Dr. K.S. Peck Dr. J.R. Torline

M.Tech. / The purpose of this study was to determine the effectiveness of the homoeopathic complex remedy, Sepia® from Natura (Pty) Ltd. in South Africa, in alleviating climacteric symptoms in climacteric women as compared with a placebo remedy. Volunteers were recruited using flyers and posters placed at the Technikon Witwatersrand Clinic, and at pharmacies and health shops within the central Johannesburg area. Newspaper advertisements were placed in local newspapers advertising free homoeopathic treatment for climacteric symptoms by taking part in a research project. A sample size of forty subjects was chosen according to the delimitations of the study. A signed consent form was compulsory for participation in the study. The study was a two group experimental design consisting of an experimental group, who were administered Sepia®, and a control group, who were administered a placebo preparation. The study was conducted in a double-blind manner. The subjects were given sufficient medication to last for the duration of the study and were given instructions on how and when to take the medication, and how to store it. The duration of the study was eight consecutive weeks (two consecutive months). At the end of the treatment period there were fifteen subjects in the treatment group, and fourteen subjects in the placebo group During the treatment period the participants were required to fill out a Climacteric Symptom Questionnaire on a weekly basis and a Hot Flush Score Sheet on a daily basis. All the daily Hot Flush Score Sheets and weekly Climacteric Symptom Questionnaires were completed by each participant. They were collected after the eight week treatment period and subjects ceased taking the medication

Early menopause, the cessation of menstrual function before age 45, occurs in 10% of women, and is associated with higher premature mortality and increased risk of cardiovascular disease. Lifestyle factors like physical activity may influence menopause timing, but results from prior research are inconsistent. We evaluated the association between physical activity and the occurrence of early natural menopause in the Nurses’ Health Study II. Premenopausal women were followed prospectively from 1989 to 2011. Menopause status was self-reported biennially. Time per week participating in specific activities was reported every four years and used to calculate metabolic task hours (MET). Moderate and vigorous activity in adolescence and young adulthood was reported in 1997. We used Cox proportional hazards model to evaluate the association between physical activity and incidence of natural menopause before age 45 controlling for potential confounding factors. We observed no significant association between adulthood physical activity and early menopause. For example, compared to women with/wk, the hazard ratio for women in the highest category (≥42 MET h/wk) of cumulatively-averaged total physical activity was 0.90 (95% confidence interval: 0.76-1.07; P-trend: 0.63). Similarly, activity in adolescence and young adulthood were unrelated to risk. Body mass index did not modify the relation of physical activity and early menopause. Our findings suggest that physical activity is not associated with incident early menopause.

OBJECTIVE: To assess the association between menopausal status and female sexual function among mid-aged women with human immunodeficiency virus (HIV) infection. METHODS: We carried out a cross-sectional study of 221 sexually active HIV-infected women ages 40 to 59 years, based on a secondary analysis of a three-hospital survey in Lima, Perú. We classified menopausal status according to Stages of Reproductive Aging Workshop criteria (STRAW+10); this exposure variable was categorized as binary (non-postmenopausal and postmenopausal) and-for exploratory analysis-as multinomial (pre-, peri-, and postmenopausal). We defined low sexual function (LSF) using the 6-item Female Sexual Function Index (total score ≤19). Socio-demographic and clinical variables were assessed, including age, used highly active antiretroviral therapy scheme, disease duration, depressive symptoms, and co-morbidities. We performed Poisson generalized linear models with a robust variance to estimate 95% confidence interval (CI), crude prevalence ratios (cPRs), and adjusted prevalence ratios (aPRs) by epidemiological and statistical approaches using nonparametric method of bias-corrected and accelerated bootstrap resampling with 1,000 repetitions. RESULTS: Studied women had a median age of 47.0 years (interquartile range: 7.5); 25.3% were premenopausal, 25.8% were perimenopausal, and 48.9% were postmenopausal. Also, 64.3% had LSF. The frequency of LSF was 53.6% in non-postmenopausal and 75.0% in postmenopausal women. Postmenopausal status was associated with LSF in both the crude (cPR = 1.39; 95% CI: 1.13-1.71) and the adjusted regression models (aPR = 1.38; 95% CI: 1.12-1.71). CONCLUSIONS: HIV-infected postmenopausal women have a higher prevalence of LSF than those non-postmenopausal ones, even when adjusting for multiple potential confounders. / Revisión por pares

