MENOPOZAL DÖNEM SEMPTOMLARI VE HEMŞİRELİK BAKIMI

Öz

Küresel yaşam, beklenen yaşam süresinin artmasına neden olmuş ve kadınlar artık yaşamlarının yaklaşık üçte birini klimakterik dönemde geçirmektedirler. Bu nedenle de kadınlar menopoz semptomlarının etkisini daha uzun süre yaşamaktadırlar. Menopozal geçiş sürecinde ortaya çıkabilecek semptomlar kadınların yaklaşık %85'inde görülmektedir. Kadınların yaşadığı menopozal semptomlar; vazomotor semptomlar, uyku ile ilgili değişiklikler, emosyonel değişiklikler, saç ve deri değişiklikleri, ürogenital değişiklikler ve cinsel değişiklikler, metabolik sendrom ve kardiyovasküler değişiklikler, gastrointestinal değişiklikler ve kas-iskelet sistemi değişikliklerini kapsamaktadır. Bu semptomların görülme sıklığı ve özellikleri kadından kadına değişiklik göstermektedir. Hemşirelerin, kadınlara kanıt temelli güncel bilgiler vermesi, kadınların bu bilgiler doğrultusunda bilinçli seçimler yapmalarını sağlaması ve seçimlerini günlük yaşamlarına uygulamalarına destek olmaları önemlidir. Böylece hemşirelerin eğitici, danışman, araştırmacı, uygulayıcı ve destekleyici rolleri menopozal dönemdeki kadınların yaşadıkları sorunlarının çözümünde önemli rol oynayacaktır ve kadınların menopozal semptomlarla baş edebilmeleri mümkün olabilecektir. Sonuç olarak hemşireler tarafından bu doğal süreçte rahatsız edici semptomların olabileceği ve bunların büyük çoğunluğunun uygun danışmanlıkla hafifletilebileceği mesajının verilmesi, kadın, aile ve toplum sağlığına katkı sağlayacaktır. Bu derleme menopozal dönem semptomlarını ve hemşirelik bakımını incelemek amacıyla yazılmıştır.

Anahtar Kelimeler

• menopozal semptomlar
• Menopoz
• hemşirelik

MENOPOSAL SYMPTOMS AND NURSING CARE

Öz

Global life has led to an increase in life expectancy and women now spend about one third of their lives in the climacteric period. For this reason, women experience the effects of menopausal symptoms for a longer period of time. Symptoms that may occur during the menopausal transition are seen in approximately 85% of women. Menopausal symptoms experienced by women; These include vasomotor symptoms, sleep-related changes, emotional changes, hair and skin changes, urogenital and sexual changes, metabolic syndrome and cardiovascular changes, gastrointestinal changes, and musculoskeletal changes. The incidence and characteristics of these symptoms vary from woman to woman. It is important for nurses to provide women with up-to-date evidence-based information, to enable women to make informed choices in line with this information, and to support them in applying their choices to their daily lives. Thus, the educators, consultants, researchers, practitioners and supportive roles of nurses will play an important role in solving the problems experienced by women in the menopausal period, and it will be possible for women to cope with menopausal symptoms. As a result, giving the message by nurses that there may be disturbing symptoms in this natural process and that most of them can be alleviated with appropriate counseling will contribute to the health of women, families and society. This review was written to examine menopausal symptoms and nursing care.

Anahtar Kelimeler

• menopausal symptoms
• Menopause
• nursing

Kaynakça

1. Bhat AV, Carvalho L, Carvalho P. Severity of menopausal symptoms and biophysical parameters among perimenopausal women. J Nurs Occup Health. 2020;1(3):52-55.
2. Pathak V, Ahirwar N, Ghate S. Study to assess knowledge, attitude and practice regarding menopause among menopausal women attending outdoor in tertiary care centre. IJRCOG. 2017;6:1848-1853.
3. Hachul H, Polesel DN, Tufik S. Insomnia During Menopause. In: Attarian H, Viola-Saltzman M. editor. Sleep Disorders in Women, published by Humana, Cham. 2020 p:323-335.
4. Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T. Symptoms of menopause—global prevalence, physiology and implications. Nat Rev Endocrinol. 2018;14(4):199.
5. Vijayalakshmi S, Chandrababu R, Eilean VL. Menopausal transition among northern Indian women. NUJHS. 2013;3:72-79.
6. O'Neill S, Eden J. The pathophysiology of menopausal symptoms. Obstet Gynaecol Reprod Med. 2017;27(10):303-310.
7. Cano A. Menopause: A Comprehensive approach. 1th Edition, Springer, 2017.
8. Panay N, Briggs P, Kovacs GT. Managing the menopause. 2nd Edition, Cambridge University Press, 2020.

