Attitudes toward menopause among middle-aged women: A community survey in an island of Taiwan

Abstract

Objectives

The purpose of this report is to explore the attitudes toward menopause of middle-aged women in Taiwan as well as to examine related factors.

Methods

A large community-based sample of Taiwanese women aged 40–54 years who are living on the islet of Kinmen were recruited for this study. Attitudes toward menopause were collected with a self-administered questionnaire.

Results

Of a targeted population of 1429 individuals, 1113 (78%) participated in the study. The mean age was 48.5 ± 4.0 years (range, 43–57 years) and 434 women (39%) were premenopausal. The rate of current hormone use was 13.5%. Compared to premenopausal women, fewer postmenopausal women agreed that menopause depressed them, and that interests distracted their attention from menopause (p < 0.01, Mann–Whitney test). Postmenopausal women did not believe that menopause would change their lives, and not having periods made women feel regretful. Compared with the illiterate women, higher educated women were more regretful about menopause (p < 0.05, Mann–Whitney test). Women who experienced vasomotor symptoms within 2 weeks of the study expressed a more negative attitude regarding menopause.

Conclusions

Women in Taiwan held a more positive attitude toward menopause as compared to prior studies in other countries. They had a more positive attitude when they actually faced menopause. Education and vasomotor symptoms had a significantly negative impact on menopausal perceptions. This report provides more insight on the perception of menopause in Taiwanese women that will guide future public health initiatives.

Introduction

Modern medicine has significantly prolonged human life. Menopause is the depletion of ovarian function followed by the cessation of menstruation. For middle-aged women, this loss is a critical issue that represents the end of fertility and the onset of the aging process. Owing to a lack of estrogen, women during menopause may experience compromised physical well-being [1] and climacteric symptoms, such as mucosal dryness, hot flashes, sweats, and emotional fluctuation. Attributing menopause to ‘deficiency disease’, hormone replacement therapy (HRT) has become mainstream during the previous three decades. However, the role of hormone therapy (HT) has become debatable since the results of Heart and Estrogen/progestin Replacement Study [2] and the Women's health initiative (WHI) in 2002 [3].

Numerous factors determined a woman's perceptions and beliefs about menopause. Menopausal status, social background, education, occupation, physical or emotional health, and general symptoms may influence the view of menopause [4], [5]. Cultural influences are thought to affect the menopausal transition experience but little cross-cultural data exists. While menopause has been extensively investigated elsewhere, menopause studies are very limited in Taiwan. Most of these studies are clinical, and they focus on menopausal symptoms [6], [7], [8], [9]. In our previous survey, we found the prevalence of vasomotor symptoms among the community women in Taiwan was low compared with that of western studies [10]. The impact of vasomotor symptoms among Taiwan society is also unclear.

The purpose of this study is to examine the attitude about menopause in a group of middle-aged women in a Taiwan rural community. We investigate the relationship between their attitude and menopausal status, educational level, and the appearance of vasomotor symptoms.