilibrium.

Coping

Occurs in the context of life changes that are perceived to be stressful.

Strategy

A plan of action designed to achieve a long-term or overall aim.


1.10 Limitations of the Study

The study was constrained in a number of ways. However, the obvious limitation of this study includes the following;

  1. The study was limited in the area of determining women who have full knowledge about menopausal age in Udi education Zone of Enugu state. Perhaps similar investigation of menopausal perception and coping strategies which include women in Enugu South Education Zone could yield a different result.
  2. Possibly there could have been some faking of responses to the items on the questionnaire provided by the researcher. The extent it occurs may influence the findings of this research study.
  3. The study was centered on women in Udi Educational Zone of Enugu State. The inclusion of single parents could further validate the findings of future studies for greater generalization.

1.10 Organization of the Study

This study is divided into five chapters. Chapter one is introduction which consists of the background to the study, statement of problem, research questions, research hypotheses, objectives of the study, the significance of the study, the scope and limitations of the study and finally the organization of the study. Chapter two deals with the literature review which consists of the conceptual literature, theoretical literature, empirical literature, theoretical framework. Chapter three gives the research methodology including research design, population of study, sample size, sampling technique, method of data collection, instrument of data analysis, method of data analysis, validity/reliability of instrument. Chapter four is presentation and analysis of data, discussion of findings. Chapter five gives the summary, conclusion and recommendations.


Chapter Five


Discussion, Implication and Recommendation

This chapter includes a discussion of the findings, implication of the study to counselors, recommendations, conclusion, summary and suggestions for further studies.


5.1 Discussion of Findings

The research questions and hypotheses are discussed in the order which they appear in the study. However, research questions with related hypotheses are discussed jointly. Specifically, the discussion is organized using the following sub-headings.

  1. Perception of menopause by women
  2. Reproductive health behaviour of women approaching menopauses
  3. Perceived influence of menopause on family life of women.
  4. The coping strategy used by women in menopausal age.
Perception of Menopause by Women

From the results of the data analysis made, it is obvious that there are similarities between the married women and unmarried women in their responses. The findings on perception of menopause by women reveal beginning of old age, lonesome period, loss of attractiveness and end of reproductive life. Menopause was identified to have associated with women age that caused their reproductive cycle to changes, thus the manifestation of menopause. As harmony decline, women could experience a variety of physiological and emotional change. These findings agreed with the finding of Bobak (1990) that menopause implies the period in a woman‟s life which certain hormonal changes occur, little by little and modifying her reproductive life. It was observed that during this menopause, ovulation usually becomes irregular with non-ovulation cycles occurring frequently as the menopause approaches.

Respondents agreed with the hypothesis made that there is no significant difference in the mean perception of menopauses between married and unmarried women in menopause. The result of the analytical finding is supportive in accepting the null hypothesis as stated above. The respondents also agreed with the hypothesis made that there is no significant difference in the mean perception of menopause between married women with even distribution of sex of children and married women with only one sex of children

Reproductive health behaviour of women approaching menopause

The findings of the study shows that lack of sexual arousal, decrease in sexual responsiveness, quick conception to beat up the period and getting into unprotected sex are the reproductive health behaviour of women approaching menopause. It is obvious that with increasing age, levels of sexual desire in both sexes and low sexual desire become more common particularly, with women in their late 40‟s and 50‟s. This finding is in line with Hunter (1990) who found a stepwise decrease in sexual interest across the menopause age women. Such interest represent loses that may influence whether they continue to take pleasure in expression of sexuality. Supporting the above finding Haltrom (1977) maintained that there is les effect of menopausal status on sexual function, the effect being some reduction in sexual desire and reduction in sexual activity. It therefore becomes imperative that women must be familiar with their menopause age to avoid becoming victims of irregulated fertility that could expose them to the risk of death.

Perceived influence of menopause on family life of women The findings on perceived influence of menopause on family life of women shows stained relationship with husband, strained relationship with children, loss of sexual enjoyment and loss of regards especially for childless woman by the society. The finding is in agreement with Tindal (1997) who pointed out that menopause age is often a period of stress. At menopausal age, the women‟s husband and children whom they loved dearly may suddenly become obnoxious and irritating to them. Obviously, these behaviour and responses from the family members could disorganize women in the menopausal age. The relationship with the woman and her husband may be under a stain for some reasons. In this regard Ezeilo (1995) pointed out that a childless woman in menopausal age cannot find peace and joy in a culture that places high premium on child. In deed, the status of a Nigeria woman seems to depend on the number of children she has and the distribution of the sexes of the children.

The coping strategy used by women in menopausal age

The finding on coping strategy used by women in menopausal age indicates resigning to fate, discussing with people who have passed menopausal stage and seeking medical attention. It is obvious that there is need for coping strategy for women in menopausal age. It will eventually equip women to over come family challenges and cultural norms that are obnoxious to women in their menopausal age. This finding is in line with Odunukwie (2010) who indicated that coping strategy will help in exposing women to what they are expected to know during menopause and may also help alleviate, regulate and ease the symptoms of menopause. Coping strategy as a behaviour will help women to function better in a given situation.