9. Li J, Luo M, Tang R, Sun X, Wang Y, Liu B. et al. Vasomotor symptoms in aging Chinese women: findings from a prospective cohort study. Climacteric. 2020;23(1):46-52.
10. Kilci Ş, Ertem G. Menopozda semptom yönetiminde kullanılan kanıta dayalı uygulamalar. Sakarya Üniversitesi Holistik Sağlık Dergisi. 2019;2(3):36-54.
11. McCormick CA, Brennan A, Hickey M. Managing vasomotor symptoms effectively without hormones. Climacteric. 2020;1-7.
12. Zolfaghari S, Yao C, Thompson C, Gosselin N, Desautels A, Dang-Vu TT. et al. Effects of menopause on sleep quality and sleep disorders: Canadian Longitudinal Study on Aging. Menopause. 2020;27(3):295-304.
13. Pengo MF, Won CH, Bourjeily G. Sleep in women across the life span. Chest. 2018;154:196-206.
14. Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nat Sci Sleep. 2018;10:73-95.
15. Nowakowski S, Matthews KA, von Kanel R, Hall MH, Thurston RC. Sleep characteristics and inflammatory biomarkers among midlife women. Sleep. 2018;41:049.
16. Duman M, Timur TS. The effect of sleep hygiene education and relaxation exercises on insomnia among postmenopausal women: A randomized clinical trial. Int J Prec Med. 2018;24(4):12650.
17. Oliveira D, Hachu H, Goto V, Tufik S, Bittencourt LRA. Effect of therapeutic massage on insomnia and climacteric symptoms in postmenopausal women. Climacteric. 2012;15(1):21-9.
18. De Kruif M, Spijker AT, Molendijk ML. Depression during the perimenopause: a meta-analysis. J. Affect Disord. 2016;206:174-180.
19. Maki PM, Kornstein SG, Joffe H, Bromberger JT, Freeman EW, Athappilly G. et al. Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. J. Womens Health (Larchmt). 2019;28:117–134.
20. Mulhall S, Andel R, Anstey KJ. Variation in symptoms of depression and anxiety in midlife women by menopausal status. Maturitas. 2018;108:7-12.
21. Soori MARZIE, Kolivand M, Momtaz Ya SN. The effect of group cognitive-behavioral therapy on depression in menopausal women: A randomized clinical trial. International J Life Science and Pharma Research. 2018;8:12-9.
22. Nazarpour S, Simbar M, Tehrani FR. Factors affecting sexual function in menopause: A review article. Taiwan J Obstet Gynecol. 2016;55(4):480-487.
23. Nazarpour S, Simbar M, Tehrani FR, Majd HA. The relationship between menopausal symptoms and sexual function. Women & Health. 2018;58(10):1112-1123.
24. Simon JA, Nappi RE, Kingsberg SA, Maamari R. Brown V. Clarifying Vaginal Atrophy’s Impact on Sex and Relationships (CLOSER) survey: Emotional and physical impact of vaginal discomfort on North American postmenopausal women and their partners. Menopause. 2014; 21(2):137–42.
25. Newson L. Menopause and cardiovascular disease. Post reprod. Health. 2018;24(1): 44-49.
26. Pu D, Tan R, Yu Q, Wu J. Metabolic syndrome in menopause and associated factors: a meta-analysis. Climacteric. 2017;20(6):583-591.
27. Muka T, Oliver-Williams C, Colpani V, Kunutsor S, Chowdhury S, Chowdhury R. et. al. (2016). Association of vasomotor and other menopausal symptoms with risk of cardiovascular disease: a systematic review and meta-analysis. PloS one. 11(6), e0157417.
28. Ifeanyi OE. A Review on insulin and vitamin D in pre menopausal and menopausal women. Int. J. Curr. Res. Med. Sci. 2018;4(2):109-122.
