Menopause student concepts_2e_ch19_lecture_ex3 (1) (2)

Module Overview

• Focus: Sexuality and Menopause

• Context: Nursing Education

Understanding Menopause

Definition

• Menopause: Permanent cessation of menses.

  • Climacteric: Period leading to cessation.

  • Perimenopausal: Time as reproductive function declines.

  • Postmenopausal: One year after the last menstrual period.

Timing

• Typical age range in the U.S.: 48-55 years.

Nature

• Recognized as a normal physiological process.

Factors Influencing Menopause

• Genetics: Family history can affect timing.

• Lifestyle Factors:

  • Smoking

  • Higher altitude living

  • Obesity

• Health Risks: Increased susceptibility post-menopause, including:

  • Heart disease

  • Osteoporosis

  • Macular degeneration

  • Cognitive changes

  • Breast cancer

Physiology and Etiology of Menopause

• Marks the biological end of fertility.

• Causes include:

  • Natural Aging

  • Surgical Intervention

  • Chemical Induction (e.g., chemotherapy)

• Decrease in ovarian function.

Clinical Manifestations

General Changes

• Estrogen decline affects:

  • Breast tissue

  • Body hair

  • Skin elasticity

  • Subcutaneous fat reduction

  • Size reduction of ovaries, uterus, cervix, vagina.

Symptoms

• Common symptoms include:

  • Hot flashes

  • Palpitations

  • Insomnia

  • Bone remodeling imbalances leading to osteoporosis.

Vaginal Health

• Increased vaginal pH leading to:

  • Higher risk of urinary tract infections (UTIs)

  • Vaginal infections due to reduced lubrication.

• Potential for painful intercourse and related injuries.

Collaborative Care

• Goals:

  • Relief of symptoms.

  • Minimization of postmenopausal health risks.

  • Patient reassurance, education, support.

Diagnostic Tests

• Hormonal changes indicative of menopause:

  • Rise and persistence of Follicle-stimulating hormone (FSH).

  • Rise and persistence of Luteinizing hormone (LH).

Pharmacologic Therapy

• Hormone Replacement Therapy (HRT):

  • For managing severe menopause symptoms.

• Selective Estrogen Receptor Modulators:

  • Exhibit site-specific actions in different tissues.

• Ongoing controversies around HRT use.

Complementary and Alternative Therapies

• Options may include:

  • Acupuncture

  • Massage

  • Herbal remedies

  • Dietary supplements

  • Bioidentical hormones

  • Meditation and yoga practices.

Nursing Process Approach

Focus of Nursing Interventions

• Symptom management.

• Disease risk reduction.

• Patient education and resource provision.

Data Collection

• Health History:

  • Focus on urinary issues, menstrual, and sexual history.

• Physical Assessment:

  • Vital signs, breast, pelvic, and abdominal assessment.

Identifying Nursing Problems

• Potential diagnoses include:

  • Deficient Knowledge

  • Ineffective Sexuality Pattern

  • Situational Low Self-Esteem

  • Disturbed Body Image (NANDA-I ©2012).

Planning and Interventions

Goals for Clients

• Enhance understanding of the menopause process.

• Education on coping strategies for symptoms.

• Promotion of weight-bearing exercise programs.

Patient Education Topics

• Understanding menopause physiology.

• Dietary advice for health maintenance.

• Importance of weight-bearing exercises and regular health screenings.

Supporting Sexuality

• Address changes in sex life and suggest remedies for vaginal lubrication.

• Promote open communication regarding feelings and concerns.

Enhancing Self-Esteem

• Encourage active participation in social and volunteer activities.

• Emphasis on the importance of a healthy lifestyle.

Body Image Management

• Support discussions around body image perceptions.

• Encourage personal recognition of strengths and capabilities.

Evaluation of Nursing Care

• Expected outcomes include:

  • Client showing positive self-regard

  • Expression of feelings related to menopause

  • Description of health maintenance strategies.