Implications of the Study

Based on the finding of the study, the following implications were deduced;

On family life, the result of the study shows decrease in sexual responsiveness and loss of sexual enjoyment. Problem can occur in the family when the woman is no longer able to perform her sexual functions with her husband since this is a strong act that helps to cement the cordial relationship between couple. Some of these women do have decrease in their sexual responsiveness during this period because they no longer deem it necessary to engage in sexual intercourse with their husbands after getting the number of children they want and so they may see menopause as a stage to liberate them from this sexual function. Others may not respond to their sexual function because of the pain they feel during the act at this period due to the dryness of their vagina. In whichever case, problem can arise between the husband and wife when the man no longer gets the sexual satisfaction from the wife. This may have the effect of making the man to get involved in extra-marital sexual activities to ease off tension, thus making him have divided attention that may affect peace in his family.

Menopausal period can breed trouble in the family which also affects the entire society since the family is the foundation of any society. Peace in the family extends to peace in the society and in the nation as a whole while chaos in the family has adverse effect in the society and nation in general.

Menopause period has implication for women‟s health. The result of the finding will help the women to adopt appropriate health care when they are approaching menopause. The women will particularly not relegate to the background child spacing principle in a bid to beat up the period. Getting into unprotected sex could lead to pregnancy which is generally seen as a mistake (i.e. when a woman who have stopped bearing children becomes pregnant) and getting pregnant at that age may be very dangerous. The result of the study will also help to increase the good health status of women

The guidance counsellors will use their professional skills to assist menopausal women go through the stage with ease. To those of them who are yet to experience the trauma from the stage, they will be helped not to be victims. To those of them who have already fallen victims of the stage as regards their family lives, reproductive health behaviour, or coping strategies to be adopted, the guidance counselor will use his/her position to help them live adjusted life and overcome the problem.

The guidance counsellor therefore can at different intervals and different places organize workshops and seminars on menopause both to men and women generally. Different topics and problems related to the stage should also be propagated to the women, their husbands, parents and to all men by the guidance counselor so that they get acquainted with the stage and adopt appropriate coping strategies before, during and after the stage.

The information the guidance counsellor will circulate will help the women approach menopausal period without fear, get adjusted during the stage, adopt appropriate coping strategy during the stage, and for harmonious living in their families.


5.2 Recommendation

Based on the findings of the study, the following recommendations were made.

  1. Enugu state and Udi local government authority should organize seminar, conference, workshop and talk on menopause for women in their locality. This will enable rural and urban women to be familiar with the concept of menopause.
  2. Religious bodies and counsellors should sensitize women of menopause age on the importance of family planning. This will help women to overcome the challenge of having to give birth every year to beat the menopausal age and reduce the risk of death.
  3. Women of menopause age should be educated by counsellors and NGOs on the effect of menopause on
    family life.
  4. Husbands and children in the family should be made to understand with women (mothers) in their menopausal age. When this is done, it could reduce conflict in the family.

5.3 Suggestion for Further Studies

Based on the strength of the findings of the study the researcher suggested that further research studies be done in the following areas;

  1. An appraisal of the perception of menopause by women in South-East geo-political zone of Nigeria.
  2. Effect of menopause on women‟s reproductive health behaviour in Enugu state.
  3. Evaluation of the perceived influence of menopause on family life of women in Nigeria.
  4. Enhancing coping strategies of women in Menopausal age in Nigeria.

5.4 Summary of the Study

Menopause has been variously defined. All in all, it is a period or stage in the life of women when they stop menstruating. The stage comes with changes in the whole body of the woman such as hot flushes, virginal dryness, decreased sexual responsiveness and others.

The study sought to find out how women in Udi Educational zone perceive menopause. Literature review on menopause was carried out based on concept of menopause, concept of perception, concept of coping strategies, some theories and empirical studies relating to menopause were reviewed.

The sample for the study was 600 women in the study area. Questionnaire was used to collect information from the women. 600 questionnaire copies were distributed but only 583 were collected back. Out of these 583 women sampled using questionnaire, 150 were married women with even distribution of sex of children, 150 were married women with one sex of children, 150 were married women without children while 133 were unmarried women all in menopause stage.

The questionnaire items were used to answer the research questions. The research questions were quantitatively analyzed using mean. The hypotheses were tested using t-test at 0.05 level of significance.

The major findings of the study included:

  1. Both married and unmarried women perceive menopause as beginning of old age and the end of reproductive life.
  2. Lack of sexual arousal, decrease in sexual responsiveness and getting into unprotected sex are the reproductive health behaivour of women in the study
    area.
  3. Women in menopausal age have strained relationship with husband and children. They equally have loss of sexual enjoyment,
  4. The coping strategies adopted by the women are: resigning to faith, discussing with women who have passed menopausal state and seeking medical attention
  5. There is no significant difference in the mean perception of menopause between married and unmarried women in menopause.
  6. There is no significant difference in the mean perception of menopause between married women with even
    distribution of sex of children and married women with one sex of children
  7. There is no significant difference in the mean perception of menopause between married women without children and married women with children.

5.5 Conclusion

Conclusively, from the findings of the study and the information from the related literature, it implies that women in the study area do not perceive menopause as a problem.

The period however is characterized by lack of sexual arousal, decrease in sexual responsiveness, strained relationship with husbands and children and lack of sexual enjoyment. The coping strategies adopted are resigning faith, discussing with women who have passed menopausal state and seeking medical attention.

Therefore, both women and men should be educated by counselors, health workers and NGOs through seminars and workshops on menopause. So that they can get acquainted with the stage and adopt appropriate strategy during the stage for a harmonious family living.


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