Qualitative Assessment on Health Behaviour and Experinces of Women During Menopause.

Introduction

Background

Menopause is the last stage of the menstruation cycle in a woman. It is a natural biological process of the reproduction system in which the women's menstrual cycle permanently stops. According to Marlatt et al., (2018), at the time of menopause, the oestrogen level in a woman declines due to ovarian failure.Menopause in women occurs generally between the age of 40-58. At the time of the whole transition of the menopause that is at the time of perimenopause and postmenopause a woman experiences physical and emotional symptoms which affects their quality of life. Women go through various metabolic impairments such as weight gain, increase in visceral and subcutaneous abdominal adiposity, hypertension, hyperinsulinemia, and impaired glucose tolerance.

Menopause is a change in women expectedly seen at the age between 40-58, in which the natural ability of a woman to reproduce stops. According to Ozcan (2019), in developing countries menopause is seen in an earlier age as compared to the developed countries. In developed countries menopause is seen between the ages of 49-52. However in the developing countries women are seen to undergo menopause at the early stage of 43-50. 

According to Stanzel et al., (2018), the World Health Organisation has defined menopause as the permanent pause in the menstrual cycle of women resulting from loss in the ovarian activity and life. Annually almost 25 million women around the globe are expected to enter the stage of menopause. A woman spends one third of her total life in menopause. The symptoms and problems of menopause affect the lifestyle of a woman very negatively. If not taken proper care from the beginning, women have to go through major ovarian surgeries which affects the duration of life in women. As state by Ermawati et al., (2018), women tend to suffer through psychological problems at the stage of menopause.

However, women who are working and are financially independent make lifestyle adjustments, social adjustments, adapt to hobbies and prefer socialising which helps them combat the symptoms of physiological changes. Most women are seen to be at the stage of depression and low self esteem at this time. Women are generally suffering with sudden major body changes which affect both their mind and body. Women who are regularly involved in some kind of physical activity can make their lifestyle healthy and lower the symptoms of menopause. 

Problem statement

The most common problems faced by women in Belfast during the time and pre and post menopause are weight gain, increase in visceral and subcutaneous abdominal adiposity, hypertension, hyperinsulinemia, and impaired glucose tolerance. As stated by Ozcan (2019), some other major problems women face are osteopenia, osteoporosis, cardiovascular disease, cancer, metabolic disorder and obesity. The lifestyle of a woman goes through impeccable change during this period of time. All this disorder and symptoms at the time of menopause is seen to affect the lifestyle of a woman negatively. Menopause in a woman can also have a negative impact in the duration of life in women. Therefore, women are advised to take necessary steps and adapt to a healthy lifestyle long before menopause. 

The healthy lifestyle in a woman can lower the symptoms and problems they face. However women with low income or low family income can not afford to provide themselves with a healthy lifestyle in comparison to the women who have a good income or family income. According to Namazi  et al., (2019). Women who have low income and can afford a healthy lifestyle experience the symptoms of menopause more frequently than the women who have a healthy lifestyle. 

Aim and objectives

The main aim of this research is to understand the health and lifestyle behaviour of a woman who goes through menopause. The research aims to analyse the perimenopause and postmenopause symptoms in a woman and the remedies and tools they use to combat these changes in lifestyle. 

Objectives

• To analyse the health, lifestyle and behaviour of women who are transitioning or have transitioned through menopause.
• To understand what methods and tools women use to overcome the symptoms of menopause for a quality life. 

Research questions

The questions formulated for the research are-

1. What are the health behaviours and experiences of women who are transitioning or have transitioned through menopause?
2. What tools are used by women to overcome the symptoms of menopause for a quality life? 

Rationale and significance

According of Moshki et al., (2018), women experience some common symptoms like vaginal dryness, hot flashes and sleep disturbance. The lack of proper sleep can result in anxiety and depression in women. Its treatment can be of symptom relief and adaptation of a healthy lifestyle. Women who are regularly involved in some kind of physical activity tend to combat the symptoms of menopause easily in comparison to a woman who is less involved. The significance of this dissertation is to provide an understanding about various symptoms and lifestyle changes a woman goes through during menopause and provide with methods, tools and programs to combat the symptoms and lead a healthy lifestyle. 

