Women And Men Health Issues Discussion
Midlife can be a vulnerable period for physical and psychological conditions, particularly for women going through the menopause transition. A study by El Khoudary et al. (2019) found that women in midlife experience a range of physical and psychological symptoms associated with the menopause transition. The study surveyed over 2,000 women between the ages of 40 and 65 and found that the most common physical symptoms were hot flashes, night sweats, and vaginal dryness. At the same time, the most common psychological symptoms were mood changes, irritability, and difficulty sleeping.
PLACE YOUR ORDER HERE NOW
It is important to note that menopausal symptoms vary in terms of race and ethnicity. For example, Williams et al. (2022) examined the differences in menopause symptoms between women from different ethnicities and geographical locations. The study found that women from certain ethnicities, such as African-American and Hispanic women, were more likely to report severe symptoms of menopause compared to women from other ethnicities (Williams et al., 2022)Women And Men Health Issues Discussion. In contrast, women from certain geographical locations, such as Japan and Southeast Asia, were less likely to report severe symptoms of menopause than women from other parts of the world.
A study published in the Journal of the American Medical Association in 2017 examined the health risks associated with menopause. The study found that women going through the menopause transition are at increased risk for heart disease, stroke, and osteoporosis. The study also found that low estrogen levels and other aging-related changes, such as weight gain, can increase the risk of these health problems. Santoro et al. (2021) emphasize the importance of symptom recognition and management during the menopause transition, especially the need for healthcare providers to be aware of the symptoms that can be attributed to endocrine changes during the menopause transition and to provide personalized care that addresses the unique concerns and risk factors of each patient.
Several health concerns for the patient, including obesity, family history of breast cancer, menopausal symptoms, and hypertension, each have potential implications for the patient’s overall health and requires careful management and monitoring. Obesity is a significant risk factor for breast cancer, particularly in menopausal women. According to Kolb and Zhang (2020)Women And Men Health Issues Discussion, obese women are more likely to develop breast cancer and have worse disease outcomes than non-obese women. Therefore, weight management should be a priority for the patient, and lifestyle modifications such as increased physical activity and dietary changes are recommended. Perimenopausal symptoms, such as hot flashes, night sweats, and genitourinary symptoms, are common and can significantly impact the patient’s quality of life.
Healthcare providers should consider the use of hormone therapy or non-hormonal therapies, such as selective serotonin reuptake inhibitors (SSRIs), for the treatment of vasomotor symptoms. Genitourinary symptoms may be managed with the use of topical estrogen therapy, vaginal lubricants, or other medications. Hypertension is a common health concern for many individuals, and management typically includes lifestyle modifications, such as dietary changes and increased physical activity, as well as the use of antihypertensive medications.
In the case of a patient who is already taking antihypertensive medication, healthcare providers may consider adjusting the medication regimen and adding additional medications to achieve better blood pressure control. Given the patient’s family history of breast cancer, yearly mammograms are recommended for breast cancer screenings. The patient should also undergo yearly pap smears to monitor any changes related to her previous ASCUS diagnosis.
In addition to the non-pharmacological interventions mentioned above, several pharmacological options are available for managing hot flashes in women. Hormone therapy (HT) is the most effective pharmacologic therapy for managing hot flashes, and it is the preferred treatment for healthy women aged 50-59 years (Stuenkel, 2021). However, the use of HT is associated with risks such as breast cancer, stroke, and venous thromboembolism; thus, women with a history of breast cancer or a high risk of breast cancer, as in the case study, should avoid HT in treating perimenopausal symptoms (Stuenkel, 2021)Women And Men Health Issues Discussion.
In the case study provided, the patient is experiencing moderate to severe hot flashes, which are affecting her daily life. As such, menopausal hormone therapy (MHT) may be a viable option for symptom relief, provided that there are no contraindications. However, given the patient’s family history of breast cancer, careful consideration must be given to the potential risks associated with MHT, as estrogen therapy has been linked to an increased risk of breast cancer. Similarly, women with a history of CHD, VTE, or stroke, or those at moderate or high risk for these complications, may also not be good candidates for MHT due to the potential risks associated with hormonal therapy.
If MHT is deemed inappropriate or not preferred by the patient, nonhormonal pharmacotherapy options such as SSRIs, SNRIs, anti-epileptics, clonidine, oxybutynin, and centrally-acting drugs may be recommended. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are also effective in reducing the frequency and severity of hot flashes. Clonidine, a centrally acting alpha-2 adrenergic agonist, is another option for managing hot flashes, especially in women with a contraindication to HT or who do not tolerate other medications (Paciuc, 2020)Women And Men Health Issues Discussion.
Di Donato et al. (2019) found that vaginal estrogen therapy improved vaginal health and quality of life for women experiencing GSM symptoms. The randomized, double-blind, placebo-controlled trial included 302 postmenopausal women experiencing moderate to severe dyspareunia and vulvovaginal atrophy. Participants were randomized to receive either vaginal estradiol or a placebo twice weekly for 12 weeks. The results showed that women in the estradiol group experienced significant improvement in symptoms, as measured by the Vaginal Maturation Index, vaginal pH, and the Female Sexual Function Index, compared to the placebo group. The authors concluded that vaginal estrogen therapy is an effective and safe treatment option for postmenopausal women with GSM symptoms.
