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Introduction
Most women experience various changes during their middle years. Social, physiological, psychological, and economic changes might also occur. However, several chronic illnesses, including heart disease, diabetes, arthritis, and heart disease, have a high propensity to develop around middle age. Menopause and its symptoms are also experienced by women during this time. Although it is natural, menopause may have an impact on women's health and quality of life (Shahzad et al., 2021).
Between one and two years after menopause, perimenopause starts with the initiation of alterations in the menstrual cycle, as the first clinical, biochemical, endocrine, and psychoemotional signs of the impending last menstrual period start to surface. The WHO defines postmenopause as the time following the last menstrual cycle, whether menopause was naturally induced or not (Beck et al., 2020).
Numerous vasomotor, psychological, somatic, and atrophic changes that are displayed with very specific symptoms known as climacteric are caused by the gradual or abrupt cessation of estradiol and progesterone production by the ovaries. Ailments that develop during menstruation can significantly lower a woman's quality of life, thus it's critical to develop efficient treatments for their disagreeable symptoms (Naworska et al., 2020).
Most of the women accepted that themselves are uneducated. The fact that the ladies had come to this stage in their lives without having any idea of how perimenopause might affect them infuriated them. They discussed how utterly unprepared they had been, how it had left them feeling powerless and having lost faith in both their bodies and themselves. Many of them said that they had never even heard of the term "perimenopause" before. Many of the women advocated for earlier teaching in schools and used words like "disgraceful" and "shocking" to describe the lack of information (Wang et al., 2018).
One of the things that affected how well women coped with menopause was their attitude towards it. The quality of women's lives also rises as they develop a more positive approach towards menopause. Additionally, menopausal symptoms are said to affect women less severely who have a cheerful outlook. In addition, because of the impact it has on the individual, attitude is a powerful organizing element for behaving and can initiate healthy behaviour (Smail et al., 2020).
Women go through a lot of physical, psychological, and emotional changes during perimenopause and menopause. Women all around the world are affected by signs related to the menopause transition and beyond. Unfortunately, the assistance doctors can offer to women in need is constrained by the wide variation in their knowledge of and comfort with addressing menopausal symptoms (Voedisch et al., 2021).
Women must approach changes associated with menopause with adequate understanding and a good attitude. Even though many women go through menopause at some point in their lives, teachers have it much harder than other female employees because of the nature of their jobs (Gebretatyos et al., 2020).
The menopausal age of the female comes up with several symptoms. Those difficulties are the result of numerous variables. Age, a natural phenomenon influenced by genetic and environmental variables, is one of these elements. The average age at natural menopause, which varies depending on the population, is 51 years old. Women now spend a third of their lives in postmenopause as a result of an increase in life expectancy. The rate of perimenopausal and postmenopausal women has also been impacted by the rise in living standards (Converso et al., 2019).
For women to deal with changes linked to menopause, they need to have adequate understanding and a positive attitude about it. Even though all women eventually go through menopause, teachers have it far harder than other female employees because of the nature of their jobs. For instance, menopause has not received much attention in Eritrea, so there are gaps in women's knowledge, attitudes, and the consequences of health education on the given topic, knowledge of women related to perimenopause and menopause symptoms (Gebretatyos et al., 2020).
Given that menopause is an inevitable part of life, having a basic understanding of what it is, when it occurs, and the symptoms it causes might help you adjust. As a result, a woman's positive attitude towards menopause also significantly influences how severe her menopausal symptoms are revealed. Numerous studies have indicated that women lack understanding about menopause and have a negative attitude towards it. These studies claim that the dissemination of conflicting information and social rumours worsens the lack of understanding and restricted access to accurate information on menopause and associated symptoms (Orabi, 2017).
Owing to the importance of knowledge of perimenopause and menopause and their effect on the social, physiological, psychological, and economic status of women, the present study aims to explore the international literature related to women’s knowledge and experience of perimenopause and menopause and to inform future directions for research and individualized healthcare delivery.
Research questions
Even though practically all women will experience menopause, there is a negative perception of it, little knowledge about it in the general community, and inadequate training in society. As a result, a lot of women fear menopause and associate it with negativity, and doctors often fail to detect the symptoms, which can have a significant negative impact on a patient's overall welfare. Moreover, women’s health-related policies, strategies and programs related to women’s menopausal health also affect the quality of life of women. This is a serious issue because menopausal symptoms greatly reduce a woman's quality of life in terms of her health. Therefore, the present report deals with the below-mentioned objectives:
- To explore the information required for women’s health and knowledge related to perimenopause and menopause across the globe using literature survey and primary research methods
- To analyse policies and associated programs should also be a criterion for the estimation of quality of life in the world.
Research Design
The research design of the present report is based on the integrative review of primary research on women’s knowledge and experience of perimenopause and menopause.
Methods
Several search engines such as CINAHL, Wiley Online Library, SCOPUS, Medline, Google Scholar and PubMed were used to search for the relevant literature from 2011 to 2021. Further, qualitative and quantitative studies written in English exploring women’s knowledge and experience in knowledge were included.