Literature review

Overview

 This section deals with the various issues which women face during their menstrual cycles in Belfast, the common attitude of women as a population towards the phenomenon of menopause, the various other health implications which have an effect of negative value over their health. Lastly this section talks about some of the remedies which can be used to combat the symptoms of menopause.

Menstrual issues of women in Belfast

Menstrual leaves are something which is still not talked about openly even in the progressive 21st century. Belfast is among those places. Women cannot express their discomfort and pain and have to regularly attend their workplace. Only 27% of the women manage to break out of the barrier of shame and taboo and manage to communicate with their superiors regarding their discomfort and try to seek necessary leave. Only half of the women who manage to communicate take a leave and that too they do not have the freedom of taking more than a single day of leave.

The NHS , which is the national health forum for the country, has reported that one-fifth of women who are working suffer from period pain and it would be beneficial for them if they got a leave for a few days (McCormick, 2022). “Period Leave” is still something of a debate in the major corporations in the world but is expected to become more realistic and have lenient provisions for women who work through the pain of their menstrual cycles.

Historically northern Ireland has been a place where there has been remarkable violence against women. In the period known as the “ troubles'' women political members were wrongfully incarcerated and brutally tortured during their days of imprisonment (Swaine,2022). The women used their body as the instrument to answer to the injustices of their imprisonment and in general cases of discrimination. The menstruation period of women came to be seen as the symbol of protest against the unruly authorities and they protested as long as their rights were met by the latter on favourable terms. This instance tells us that menstrual education is something which has been lacking in Ireland historically and still remains to be so which causes problems for the female population.

Tools preferred by the women to alleviate their symptoms

Menopause is a natural stage of the menstrual cycle in a woman when the oestrogen levels are down for the individual and the natural decline of ovarian capacities take place. About 80% of women reported that they experienced marked symptoms of menopause such as insomnia, occurrences of hot flashes, which changed the type of lifestyle that they led. These symptoms brought about significant change in their behaviour patterns as well. A person whose sleep patterns are severely affected by acute insomnia will be prone to a feeling of irritation and constant tiredness. The hot flashes made them mentally and emotionally nervous as the occurrences of the same did not have a particular time and often occurred in public spaces (Pilewska et al., 2020).The attitude was marked by a mass desire by the female patients to alter their weights so that they cou;d combat the symptoms of menopause.

Another noteworthy component of the attitude of the women concerned were that most of them were not ready for this eventuality. They were misinformed or did not have the necessary education regarding what to do and how to tackle the situation of menopause once it came. On the other hand the concerned women of that particular age group were very keen on weight alteration strategy as a tool to combat against menopause but the same women were not very enthusiastic about opting for the hormonal replacement therapy (HRT) which would have proved to be very useful in the alleviation of the concerned symptoms (Vermeulen et al., 2019). Majority of the women did not feel confident or safe about the hormonal replacement therapy and as a result did not show faith in the procedure and chose not to opt for it. The knowledge regarding the therapy treatments were not made available to the women which resulted in that particular attitude.

Impacts of menopause on the quality of life and the ways in which they can be improved

Menopause has several other implications regarding the overall health of the female individual. This can result in several other ailments such as depression, anxiety and stiffness in the joints. These are several health implications of menopause which have a negative effect on the health of the women in large numbers. The menopause itself is an issue which is not understood by the patients to the necessary level as is clear from above mention of women who were not prepared to tackle the situation.

The negative implications are wide-reaching and as a result need more specialised attention so that they themselves do not engorge into something more severe (Herson et al., 2022). For example, the depression caused by menopause if goes unchecked and does not receive the correct professional services then it might lead to other mental health complications which has its own set of health implications on the individual.

Since there is a significant negative attitude towards the hormonal therapy treatment among women, the natural ways to combat menopause symptoms must be used. This usually implies introducing multiple lifestyle choices within the lives of the women. Diets should be given proper scrutiny so that they have the necessary nutritional value especially vitamin D (Rabiee et al., 2019). Having the right nutritional break-up in the diet will be a huge step in alleviating the symptoms.

Other steps include a daily regimen of robust exercise, keeping the body constantly hydrated, having a lot of fruits and vegetables and so on. The women of this age group must focus on keeping a weight which is neither below nor above the expected standards and levels. Exclusion of sugar from the diet is also a beneficial step in alleviating the menopausal symptoms.

