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The use of complementary and alternative medications by menopausal women living in South East Queensland

Gollschewski, Sara Emilie (2006) The use of complementary and alternative medications by menopausal women living in South East Queensland. PhD by Publication, Queensland University of Technology.

Abstract

Complementary and alternative medication (CAM) use during menopause is a growing public and women's health issue. The use of CAMs is increasing and evidence of CAM use in the general population suggests that women in the menopausal age range are more likely to use CAMs. In the context of menopause, preliminary research has indicated that women are using a number of CAMs to address symptoms. In a study of American women aged 45 to 65 years, 22% of women used CAMs during menopause, specifically herbal or naturopathic remedies (13%), relaxation techniques (9%) and dietary soy supplements (7%). Fourteen percent (14%) of women strongly agreed with the proposition that approaches such as nutrition and vitamins were better than hormones (Newton et al., 2002). The term 'menopause' is a concept of varying perceptions and perspectives. From the biological perspective, menopause is constant, however from the individual perspective, menopause is a unique experience shaped by cultural, emotional, psychological and physical characteristics. Symptoms commonly cited during menopause include hot flushes, night sweats palpitations, irregular menses and muscle and bone pain. The use of CAMs during menopause has the potential to address current symptoms and promote long term health and wellness.

The reviewed literature indicated that while a preliminary understanding of CAM use during menopause is evident, further research is needed to clarify and contextualise current prevalence rates and types used. In addition, an understanding of the reasons and factors that influence women to use CAMs during this transition is crucial to understanding women's menopausal experience. This project aimed to explore the prevalence of CAM use during menopause and to identify the reasons that influence women to use these therapies during the transition. To address this question, a two phase study was designed to incorporate both quantitative and qualitative research methods. For Phase 1, a secondary data analysis was undertaken on a dataset that explored women's menopausal experiences and therapies used to address symptoms and for phase 2, focus groups were used to explore women's personal experiences and perceptions of CAM use during menopause.

The secondary data analysis was undertaken on a population based sample of 886 women aged 47-67 years. Women were randomly selected from the electoral roll on the basis of gender, age and postcode, which were selected to ensure representation of urban and rural and varying socioeconomic status. From this analysis, the findings indicated that 80% of women used at least one type of CAM with therapeutic techniques (activities such as walking and swimming) the most commonly used (83.0%), followed by nutrition (66.8%), phytoestrogens (55.8%), herbal therapies (41.3%) and CAM medications (25.1%). Women who used CAMs were more likely to experience anxiety and vasomotor (hot flushes and night sweats) symptoms, have higher education levels, be low to middle income earners, be aged under 55 years, be previous users of hormone therapy (HT) and have participated in self breast examinations. CAM users were 40 to 90% less likely to be currently using HT or to smoke more than 20 cigarettes per day.

The results of the secondary data analysis indicated the prevalence and factors associated with CAM use, however the factors that influence women to use CAMs during the menopause were unclear. A series of three focus groups and two telephone interviews were undertaken with a group of 15 women, who were current users of CAMs, aged 47-67 years and fluent in English. Women were recruited through an advertisement placed in a newsletter distributed by a large metropolitan hospital; a flyer displayed on noticeboards of libraries and shopping centres; and a media release through the local community newspaper and on a state wide radio station. Analysis of the transcripts indicated that a number of factors interact to influence a woman's decision to use CAMs. Influences included relationships with family, friends and health practitioners, effects of symptoms, information on CAMs and menopause, current menopause research, personal perceptions of health, wellness and effectiveness of CAM therapies to alleviate symptoms.

Taken together, the results of the Phase 1 and 2 combined with the literature indicated that women were using multiple forms of CAMs. A post hoc analysis was undertaken and the CAM questions analysed in Phase 1 were critiqued within this new knowledge of CAM use. As a consequence, CAMs were redefined into four groups to enhance current understandings. After reclassification, the use of at least one CAM was 71.6%, with the most commonly used dietary phytoestrogens (60.0%), followed by dietary supplements (47.0%), herbal therapies (35.9%) and phytoestrogen supplements (33.0%). Sociodemographic, health and symptom characteristics were further profiled against the redefined categories of dietary phytoestrogens, dietary supplements, herbal therapies, phytoestrogen supplements and users of multiple CAMs. The consistency of associations varied according to the CAM category with no significant association present across all four CAM categories. This post hoc analysis clarified CAM categorisation and highlighted the high prevalence of women who were using multiple forms of CAMs. Additionally, multivariable analysis validated and confirmed the results of Phase 1 as similar profiles of a CAM user were found.

This research has identified the prevalence of CAM use during menopause in Queensland women and has begun to elucidate the reasons that influence women to use these therapies during this transition. The utilisation of both quantitative and qualitative methods has provided a comprehensive and holistic depiction of women's use of CAMs during menopause. The results and conclusions drawn from this research have highlighted areas that need addressing within the research and health service domain. For future research, development of a comprehensive CAM survey instrument is required and clarification of the definition of CAMs is also needed. Multiple definitions are currently used to describe CAM use, creating confusion in classifying types of CAMs and comparing prevalence rates between studies. With regard to health service recommendations, there is a need for increased access to information on menopause and alternative therapies for women. Open, active and participatory relationships between health practitioners and menopausal women are essential and health practitioners need to be aware women are using a variety of CAMs during the menopause and are likely to continue to do so even if health practitioner support is not apparent.

Impact and interest:

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ID Code: 16430
Item Type: QUT Thesis (PhD by Publication)
Supervisor: Lyons-Wall, Philippa& Anderson, Debra
Keywords: complementary and alternative medications, menopause, symptoms, Australian, SF-36, demographic characteristics, focus groups, influences of use
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Public Health & Social Work
Department: Faculty of Health
Institution: Queensland University of Technology
Copyright Owner: Copyright Sara Emilie Gollschewski
Deposited On: 03 Dec 2008 14:03
Last Modified: 29 Oct 2011 05:47

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