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1
Psychos=
omatic
aspects during menopause<=
/span>
Training
Course in Sexual Health Research
March
20, 2006
Prof.=
Willy
Pasini
2
• Menopause
is a relatively long period of the life of a woman with changes starting from the ovary accompanied =
with biological, psychosomatic, psychological and in some cases, behavioural symptoms.<=
/div>
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3
Menopause=
• Natural m=
enopause
is defined as the permanent cessatio=
n of
menstruation that results when the b=
ody
produces less oestrogen and
progesterone. A woman has reached menop=
ause
when she has not menstruated for 12
months. This usually happens between 45=
-55
years of age. (WHO,94)
4
<=
span
lang=3DEN-GB>Menopause: bio-psycho-social Model
• A. It is not a DISEA=
SE --
medial definition often criticized for not recognizing the social and cult=
ural aspects of the transition period in w=
omen's
lives
B. CHANGE of life and not only of LOSSES -- part of th=
e aging process and does not in itself =
require
therapy.
C. Menopause
"prevention" of LONGEVITY -- preventative treatment sometimes sought for sympto=
ms and bone loss through Hormone Therapy=
(HT).
There is a
psychological prevention of the forthcoming 30 years.
5
MODIFICATION AND L=
OSS
<=
span
class=3DBB style=3D'position:absolute;left:-4.43%;top:-.15em'>•1. Aesthetics
<=
span
class=3DBB style=3D'position:absolute;left:-4.43%;top:-.15em'>•2. Body functions
<=
span
class=3DBB style=3D'position:absolute;left:-4.43%;top:-.15em'>•3. Menstrual functions
<=
span
class=3DBB style=3D'position:absolute;left:-4.43%;top:-.15em'>•4. Procreative functions
<=
span
class=3DBB style=3D'position:absolute;left:-4.43%;top:-.15em'>•5. Sexual functions
<=
span
class=3DBB style=3D'position:absolute;left:-4.43%;top:-.15em'>•6. Intimacy of the couple
<=
span
class=3DBB style=3D'position:absolute;left:-4.43%;top:-.15em'>•7. The social role
<=
span
style=3D'visibility:hidden'>•=
6
1.
Aesthetics
=
;
•Chan=
ges in
the body due to natural aging process can be disturbing for some women. The increase of =
wrinkles, especially on the face, is =
more
disturbing for a=
women
than for a man.
7
2. Bodily symptoms=
•Some women
experience "hot flashes", dryness=
in
the vagina, mood swings, and a variety =
of
other symptoms.
•Certain women suffer of
osteoporosis, a beginning of urin=
ary
incontinence or of a loss of memor=
y.
However, these symptoms are n=
ot
obligatory.
8
3. Menstrual functions
•
•Certain women consider the irregularity and then the loss of the menstrual function as=
the
sign that they =
cannot
procreate any more. Menstruations for certain women are a regulation of the time of thei=
r =
monthly activities and it is thus as =
if they
had lost the
metronome.
•
•In many cultures, menstrual blood has=
various
significance -- it=
is
often a symbol of youth and fertility, rites and rituals associated with menstruation change in some societies=
and
these have =
an
impact on the role of women in those societies.
9
4. Procre=
ative
functions
• With the menopause, the ovary is no =
longer able to produce ovules. =
Nowadays, with the knowledge of genetic diseases after 40 years, man=
y =
women aim to have children earlier. =
10
5. Sexu=
al
functions
•The desire is not decreased because t=
he =
testosterone continues to be produced=
by the adrenal glands. However, it can somet=
imes be <=
span
lang=3DEN-GB style=3D'font-size:81%'>decreased because of social reasons i=
n a
society which
stigmatizes the sexuality of older persons
espec=
ially
post menopausal women.
•Exci=
tation
and orgasm can remain at the same level or can slightly decrease.
11
6. Intimacy of the
couple
<=
span
style=3D'font-size:63%;visibility:hidden'>•
•Sexu=
ality in
the older couple is more often affected by =
the health status of the man than the=
woman.
Chronic illne=
sses
such as diabetes or hypertension, can result in erection problems which will naturall=
y affect
the sexual relat=
ionship
of the couple.
12
7. The social role=
•Post menopausal women in different so=
cieties
may have diffe=
rent
roles and responsibilities that women of reproductive age.
=
•Powe=
r can be
restored to older women as they are now seen "as men" with the powers and
responsibilities of village
elders in some African societies.
•=
In other countries, post menopausal w=
omen are
expected to no lon=
ger be
sexually active. They are expected however to maintain and nurture the famil=
y =
unit.
•High=
er
status is usually given to older women in many =
countries
13
1.Organic
disorders (Amenorrhoea; Vulvar craurosis; Osteoporosis; Urinary problems)
<=
/span>
2.Mixed
psychosomatic and somatopsychic disorders (Vasomotor disorders: insomnia and hot
flashes; Pains:
Extreme headaches, pains of the back and dyspareunia; Change of the weight, obesity and bulimia)
3.Psychological
and psychiatric disorders (Hypocondria (maniacs of the smear); Depressions; Emotional psychoses)
Disorders related to the menopause
14
Therapies=
•
•1. Hormonotherapy
with human face
•2.
Psychotropic (pay attention to dependence)
•3.
Relations with the gynaecologist
•4. Short
focal psychotherapy
•5. Therapy
of communication
•6.
Body approach
•7. Self-help
and group of quality of life
•
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