Gaps

In the literature part it has been mentioned that there is a hesitant attitude of women towards hormonal replacement therapy. There is a significant gap in literature regarding what might be the reasons behind the hesitant nature and why does that nature of women change when it comes to using natural remedies as a deterrent to menopausal symptoms.

Summary

The section of the study shows that women face several problems during menopause which includes discomfort at the workplace. There are several other health implications of menopause which are in themselves quite serious in nature and rather than using artificial remedies, women have a far more positive attitude towards having natural remedies for their symptoms of menopause.

Methods

Research approach

The very common approach to research is either the deductive or the inductive approach. These two approaches are the ones which give the specific research the correct framework around which the research itself can be built. The two approaches are complementary to each other as they have the benefits and drawbacks which make them fit with each other. Both of these approaches operate on opposing paradigms. The journey of an inductive approach will take the researcher from a specific observation as a starting point and lead to the formation of a theory which will be general in nature and therefore can be applied to a much larger sample population (HR et al., 2022).

The end result being generalised will give the results a probabilistic nature as far as the accuracy of the conclusions are considered. On the other hand, the deductive approach starts with a theory as the initial premise and then reaches a specific observation. The results which the researcher gets from this opposite paradigm have a better level of accuracy. The reason being the end results are not general, rather specific in nature which removes any potential ambiguity which might be a result of the inductive approach (Pearse, 2021). The research which is being conducted, will however opt for the inductive approach as the topic pertains to how menopause might affect a large population of women in a particular place. Since the desired outcome needs to be applied to a larger sample population the inductive approach will be the ideal one for this research.

Method of data collection

Data collection is a very important aspect of any research. The latter is largely dependent on raw ,numerical data which can be analysed to support the desired outcomes. The data should be collected in a way so that it represents the elements of the necessary research and accordingly collects the statistical numbers which can be thereby analysed by the researcher. When it comes to data collection, there are two types- one is the primary source of data collection. This method is carried out by the researcher in real time and in real location to get the data in the most raw form which can be analysed to the fullest extent. Conducting primary research is quite time consuming and has a high cost coefficient for the researcher (Nayak et al., 2019).

Various tools such as integrated questionnaires, elaborate surveys, and personal interviews can be used in this method of data collection. Since the method is conducted by the researcher themselves he or she can personally guarantee the accuracy and veracity of the collected data. On the other hand, secondary methods take less time and are cost efficient but on the other hand the researcher themselves cannot guarantee the accuracy or the reliability of the data as it has been collected from other sources (Ruggiano et al., 2019). Secondary data usually comes from government records, published articles or journals and so on. This research uses secondary research methods as it caters to a large target population and therefore already published sources especially medical records from the Government records will prove to be very useful given the topic is macro-level medical research.

Type of research design

The type of research which is being employed in this particular assessment is the qualitative research method. This helps in understanding the broad and holistic concepts which are being talked about in the research. The topic of the research talks about the changes in behaviour patterns of women when they are going through menopause. Therefore the desired objective of the research is not tangible or cannot be measured through numerical or statistical values. Through the Qualitative research method the researcher will get a detailed understanding of the underlying problem and will be able to give a much broader context to the same (Mackieson et al., 2019). The underlying data based on which the qualitative conclusions will be formed need to be verified, credible and reliant. The qualitative method puts additional focus on the veracity and credibility of the study. The final analysis will be specific to the objectives of the research questions rather than being generalised outcomes.

The research design used is the descriptive research design. This sort of research design is beneficial when it comes to deal with multiple variables, within a large target population. The study topic deals with both the parameters mentioned above. Understanding the problems of menopause among women in a select population entails that the number of participants in the research is going to be more and the main topic is mentioning a qualitative phenomenon (Siedlicki et al., 2020). The study concerns the health behaviour of the women during this time of their lives and that is something which cannot be expressed in terms of raw and hard statistics. That is what makes the descriptive model the right fit for this study. The case study is an effective method of descriptive analysis and this study is taking the example of a particular place that is Belfast. Therefore taking the sample population from a fixed geographical area is another parameter which makes the use of a descriptive model even more ideal for this research.