29. Boschitsch E, Durchschlag E, Dimai HP. Age-related prevalence of osteoporosis and fragility fractures: real-world data from an Austrian menopause and osteoporosis clinic. Climacteric. 2017;20(2):157-163.
30. Fistarol M, Rezende CR, Figueiredo Campos AL, Kakehasi AM, Geber S. Time since menopause, but not age, is associated with increased risk of osteoporosis. Climacteric. 2019;22(5):523-526.
31. Atan ÜŞ, Yiğitoğlu S. Menopozda semptom yönetimi ile ilgili kanıta dayalı uygulamalar. Uluslararası Hakemli Kadın Hastalıkları ve Anne Çocuk Sağlığı Dergisi 2015;3: 35-59.
32. Massoni AM, Menoya I, Bocanera R, Pezzotto SM, Mario E, Morosano ME. Hypovitaminosis D and associated risk factors in postmenopausal women. Health 2014;6(2):1180-1190.
33. Mata-Granados JM, Cuenca-Acebedo R, Luque De Castro MD, Quesada Gómez JM. Lower vitamin E serum levels are associated with osteoporosis in early postmenopausal women: A cross-sectional study. J Bone Miner Metab 2013;31(2):455-60.
34. Nie X, Xie R, Tuo B. Effects of estrogen on the gastrointestinal tract. Dig. Dis. Sci. 2018;63(3):583-596.
35. Nachtigall LE, Nachtigall L. Menopause and the gastrointestinal system: our gut feelings. Menopause. 2019;26(5):459-460.
36. Chen C, Gong X, Yang X, Shang X, Du Q, Liao Q. et al. The roles of estrogen and estrogen receptors in gastrointestinal disease. Oncol. Lett. 2019;18(6):5673-5680.
37. Calleja-Agius J, Brincat M. The effect of menopause on the skin and otherconnective tissues. Gynecol Endocrinol 2012;28:273–277.5.
38. Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T.Symptoms of menopause – global prevalence, physiology and implications. Nat Rev Endocrinol 2018;14:199–215.
39. Jenabi E, Shobeiri F, Hazavehei SM, Roshanaei G. Assessment of question-naire measuring quality of life in menopausa l women: a systematic review. Oman Med J 2015; 30: 151–156.
40. LePillouer‐Prost A, Kerob D, Nielsen M, Taieb C, Maitrot Mantelet L. Skin and menopause: women's point of view. J. Eur. Acad. Dermatol. Venereol. 2020;34:267-269.
41. Tran S, Hickey M, Saunders C, Ramage L, Cohen PA. Nonpharmacological therapies for the management of menopausal vasomotor symptoms in breast cancer survivors. Support. Care in Cancer, 2020;1-11.
42. Roush K. Managing menopausal symptoms. AJN The American Journal of Nursing, 2012;112(6):28-35.
43. Mathew E, Fernandez A, Hudgins LE, Raman S. Common sleep disorders in women. Indian J. Ment. Health Neurosci. 2019;2(1):24-30.
44. Marshall S, Rees M. Managing menopause and post-reproductivehealth with nutrition and lifestyle. Nutr Diet. 2020;77(S1):63.
45. O'Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S. et al. Canadian consensus on female nutrition: adolescence, reproduction, menopause, and beyond. J Obstet Gynaecol Can. 2016;38(6):508-554.
46. Wicks SM, Mahady GB. Nutritional and Dietary Interventions for Menopause. In Tremellen K, Pearce K.” Nutrition, Fertility, and Human Reproductive Function. Published by Taylor&Francis Group, 2015 p:165.
47. Simopoulos AP. An increase in the omega-6/omega-3 fatty acid ratio increases the risk for obesity. Nutrients. 2016;8(3):128.
48. Schwalfenberg GK. Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health. J Nutr Metab. 2017.
49. Noble N. Symptom management in women undergoing the menopause. Nursing Standard (2014+). 2018;32(22):53.
50. Kamdaeng P. The Management of Menopausal Symptoms. Nursing Journal, 2020; 47(1):478-488.