SHARE

Menopause is the cessation of menstrual cycles (Pillitteri, 2007). It is the time when menses cease marking the end of reproductive abilities due to natural changes in sex hormones (Ladewig et al., 2006; London et al., 2007) — it is the permanent end of fertility and fecundity (Ricci, 2007). Women refer this period as a “change of life”, because it marks the end of their ability to bear children and the beginning of a new phase of life (Pillitteri, 2007). Climacteric or “change of life” is often used synonymously with menopause (Ladewig et al., 2006; London et al., 2007).

The potential impacts of declining levels of sex hormones on neurologic functioning has received particular attention because of estrogen’s presumptive beneficial effects on neurotransmitters, neuroconnectivity, and neuroprotection that will significantly affects the body’s physical, emotional, psychological, cognitive and mental functions. These brought the menopausal symptoms (menopausal syndrome) that greatly alters the quality of life of every women on their transition to menopausal period and ageing.

There is a growing interest in identifying the solutions for the care of women’s health particularly for menopausal women in a primary care setting. Menopausal stage is the period when women’s health decline physiological, emotional/psychological and mental/cognitive. Health care providers (nurses) in the primary health care should include a program about the proper care of menopausal women. Detection of signs and symptoms, education about menopause and the proper care of menopausal women’s health and improving the quality of life of every menopausal women. Nurses should prepare women to accept the ageing process and open their views to welcome the unwelcome symptoms of menopause. Preparation is the key intervention for the perimenopausal stage—promotive, preventive and health maintenance approaches. Menopausal and post-menopausal stages include caring, acceptance and use of maximum potentials—curative, palliative and rehabilitative approaches.

The PCA for Menopause Women is a model of interventions for the signs and symptoms of menopause with the aim of improving the quality of life of women during menopausal period. The paradigm includes the detection of signs and symptoms (assessment) and formulation of appropriate interventions for every signs and symptoms occurring in every stages of menopausal period. The menopause women need Preparation, Care and Acceptance and they should be prepared, cared and accepted for them to accept themselves. And it is the responsibility of the nurse to prepare, give care and teach the client the importance of acceptance in promoting and improving the quality of life of menopausal women.

menopausal tools

Discussions

            The Menopause Assessment Tool and Intervention Index (MATII) is a guide to assess and evaluate the occurrence and severity of signs and symptoms experienced by women in their menopausal period (perimenopause, menopausal and post-menopause) which will aid in formulating interventions needed in improving the quality of life of menopausal women.

Demographic data, educational attainment and occupation data is needed to know the client’s level of understanding for the need and extent of health education. The years of menopausal symptoms will categorize the client’s condition for staging.

            Menopausal signs and symptoms are classified into to somatic, psychological and psychosomatic symptoms. Severity and occurrence will be identified according to scoring—absence (0); present but bearable (1); present and unbearable (2); affects ADL’s (3). Evaluation will be based on Mild (score of 1-22), Moderate (score of 23-44) and Severe (score of 45-66).

Researches revealed that diet, diversional activities and exercises can lessen the occurrence of somatic and psychosomatic symptoms while health education and awareness can minimize psychologic symptoms. Hormonal replacement therapy (HRT) is proven to be effective as palliative measures for the signs and symptoms of menopause.

            The intervention index followed the mnemonics HELPED & CARED for the EDAD (tagalong word for aging—menopausal period is a part of the women’s aging process). For Mild cases, EDAD Approach (Education–Diversional Activities–Diet) is suggested. This is the normal state wherein the menopausal women can manage the symptoms without affecting the quality of life. Health education, diversional activities and diet control are needed to address the bearable signs and symptoms. This approach follows the promotive, preventive and health maintenance functions of the nurse.

HELPED Approach (Hormonal replacement–Education–Leisure time– Physical activity–Exercises–Diet)—meaning to give help or support for those who suffer—is for Moderate cases. This approach composed of HRT, health education, leisure time for relaxation, physical activity and exercise program and diet therapy to manage the unbearable symptoms. This is under the curative and palliative care.

CARED Approach (Confinement–Activity–Replacement of hormone–Education–Diet) focused on palliative, curative and rehabilitative aspects of care. This approach means to take good care of the menopausal women experiencing severe symptoms that affect ADLs. For the Severe cases—confinement or hospitalization is required to manage and treat the symptoms and prevent occurrence of complications. Activity programs for exercise, rest and relaxation. HRT is on intensive and/or aggressive basis wherein monitoring is required. Health education is focused in maximizing the full potentials and improving the quality of life.Diet therapy is for support management.

References:

  • Ladewig, P. A. et al. (2006). A Look at Contemporary Maternal-Newborn Nursing Care, 6th ed.
  • New Jersey: Pearson Prentice Hall, 100. London, M. L. et al. (2007). Fundamentals of Maternal and Child Nursing Care, 2nd ed. New Jersey: Pearson Prentice Hall, 88. Pillitteri, A. (2007). Maternal & Child Health Nursing Care of the Childbearing & Childrearing Family, 5th ed. Philadelphia: Lippincott Williams & Wilkins, 87. Ricci, S. S. (2007).
  • Essentials of Maternity, Newborn, and Women’s Health Nursing. Philadelphia: Lippincott Williams & Wilkins, 97–98.
SHARE
She is currently working as a medical-surgical nurse at Ministry of Health, Sultanate of Oman. A writer, blogger, researcher, correspondent and publication consultant for nursing journal and health-related educational websites. Her field of specialization focused on Intensive Care and Emergency Management. She is now taking up MAN major in Adult Health Nursing at the University of the Philippines Open University. A nursing professor for 8 years in the Philippines and served as a staff nurse at UST hospital. A caring and devoted nurse who introduced a “Pinay Nightingale” in the land of the pharaohs. A nurse by profession, an educator by devotion and a writer / researcher by passion.