Research philosophy

The underlying research philosophy in this study is the concept of interpretivism. The type of philosophy allows the researcher to go deep within the study and have a better and detailed understanding of the problem. The researcher has the necessary flexibility to implement his interests as the central theme of the study. The topic deals with a social phenomenon and the research in order to be successful needs the personal interpretations of the researcher. That is what makes this philosophy an ideal concept to be adopted during this study (Zahle, 2021). The researcher can identify the key points of the social phenomenon and the subsequent ramifications of the same on the society.

Ethical consideration

The secondary method of data collection implies that the researcher must take the data from existing published sources. Therefore the former has to obtain the informed consent from the parties who had collected the data in the first place. The researcher should be neutral and draw their own sets of interpretation from the given data and not be influenced by the existing analysis. Lastly it falls within the ethical obligations of the researchers to inform the original party if they come upon an inference of great significance from analysing the same set of data. The sources of information must be protected from an confidentiality point of view (Silleyew, 2019).

Analysis and discussion

Overview

This part talks about the various physical implications of menopause on the woman's body, the types of mental disorders they might lead to and the necessary treatment and medications which are used and administered to alleviate the symptoms. The physical and mental implications both have been discussed in this section.

Thematic analysis

Theme 1: Difficulties Belfast women deal with during the menopause

As started by Ragasudha et al., (2021), for women, particularly those who are peri/menopausal, hormonal changes are the primary cause of the wide variety of symptoms that may negatively impact their daily lives. Working women commonly find it challenging to speak with other people about their worries since their own GPs frequently lack the specialised expertise necessary to provide appropriate, individualised guidance and frequently do not have the time to address all the problems in a single appointment.

In addition, general practitioners frequently fail to give their patients enough support. Ahmadieh and Jradi, (2021) claimed that a 2021 Censuswide study found that hot flashes, memory loss, hip discomfort, and anxiety are just a few of the problems Belfast women experience during the menopause. To further understand these women's behaviours, a comprehensive nationwide survey of women over 50 was conducted, (Ahmadieh and Jradi, 2021). The core menopausal period is between the ages of 50 and 64, and the study focused on how these women behaved throughout this time.

It is found that, in an effort to make up for missed time and offset the (perhaps perceived) productivity loss, more than half of women between the ages of 50 and 64 made the decision to work longer hours. This is equivalent to more than two million women7 utilising their leisure time to find a solution to an unanticipated issue, (Crankshaw et al., 2019). The effect of this issue is felt by persons outside of these categories as well, as shown by the fact that over 370,000 working women between the ages of 50 and 64 acknowledge they have quit their employment or have contemplated doing so because they find it too difficult to deal with symptoms at work, (Crankshaw et al., 2019).

According to a recent study, only a very small percentage of women who are experiencing menopause inform their employer about their symptoms. The economy is currently and will continue to suffer due to the lack of dialogue and openness surrounding the menopause, and there is a genuine risk of needlessly squandering a pool of knowledge, ability, and potential. However, in addition to reducing a woman's ability to work, the menopause has a profound impact on her life.

The reason why women between the ages of 50 and 54 had Belfast's highest suicide rate may be due to variables affecting a person's mental health, temperament, and social life. 25% of women say that their relationship with their partner has suffered as a result of the 65% of divorces that are started by women, (Maddock et al., 2021). This is one of the key reasons why there has been a rise in divorce rates among those over 50 for the first time in ten years, (Maddock et al., 2021).

Acciording to Stefos et al., (2020) approximately, 35 percent percentage of the women in Belfast, who are in between the ages of 50 and 64 admit that the menopause has affected certain aspects of their life. The following are some of the signs: 

1. Mood (62%)
2. Sexual stimulation (46%).
3. Mental health problems (31%).
4. Social engagements (20%)
5. Time spent on recreation or hobbies (15%)
6. Communication with relatives (12%)
7. Interactions between kids (8%)
8. Relationships (8 percent)

Therefore, it may be stated that women in Belfast during menupuse experience a significant number of challenges.

