AWARENESS, PERCEPTIONS, AND IMPACT OF MENOPAUSAL CHALLENGES AMONG ELDERLY WOMEN IN OYO STATE

CHAPTER ONE INTRODUCTION 1.1 Background of the Study The menopausal experience varies significantly among women as they grow older. Typically, menopause affects women between the ages of 45 and 55 (Faubion et al., 2015; Laven et al., 2016; World Health Organization [WHO], 2022). Medically, menopause refers to the biological process in which a woman’s ovarian function gradually declines, eventually leading to the end of her menstrual cycle (WHO, 2022). It is generally defined as the stage when a woman has not had a menstrual period for twelve consecutive months without any identifiable physiological or biological cause (WHO, 2022). Also referred to as a transitional phase, menopause marks the conclusion of a woman's reproductive years and the beginning of the natural aging process (Hatice et al., 2016). This stage of life has been linked to the decline in the body's ability to repair DNA, which accelerates the aging process in the body’s cells, eventually resulting in the cessation of fertility and the onset of menopause (Laven et al., 2016). Consequently, menopause is considered a natural life stage that requires understanding, emotional support, and proactive self-care. These elements are especially important given the physical and psychological challenges that can accompany this period. During menopause, women may experience a range of physiological symptoms such as hot flashes, painful intercourse (dyspareunia), and irregular menstrual cycles (WHO, 2022). Several factors have been found to influence the occurrence and severity of these symptoms, including anxiety levels, reduced estrogen production, educational background, and self-esteem (Zhang et al., 2020). Moreover, age has been identified as a significant factor influencing the psychological impact of menopause. Research indicates that healthy middle-aged women do not usually suffer mental health issues due to natural menopause (Busch et al., 2016). However, women who experience menopause earlier or later than expected are more prone to intense psychological symptoms, including depression and emotional distress (Faubion et al., 2015). Awareness of the various factors that influence menopausal symptoms can help women better navigate this life transition. Despite this, menopause is rarely discussed in formal education settings, and many general practitioners receive minimal training in managing menopausal symptoms (Harper et al., 2022; WHO, 2022). Additionally, the way menopause is portrayed in medical discourse and the media often frames it as a pathological condition or a negative life event, rather than a natural biological process (Harper et al., 2022). Brewis, Beck, Davies, and Matheson (2017) pointed out that earlier literature often depicted menopause as a medical problem, evoking fear and negativity instead of being viewed as a natural life transition (Arseneau et al., 2021; Hickey et al., 2022). Despite its significance, there is still limited academic research and public understanding surrounding menopause. This lack of knowledge can foster misconceptions and affect how women perceive and prepare for this phase of life. As a result, it becomes essential to conduct studies that frame menopause in a more positive and natural light. Since attitudes towards menopause can directly influence how symptoms are perceived and managed, promoting a more positive outlook is crucial (Arseneau et al., 2021). According to Beck, Brewis, Davies, Fish, and Garlick (2016), attitudes represent an individual’s personal evaluation and emotional reaction to specific experiences or objects. In this context, menopausal attitudes refer to how women emotionally and cognitively perceive the menopausal transition. Various factors, such as a woman’s menopausal status, cultural background, level of education, and self-assessed physical and mental health, all play roles in shaping these attitudes. A more informed and positive attitude often leads to better preparedness for the menopausal phase (Liao & Hunter, 1998). Interestingly, studies show that women tend to develop more positive views about menopause after going through it themselves. Dashti et al. (2021) found that postmenopausal women generally had more favorable perceptions compared to premenopausal or perimenopausal women. This finding aligns with other studies showing that many women, particularly those who have experienced menopause, view it as a neutral or even positive transition rather than a distressing one. Research also indicates that anxiety related to menopause tends to decrease with age. This may be attributed to how life stage perspectives evolve as women grow older (Brewis, Beck, Davies, & Matheson, 2017). Younger women often view menopause negatively, possibly due to the dramatic physiological changes it entails. In contrast, middle-aged women tend to consider it a natural part of aging and are less concerned about the loss of fertility. Older women often perceive menopause as a gradual and normal life transition, not as a dramatic or alarming event. This highlights how age significantly shapes attitudes towards menopause. Thus, educating younger women about the symptoms and implications of menopause, as well as providing support and guidance, is vital. Negative perceptions at a younger age can impact overall well-being. According to Kopenhager and Guidozzi (2015), young women report the lowest levels of well-being, which then slightly improves around midlife (around age 50), before declining again. They suggested that improved psychological well-being in midlife may be due to shifts in health expectations and value realignment that come with age. Research from the early 1990s also indicates that women who report higher levels of well-being tend to have more positive attitudes towards menopause. This supports the idea that negative beliefs about menopause and aging contribute to decreased well-being among younger women. Brewis, Beck, Davies, and Matheson (2017) also found that factors like past premenstrual symptoms, interpersonal stress, and psychosomatic or respiratory issues were negatively associated with well-being. On the other hand, current health status and self-rated overall health had a positive relationship with well-being. These findings suggest that despite the age-related challenges they face, middle-aged women generally enjoy higher levels of well-being because they tend to adopt a more optimistic perspective on life events like menopause. Based on this, the current study aims to explore the knowledge, attitudes, and effects of menopausal challenges among older women in Oyo state . 