The search methodology on the given topic was based on keywords such as PERIMENOPAUSE, MENOPAUSE, WOMEN’S EXPERIENCE, QUALITY OF LIFE, and HEALTH OUTCOMES.
To conduct a systematic search of the literature and academic papers for review-based studies, the PRISMA tool or framework employs several techniques. PRISMA is also based on the developed inclusion and exclusion criteria in any type of study that systematically evaluates the quality of selected papers and either includes the study or excludes the study. PRISMA is mostly utilised in medical and pharmaceutical research, but in more recent years, it has also been utilised in management studies as well as non-medical research (Selcuk, 2019).
Therefore, the present study is based on the PRISMA search strategy that includes inclusion and exclusion criteria. The inclusion criteria cover the age-based search of the strategy, perimenopause studies, demographic-based strategies, and menopausal studies. The exclusion criteria of the studies included lower-aged women (<45 years).
Data Collection
For the data collection, primary research has been implemented. It will be a questionnaire-based online and offline survey method. For instance, in one of the studies, 5399 people responded to a poll that was conducted online and disseminated by the Trades Union Congress, UK networks, and social media. Respondent's own menopause transition experiences, disclosure at work, and the accessibility of information about menopause at work were the three main topics covered by the questions (Beck et al. 2020).
Data Analysis
Quantitative analysis
Using SPSS Statistics, data analysis will be carried out. Pearson correlations, means, and standard deviations were all included in the preliminary analysis. Multiple moderated hierarchical regressions will also be conducted to investigate the moderating influence of resources in the relationship between menopausal symptoms and burnout (i.e., weariness and depersonalization). Independent variables will be entered in two subsequent phases for each moderated hierarchical regression. The standardised indices of menopausal symptoms and a resource, along with the interaction term such as the sum of menopausal symptoms and the resource under consideration, will be entered in the first stage. The second stage will involve entering the control variables such as age and job capacity).
Qualitative analysis
Women will be asked whether they would like to share anything about their personal experiences with perimenopause and menopause. Four major themes emerged: the overall knowledge gap, the onset and consequences of symptoms, perimenopause: the hidden phenomena, and managing symptoms: divergent schools of thought to avoid the knowledge void. Numerous women talked about this important subject. The women's lack of education and the lack of education of their general practitioner (GP) were the two key aspects of their lived experience that were most significantly impacted by this.
Conclusion
This comprehensive analysis of the international literature shows that there are considerable regional and national differences in the understanding of women about perimenopause and menopause. Women's experiences with perimenopause and menopause vary and are impacted by deeply ingrained social trends.
References
Beck, V., Brewis, J., & Davies, A. (2020). The remains of the taboo: experiences, attitudes, and knowledge about menopause in the workplace. Climacteric, 23(2), 158-164.
Converso, D., Viotti, S., Sottimano, I., Loera, B., Molinengo, G., & Guidetti, G. (2019). The relationship between menopausal symptoms and burnout. A cross-sectional study among nurses. BMC women's health, 19(1), 1-12.
Gebretatyos, H., Ghirmai, L., Amanuel, S., Gebreyohannes, G., Tsighe, Z., & Tesfamariam, E. H. (2020). Effect of health education on knowledge and attitude of menopause among middle-age teachers. BMC women's health, 20, 1-10.
Naworska, B., Brzęk, A., & Bąk-Sosnowska, M. (2020). The relationship between health status and social activity of perimenopausal and postmenopausal women (health status and social relationships in menopause). International Journal of Environmental Research and Public Health, 17(22), 8388.
Orabi, E. (2017). Effect of health education intervention on knowledge, and attitude regarding menopausal period among premenopausal female employees. The Egyptian Journal of Community Medicine, 35(30), 71-84.
O'Reilly, K., McDermid, F., McInnes, S., & Peters, K. (2022). An exploration of women's knowledge and experience of perimenopause and menopause: An integrative literature review. Journal of Clinical Nursing.
Shahzad, D., Thakur, A. A., Kidwai, S., Shaikh, H. O., AlSuwaidi, A. O., AlOtaibi, A. F., ... & Abdulrahman, M. (2021). Women's knowledge and awareness on menopause symptoms and its treatment options remains inadequate: a report from the United Arab Emirates. Menopause, 28(8), 918-927. DOI: 10.1097/GME.0000000000001783
Selçuk, A. A. (2019). A guide for systematic reviews: PRISMA. Turkish archives of otorhinolaryngology, 57(1), 57.
Smail, L., Jassim, G. A., & Sharaf, K. I. (2020). Emirati women’s knowledge about the menopause and menopausal hormone therapy. International Journal of Environmental Research and Public Health, 17(13), 4875.
Voedisch, A. J., Dunsmoor-Su, R., & Kasirsky, J. (2021). Menopause: a global perspective and clinical guide for practice. Clinical obstetrics and gynecology, 64(3), 528-554. DOI: 10.1097/GRF.0000000000000639
Wang, M., Gong, W. W., Hu, R. Y., Wang, H., Guo, Y., Bian, Z., ... & Yu, M. (2018). Age at natural menopause and associated factors in adult women: findings from the China Kadoorie Biobank study in Zhejiang rural area. PloS one, 13(4), e0195658.
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