Theme 2: Tools used by women to take health behaviour problems in menopause

Studies on the emotions and behaviours of menopausal women show that menopause has a range of effects on women. Women's quality of life, lack of sleep, and depression are all brought on by menopause. The majority of women (78%) who experience menopausal symptoms believe that they impede their everyday lives, even though 59% of postmenopausal symptomatic women experienced 13 or more symptoms, (Paciuc, 2020). Hot flushes (92% of women), a decrease in sex drive (89% of women), and night sweats (87% of women) were the most commonly mentioned symptoms. 80% of women went through weight swings throughout the menopausal transition, and 48% of them had trouble keeping their weight steady, (Paciuc, 2020). 66% of the women in this research are now either overweight or obese, which is a separate risk factor for illness, based on self-reported heights and weights, (Luo et al., 2019).

As per Mao et al., (2022), it was discovered that 21% of the 855 women in the research conducted in the year 2022, who were between the ages of 44 and 65, were in the early phases of perimenopause, 22% were in the late stages, 41% had menopausal symptoms, and 16% had none at all. 78% of respondents said that menopausal symptoms often or infrequently interfere with their lifestyle. Herbal treatments, the most common alternative therapy for women, are used by more than a third (31%) of HRT users, (Mao et al., 2022). There are 13 or more menopausal symptoms reported in 59% of the females who exhibit these symptoms. The most common side effects include night sweats, hot flushes, and decreased sex drive (89 % of female reported it).

A recent study of 2000 women, aged 46 to 60, performed by OnePoll for Health & Her® has just confirmed the findings of the original survey, (Saint Joseph, 2022). The study's main conclusions, which looked at a sample of somewhat younger women, were as follows:

1. 9 % of perimenopausal women have thought about suicide, (Saint Joseph, 2022);
2. 86% of those who acknowledged having mental health concerns said they had never discussed it with a spouse;
3. 37% of individuals who had symptoms chose not to see a doctor;
4. To demonstrate the detrimental consequences these mental health concerns have on the job, perimenopausal women report making errors at work around 25% of the time and reporting sick 15% of the time (nearly 1 in 6);
5. 77% of respondents said they no longer had mental health difficulties despite never having them in the past, (Saint Joseph, 2022);
6. Low energy and motivation are the most prevalent mental health issue, according to 58% of responses, and 67% of those between the ages of 46 and 49, (Saint Joseph, 2022). 
7. 53% of respondents said they had low mood or sadness, 50% said they experienced worry, 42% said they experienced rage or mood swings, and 33% said they felt unworthy.

Theme 3: Suggested treatments to lessen menopause's negative effects on quality of life

Menopause has a number of detrimental affects on a woman's life. Menopause symptoms include changes in mood, anxiety, depression, foggy thinking, racing or pounding heart, hot flashes, insomnia or difficulty falling asleep, joint pain, night sweats, urinary incontinence, and dryness of the vagina. Women with symptoms were considerably more likely to be white non-Hispanic women, to have some college education, to exercise frequently, to smoke presently, and to have a higher BMI, (Holton et al., 2019)). Menopausal symptoms have also been shown to have a major negative impact on both physical and mental health. There are various suggested remedies to minimise these negative effects of menopause.

Treatments might consist of:

Hormone therapy: Oestrogen therapy is the most efficient way to manage menopausal heat flashes, (Bansal and Aggarwal, 2019). Depending on ones personal and family medical histories, the doctor may suggest using oestrogen for the shortest time possible and in the lowest amount necessary to relieve the symptoms. If the uterus is still there, the person will also need progestin in addition to oestrogen. Additionally, oestrogen slows down bone weakening. 

Vaginal oestrogen: To treat vaginal dryness, oestrogen can be applied directly to the vagina through a vaginal lotion, pill, or ring. The little oestrogen released following this procedure is absorbed by the vaginal tissues, (Bansal and Aggarwal, 2019). It may be used to treat a variety of urinary issues as well as dryness and pain in the vagina during sex.

low antidepressant doses: Menopausal hot flashes have been demonstrated to be reduced by a family of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Women who cannot take oestrogen or who need an antidepressant for a mental health condition may be able to stop having hot flashes with the aid of a low-dose antidepressant, (Karanth et al., 2019).

Gabapentin:In addition to being approved to treat seizures, gabapentin has been shown to reduce hot flashes, (Karanth et al., 2019). Women who cannot utilise oestrogen treatment or who also have midnight hot flashes may benefit from this medication.

