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Findings released from recent pivotal clinical trials on hormone therapy (HT) benefits and risks have stimulated a growing trend towards lower doses and earlier discontinuation of HT for menopausal women. Yet, there is little knowledge regarding women's personal experiences with the resultant earlier and possibly abrupt withdrawal of HT. The purpose of this study was to explore postmenopausal women's vasomotor symptom experiences after discontinuing HT. The data for this study was collected from menopausal women who discontinued HT. The study questionnaire was created through an extensive review of the literature as well as an expert panel review. The questionnaire was also piloted with a small group of women prior to its use in this study. Data analysis consisted of descriptive analysis with means and standard deviations and/or frequency distributions with percentages for demographic data, health behaviors, factors influencing HT decisions, use of CAM and perceived efficacy. Chi-square analysis, Spearman Rho correlation, and logistic regression analysis were conducted for contextual factors and vasomotor symptom experiences. A McNemar test was performed to assess within group differences for vasomotor symptoms experiences pre and post HT. Questionnaires were received from 563 menopausal women throughout the United States. This study revealed that 80% of participants experienced vasomotor symptoms after discontinuing HT. The most common predictors which accounted for only 13% of variance in the occurrence of vasomotor symptoms were younger age, type of menopause and the occurrence of vasomotor symptoms prior to initiation of HT. Of the 563 women participating in the study, less than half reported the use of CAM to treat reemerging vasomotor symptoms. For the most part, less than half of the women felt their treatment choices were helpful in relieving their reemerging vasomotor symptoms Because a woman's experience of menopause can be highly individualized, an adaptation of Bronfenbrenner's ecological theory was used guide this exploratory study. The study findings supported the usefulness of the adaptation of Bronfenbrenner's ecological theory as a model through which to view the vasomotor experiences of menopausal women who have discontinued HT. / text

Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 1999. / A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy. Includes bibliographical references (leaves 415-423).

Thesis (Ph.D.) -- University of Western Sydney, Nepean, 2001. / "A thesis submitted for the degree of Doctor of Philosophy at the School of Teaching and Educational Studies, University of Western Sydney, Nepean." "January 2001" Bibliography: leaves 252 - 262.

Thesis (M.A.)--West Virginia University, 2004. / Title from document title page. Document formatted into pages; contains viii, 115 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 53-60).

Thesis (Ph.D.)--University of Western Sydney, 2007. / A thesis presented to the University of Western Sydney, College of Arts, School of Education, in fulfilment of the requirements for the degree of Doctor of Philosophy (Social Ecology). Includes bibliographies.

Thesis (Ph. D.)--Deakin University, 2003. / Title from PDF title page (viewed on Dec. 15, 2005). Includes bibliographical references (leaves 202-225).

Introduction: This multiphase qualitative study explored the understanding of middle-aged women’s sexuality and sexual difficulties and the way they address these difficulties. Nurses’ and midwives’ role in sexuality-related care was also explored. The need to address the subject was triggered by the multidimensional nature of female sexuality that could not be limited to one single definition; the medicalisation of female sexual problems that is based on the standards of sexual function and dysfunction; the scarcity of research that reflects on women’s subjective views on sexuality and sexual difficulties and the way they address these difficulties. This is particularly crucial at the middle-age where women undergo hormonal and psychosocial changes that may affect their sexual life. Methods: Interviews and focus group discussions were used to capture the narratives of 52 middle-aged women of 40-55 years in phases one and two of the study. They were chosen purposively by education and menopausal status from clinical and non-clinical settings regardless of their marital status and sexual orientation. Additionnally, a sample of 11 nurses and midwives working in the hospital and primary healthcare centres participated in two focus group discussions. Results: Women’s narratives led to a comprehensive understanding of sexuality and sexual problems and the implications for help-seeking. Findings showed how women’s interpretation of sexuality resonates within bio-psychosocial and cultural perspectives driven by double standards and inhibiting sexual socialisation. Women’s sexuality is ‘muted’, conflicting between frustrating experiences, personal expectations and the perception of sexual selves as affected by the middle-age and social myths. Yet, sexuality is central to women’s life where they tend to play a sacrificing role and gain agency. Their sexual difficulties are multifaceted mirroring their inhibitions, relational conflicts, husbands’ sexual problems and contextual burdens. Women would firstly rely on their husbands to discuss together their common sexual issues as nobody can understand their needs more than both of them. In parallel, the gynaecologist is reportedly the first one they consult as they are familiar with him/her. Yet, some do not know who else to turn to for help. Women highlighted many personal, relational and contextual barriers to help-seeking focusing on their husbands’ negative attitude. They also criticised the services offered and the lack of resources. Within this context and in focus group discussions, 11 nurses and midwives reflected on their attitude and behaviour towards sexuality-related care. They had opposing views concerning their involvment in the assessment of patients’ sexual health and identified many barriers to having an effective role in the field. Discussion and implications: This study has a unique contribution in voicing women’s views and concerns as sexuality is underreported and poorly researched in Lebanon. Women’s narratives shed light on many aspects of their sexuality, sexual difficulties and the facilitators and barriers to help-seeking focusing on the role of nurses and midwives in this field. This comprehensive perspective that is contextually based has implications on education, clinical practice and research. It is particularly important to provide middle-aged Lebanese women with a culturally sensitive professional assistance to satisfy their sexual life. In addition, the publication of two papers from the study enriches knowledge in the field. It is of note that in this study sexuality and sexual life are interchangeably used. Nevertheless, sexuality has a broader meaning and encompasses all the thoughts, fantasies, desires, beliefs, attitudes, values, behaviour, practices, roles and relationships (WHO, 2006), whereas sexual life is more related to sexual relationships and activities (Segen's Medical Dictionary, 2012).