Over the past 50 years, women have become important participants in the labor market. With the increase in the number of middle-aged women going through the menopause transition, the question arises as to the effect of this transition on the labor market. Previous studies have shown that reproductive cycles have a non-trivial negative effect on women’s labor market outcomes. Thus, the cessation of these reproductive cycles (menopause) should bring relief for these women. However, another body of literature asserts that the menopause transition itself has a negative effect on women’s mental and physical health and so may have a negative effect on labor market outcomes. This study seeks to explore the effect of the menopause transition on labor market outcomes. The empirical analyses are done using data from the National Longitudinal Survey of Young Women, with the key explanatory variables being the menopause transition stages: premenopause, perimenopause, surgical menopause and natural postmenopause. The regressions include a control for whether the woman experienced early menopause and whether she had a hysterectomy. The first part of the study examines the impact of the menopause transition on health using depression and the scores on the activities of daily living as the measures of health status. These analyses use cross sectional data drawn from the 1995 wave of the survey for activity limitations and the 2003 wave for the depression measure. The findings of these analyses indicate that the menopause transition increases the likelihood of depression and functional limitations. The main part of the study explores the effect of the menopause transition on the following labor market outcomes: labor force participation, hours worked, full time employment, wages, and self-employment. Ordinary Least Squares, the fixed effects model, the random effects model, and the family fixed effects (siblings) model are used to examine these questions. The analysis also uses 2SLS to correct for endogeneity of the menopause variables and the Heckman two-step procedure to correct for sample selection bias. The findings show that women in premenopause are less likely to be in the labor force than women in natural postmenopause, even after controlling for life-cycle variables. The results also indicate that there are certain benefits from using hormone replacement therapy (HRT), as women who had surgical menopause and are using hormones are more likely to be in the labor force than women with surgical menopause who are not using HRT. Women in premenopause and women in perimenopause are less likely to work full-time compared to women who experienced natural postmenopause. The findings also show that there are no significant differences in hours worked by women in the different menopause stages. Women in premenopause typically earn more than women in natural postmenopause. Furthermore, women in perimenopause and women with surgical menopause are more likely to be self employed. The findings indicate that, among a generally healthy population, the menopause transition results in an increase in labor supply. However, a wage penalty is observed among women in postmenopause, when compared to women who are premenopause. The implications of the findings are that menopause should not be medicalized but should be viewed in a social and cultural context as the changes that occur during the transition may open up possibilities for positive individual development. Thus the cessation of menstrual cycles brings relief for women and results in an increase in labor supply, albeit one associated with a wage penalty.

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Klimakteriet är en naturlig process i kvinnanslivscykel där kroppen genomgår fysiologiska förändringar på grund av omställningari hormonnivån. Samtidigt är klimakteriet en utvecklingsrelaterad transition. Enligttransitionsteorin sker övergångsprocesserna inom en bestämd tidsram, följer enriktning och leder till förändringar i identitet, roll, relationer ellerbeteendemönster. Kunskap om dessa skeenden ochvad som påverkar kvinnors beteende under transitionen är en förut-sättning föratt sjuksköterskan skall kunna hjälpa dem att nå en hälsosam transition. Syftet med litteraturstudien var att belysa faktorer som påverkar val avkvinnors copingstrategier. Till resultatet användes 12 artiklar som granskadesoch analyserades utifrån syftet. Resultatet visade att det finns fem grupper avfaktorer som påverkar kvinnors val av copingstrategi: sociokulturella och socioekonomiska,typ och svårighetsgrad av klimakteriesymptom, tillgång till stödjande socialtnätverk, personlighetsrelaterade samt aktuell livssituation. Kvinnor som har etablerade nätverk kan söka hjälp och stöd i sin familjoch bland vänner. När nätverk saknas kan sjukvården bli den enda kontakten attdiskutera sina klimakteriebesvär med. Med beaktande av faktorerna som ligger till grund förolika copingstrategier bör sjukvården skapa utbildningsformer och modeller somkan hjälpa kvinnor medklimakteriesymtom att utveckla en effektiv copingstrategi. / Menopause is a natural process during a woman’slifecycle when her body goes through physiological changes due to hormonalalterations. Also, menopause is a development-related tran-sition.According to the theory of transition it will appear within a certain timeframe, follows a clear route and leads to alterations in identity, role,relations or behavioral patterns. Knowledge of these stages of change and whataffects women’s behavior during transition is a vital qualification requiredfor nurses to succeed in providing healthy transition. Thepurpose of this literature study was to high-light factors that affect thechoice of coping strategies. Twelve articles were studied and analyzed based onthe purpose of the study. The result showed that there are five groups offactors that can affect women’s choice of coping strategies; socio-cultural andsocio-economical, type and severity of menopause symptoms, availability ofsupportive social networks, personality related factors and the current lifesituation. Women with established networks can seek help and support withintheir family and amongst their friends. When there is a lack of these types ofnetworks, healthcare personnel can become the only resource for discussingmenopause-related issues. Keeping these factors in mind, which serve the basisfor different coping strategies, healthcare-institutions should createeducation and models to assist women with menopause symptoms and develop aneffective coping-strategy.

Thesis (M.S.)--University of Michigan, 1996. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Michigan, 1996. / Includes bibliographical references.