Clonidine:Paciuc (2020) opined that hot flashes may be somewhat reduced by clonidine, a tablet or patch often used to lower high blood pressure.

Medications for osteoporosis prevention or treatment: Medical professionals may suggest using a medicine to treat or prevent osteoporosis depending on the patient's needs, (Paciuc 2020). Numerous drugs have been shown to lower the incidence of bone loss and fractures. To help grow stronger bones, the doctor may prescribe vitamin D supplements.

Discussion

Menopause and the social implications

As it stands, women find it difficult to communicate the problems related to the menstrual cycles. The menopause is the same and complicates matters. As the analysis above states, there is sufficient lack of expertise within the medical community itself when it comes to dealing with the female patients suffering from symptoms of menopause. This leads to even more communication problems for women who are suffering from menopause. The suicide rates among the women of this age-group are quite significant.

The social interaction capability of the women of this age is quite hampered due to the distinct mood disorders which they suffer from the depression from menopause (Schweizer et al., 2021). Women find it difficult in maintaining their position in the family life and the percentage of divorces in this age-group is proof that women of this age group are finding it difficult from an emotional point of view to sustain their family lives and as result their entire social life is falling apart.

To replace this feeling of unrest in their social life, it is quite natural that the women of this age-group completely immerse themselves in their professional lives. The menopause restricts them from working to their fullest potential in the workplace. Coupled with the fact that there is an extra initiative from the women to work more hard during this period of their lives, the situation becomes even more untenable and complex in nature (Atkison et al., 2021).

The leave for women during the menstrual period is something which has not been taken up as policy in most of the countries, granting them leave during menopause is a matter which has not been given any thought. That implies that the society not only has a conservative attitude towards the menstrual cycle of women but also towards the menopausal time of their times. The women at this age group and circumstance often feel isolated and ostracised from society.

Menopause and the physical implications

The above analysis tells that there are a wide range of physical implications and transformations for the women during the stage of menopause. Hot flashes, mood disorders, anxiety are all different sorts of adverse effects on the women’s health during the menopause. Most of the women are of the opinion that these side-effects hamper their quality of life and they have to bring in significant changes in their lifestyles so that they can combat these symptoms form aggravating into something more serious as a significant number of menopausal women have already admitted that they have possessed of suicidal tendencies in the near past (An et al., 2022).

The women of this age group are usually unprepared to tackle this host of changes which come about in their body and psyche, and therefore find it difficult to cope with the effects a bit more than what was anticipated. They have opted for several types of treatment such as herbal therapies which implies that there is a significant initiative on the part of the women to alleviate these symptoms so that they can lead their lives as they were.

Women have really struggled to keep a steady control on their body weight which has been a hallmark as far as menopausal symptoms go. They have taken an extra focus and attention to reduce their body weight so that they can remain active in their social lives and work up to their fullest potential at the workplace (Chopra et al., 2019). Taking care of their physical health will ensure that their mental and emotional well-being is also kept in good condition.

The physical and emotional components of the body are intertwined at this stage at a level where one has to be kept stable and calm to take care of the other part. Therefore the physical complications must be treated with proper expert guidance so that mental health welfare of the menopausal women are protected as the latter is very important if they have combat and be successful in overcoming the symptoms of menopause.

Medical avenues to overcome menopausal symptoms

There are multiple ways to treat the menopausal symptoms through medicine. Hormone therapy and medication such as clonidine are the primary line of defence against the symptoms and in alleviating the symptoms and the general health condition of the woman. However the attitude of women regarding hormone therapy makes it difficult to administer it (Vermeulen et al., 2019). The knowledge pertaining to the therapy practices are seldom made available to the women and as a result they find it less trustworthy to be administered in their bodies. As a result most of them depend on medicine which they can take by mouth. Herbal medications and the natural lifestyle changes appeal to the women more in terms of overcoming the menopausal symptoms. Having a nutrient rich diet, having a proper exercise routine ,and drinking adequate amounts of water are all very important for women during their menopause stage.