Another study published in the Journal of Obstetrics and Gynaecology Canada evaluated the safety and efficacy of vaginal dehydroepiandrosterone (DHEA) for the treatment of GSM (Labrie et al., 2016). The randomized, double-blind, placebo-controlled trial included 233 postmenopausal women with moderate to severe vulvovaginal atrophy. Participants were randomized to receive either a vaginal DHEA suppository or a placebo suppository daily for 12 weeks. The results showed that women in the DHEA group experienced significant improvement in symptoms, as measured by the Vaginal Health Index, compared to the placebo group. Labrie et al. (2016) concluded that vaginal DHEA is a safe and effective treatment option for postmenopausal women with GSM symptoms. Therefore, both vaginal estrogen therapy and vaginal DHEA therapy are effective treatment options for women with GSM symptoms who do not adequately respond to nonhormonal vaginal moisturizers and lubricants. However, healthcare providers need to assess each patient’s individual risk factors and medical history before recommending hormonal therapies.
Patient education is an essential component of healthcare that empowers patients to make informed decisions regarding their health. Patient education in menopause management is crucial in ensuring a woman’s quality of life before, during, and after the transition into menopause. As seen in the case study above, the patient presents with moderate to severe hot flashes, and understanding the available therapies and treatments is necessary. Patients with hypertension require proper education on medication use, possible side effects, and lifestyle modifications. Education regarding medication side effects is necessary to ensure patients are aware of possible adverse effects associated with prescribed medications. Regular cancer screenings are crucial in early detection and management. The American Cancer Society recommends yearly mammograms for women starting at age 40 and yearly pap smears starting at age 21 or within three years of becoming sexually active (Smith et al., 2019)Women And Men Health Issues Discussion.
References
Da Silva, A. S., Baines, G., Araklitis, G., Robinson, D., & Cardozo, L. (2021). Modern management of genitourinary syndrome of menopause. Faculty Reviews, 10, 25. https://doi.org/10.12703/r/10-25
Di Donato, V., Schiavi, M. C., Iacobelli, V., D’oria, O., Kontopantelis, E., Simoncini, T., Muzii, L., & Benedetti Panici, P. (2019). Ospemifene for the treatment of vulvar and vaginal atrophy: A meta-analysis of randomized trials. Part I: Evaluation of efficacy. Maturitas, 121, 86–92. https://doi.org/10.1016/j.maturitas.2018.11.016
El Khoudary, S. R., Greendale, G., Crawford, S. L., Avis, N. E., Brooks, M. M., Thurston, R. C., Karvonen-Gutierrez, C., Waetjen, L. E., & Matthews, K. (2019). The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause (New York, N.Y.), 26(10), 1213–1227. https://doi.org/10.1097/GME.0000000000001424
Kolb, R., & Zhang, W. (2020). Obesity and breast cancer: A case of inflamed adipose tissue. Cancers, 12(6), 1686. https://doi.org/10.3390/cancers12061686
Labrie, F., Archer, D. F., Koltun, W., Vachon, A., Young, D., Frenette, L., Portman, D., Montesino, M., Côté, I., Parent, J., Lavoie, L., Beauregard, A., Martel, C., Vaillancourt, M., Balser, J., Moyneur, É., & VVA Prasterone Research Group. (2016). Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause (New York, N.Y.), 23(3), 243–256. https://doi.org/10.1097/GME.0000000000000571
Paciuc, J. (2020). Hormone therapy in menopause. Advances in Experimental Medicine and Biology, 1242, 89–120. https://doi.org/10.1007/978-3-030-38474-6_6
Santoro, N., Roeca, C., Peters, B. A., & Neal-Perry, G. (2021). The menopause transition: Signs, symptoms, and management options. The Journal of Clinical Endocrinology and Metabolism, 106(1), 1–15. https://doi.org/10.1210/clinem/dgaa764 Women And Men Health Issues Discussion
Smith, R. A., Andrews, K. S., Brooks, D., Fedewa, S. A., Manassaram-Baptiste, D., Saslow, D., & Wender, R. C. (2019). Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening. CA: A Cancer Journal for Clinicians, 69(3), 184–210. https://doi.org/10.3322/caac.21557
ORDER HERE NOW
Stuenkel, C. A. (2021). Managing menopausal vasomotor symptoms in older women. Maturitas, 143, 36–40. https://doi.org/10.1016/j.maturitas.2020.08.005
Williams, M., Richard-Davis, G., Williams, P. L., Christensen, L., Ward, E., & Schrager, S. (2022). A review of African American women’s experiences in menopause. Menopause (New York, N.Y.), 29(11), 1331–1337. https://doi.org/10.1097/GME.0000000000002060 Women And Men Health Issues Discussion