1.2 Statement of the Problem Menopause is a major life transition for women, marked by the end of menstruation and the loss of reproductive capability. Despite being a natural process, it often comes with physical, psychological, and social challenges that can greatly affect a woman’s health and well-being. Although menopause is common and expected, there is still limited understanding of how older women perceive and manage its challenges (Brewis, Beck, Davies, & Matheson, 2017). This study seeks to explore how older women understand, perceive, and respond to the menopausal transition. Several barriers hinder women's knowledge and preparedness regarding menopause, including a lack of information on its symptoms, biological changes, and related health risks. Without accurate knowledge, women may develop misconceptions or be inadequately prepared to manage symptoms. Attitudes towards menopause strongly influence how women experience and cope with it. Studying these attitudes may help uncover the cultural, social, and personal factors that shape women's coping mechanisms (Brewis, Beck, Davies, & Matheson, 2017). Furthermore, symptoms such as hot flashes, mood changes, insomnia, and vaginal dryness can disrupt many aspects of a woman’s life—including her physical health, mental state, social interactions, and career. Understanding the nature and extent of these symptoms is essential for developing supportive policies and interventions. According to Brewis, Beck, Davies, and Matheson (2017), sociocultural influences—like cultural norms, social beliefs, and medical practices—can significantly shape women’s menopausal experiences. Therefore, it is important to investigate how these external influences affect older women’s understanding, attitudes, and management of menopause. This underscores the need to evaluate the knowledge, attitudes, and effects of menopausal challenges among older women in Oyo state . 1.3 Objectives of the Study General Objective: To evaluate the knowledge, attitudes, and effects of menopausal challenges among older women in Oyo state. Specific Objectives: i. To examine the level of awareness and understanding of menopause among older women in Oyo state . ii. To investigate the attitudes of older women towards menopause and how these attitudes affect their perceptions and coping strategies. iii. To assess the physical and social impacts of menopausal challenges on older women's lives. iv. To analyze how sociocultural influences affect older women’s experiences of menopause in Oyo state. 1.4 Research Questions The following questions guide this study: i. What is the level of awareness among older women about menopause in Oyo state? ii. What are the attitudes of older women towards menopause, and how do these attitudes shape their perceptions and coping mechanisms? iii. What physical and social effects do menopausal challenges have on the lives of older women in Oyo state? iv. How do sociocultural factors influence the menopausal experiences of older women in Oyo state? 1.5 Significance of the Study This research holds significance for various stakeholders: Ministry of Health: Understanding how older women perceive and respond to menopause is vital for promoting awareness and educating the public. Many women lack accurate information, which can lead to misunderstandings and fear. The study aims to bridge this knowledge gap and empower women to make informed choices regarding their health. Healthcare Providers: Insights from the study can help healthcare professionals better understand the specific concerns and experiences of menopausal women. This may lead to improved care delivery, including personalized counseling, treatment plans, and support systems. Policymakers: The findings may inform health policy and programs related to women’s health and aging. Policymakers can use this data to advocate for enhanced healthcare services, public education campaigns, and funding for menopause-related research. Academic Community: The study adds to existing scholarly literature and offers a basis for further academic inquiry into menopause, aging, and women’s health. 1.6 Scope of the Study This study focuses on assessing the knowledge, attitudes, and impacts of menopausal challenges among older women in Oyo state . Empirical Scope: The study will explore the level of knowledge about menopause among older women, their attitudes and coping strategies, the physical and social consequences of menopausal symptoms, and how sociocultural factors shape their experiences. Geographical Scope: The research is limited to women residing in Akinyele Local Government Area, Oyo State. 1.7 Limitations of the study As with many other research endeavors, this study encountered several challenges. One of the primary difficulties was the lack of readily available and accurate materials relevant to the topic under investigation, as well as the inability to obtain sufficient data. The researcher also faced financial limitations, which created obstacles in sourcing appropriate materials and in carrying out the printing and compilation of questionnaires. In addition, time constraints posed another significant challenge. The need to balance the demands of writing the research with other academic responsibilities made the research process particularly strenuous and demanding for the researcher. 1.8 Definition of terms Knowledge: Knowledge refers to the awareness, understanding, and familiarity that older women possess regarding menopause, its physiological processes, associated symptoms, and potential management strategies. Attitude: Attitude pertains to the psychological predisposition or perspective of older women towards menopause and its challenges. Menopausal Challenges: Menopausal challenges denote the array of physiological, psychological, and social difficulties encountered by older women during the transition into menopause and the postmenopausal period.