The medication or treatment which is administered during this time should be done by trained professionals. The doses should be calibrated properly before the administration because most of these medical prescriptions might have a set of side-effects which could have a further detrimental effect on the patients. Like hypnotherapy which is beneficial for reducing the instances of hot flashes, should not be administered to patients who have difficulties regarding psychosis. The patient and family history must be analysed thoroughly before administering this type of treatment. Similarly antidepressants administered to solve the mood disorders among the women must be given in the appropriate dosages, or else there might be adverse effects on the person taking the antidepressants (Shea et al., 2021). If the person is already taking such prescribed drugs, then it should be notified so that current dosage can be accordingly calculated without harming the health of the patient.

Summary

This section summarises that there are various implications of menopause on the woman's body as well as psyche. The emotional and physical components of the female population need to be given proper attention if the symptoms of menopause has ro be alleviated and the wide ranged grave ramifications are to be stopped.

Conclusion and recommendation

Conclusion

The symptoms of menopause are seen to affect women earlier than actual menopause. Most women are not well prepared about the healthy lifestyle changes they need to make and rely upon various programs and tools in order to lower the unhealthy symptoms. Women start adapting to various weight loss programs and adapting weight loss strategies to combat the perimenopause and postmenopause symptoms. However, the signs and symptoms can vary from woman to woman based on their lifestyle, health, age and other medical conditions. Menopause is predicted by irregularity in periods at the age of 40-59. Irregular periods is the most common and expected symptom that can be seen perimenopause in a woman.

With adaptation of a healthy lifestyle and regular physical exercise can lower the symptoms and complaints from a woman during menopause. The increase in the quality of life and decrease in the complaints of symptoms are the important factors that need to be taken care of in a woman during the stage of menopause. As much as it is important to train a teenager to menstruate it is also important for women of the age 40-60 to be provided with necessary programs and training on menopause, their symptoms and methods to lead a healthy lifestyle.

Linking with objectives

Linking with objective 1

The health and lifestyle of a woman goes through impeccable change during this period of time.At the time of the whole transition of the menopause that is at the time of perimenopause and postmenopause a woman experiences physical and emotional symptoms which affects their quality of life.

Linking with objective 2:

Menopausal symptoms have also been shown to have a major negative impact on both physical and mental health. The various suggested remedies to minimise the negative effects of menopause include Hormone therapy, vaginal oestrogen, low antidepressant doses, gabapentin, clonidine, medications for osteoporosis prevention or treatment and regular physical exercises. 

Linking with objective 3: 

Menopause in a woman can also have a negative impact in the duration of life in women. Therefore, women are advised to take necessary steps and adapt to a healthy lifestyle long before menopause. Menopause reduces the woman's ability to work during that stage. Major effects on the physical as well as psychological well being of a woman is disturbed during this period. 

Recommendations

The following are the recommendations made in order to combat the symptoms of menopause in women and lead a healthy lifestyle. 

Recommendation 1: Lifestyle changes 

It is very necessary to make some lifestyle changes in order to reduce the symptoms of menopause and improve the lifestyle of women. It is advisable to quit smoking and limit the consumption of alcohol. There has been a link between the consumption of alcohol and breast cancer in women. Smoking of tobacco can cause early menopause and symptoms like hot flashes, vaginal dryness and more. Therefore, it is mostly recommended by doctors to limit the consumption of alcohol and quit smoking tobacco.

Recommendation 2: Regular physical exercise

It is also recommendable to adapt to doing physical exercise on a regular basis. Cardiovascular activities and weight-bearing exercise can help in maintaining the weight gain, improves the heart health, and also helps in reducing stress. Involving in regular physical exercise can help in combating some other major symptoms and disorders faced during the time of menopause. The symptoms like, physiological illness, cardiovascular disorder and weight gain are some of the major symptoms that can be cured with regular exercise. 

Scope and limitation

The scope of this dissertation lies in the idea to provide an understanding about various symptoms and lifestyle changes a woman goes through during menopause and provide with methods, tools and programs to combat the symptoms and lead a healthy lifestyle. This dissertation has also aimed at providing necessary recommendations to combat the effects of menopause. This study will provide a precise understanding about symptoms, and lifestyle changes a woman has to go through. However, the limitation of the dissertation lies in the data that have been collected. The data incorporated in this study is secondary data and does not contain the data collected from direct interviews with women. 

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