Keeping My Ways of Being. Middle-aged women and menopause

Sammanfattning: To deepen the understanding of menopause and its role in women's lives is the general aim of this thesis. Between 1995 and 2003, all women in two Swedish primary health care districts received a postal questionnaire, when they were 45, 50, 55 or 60. A total of 1681 women (76%) responded. Twenty-four women were given research interviews. The effects of menopause on quality of life (QoL) and number of symptoms were generally small, vasomotor symptoms being the only exception. Older women were more satisfied in these respects than younger women. Women with experience of hormone therapy (HT) reported more symptoms and lower QoL than women who never used HT. Factors concerned with women's everyday life, contentment with oneself and use of health care services were important in explaining the strong associations between attitudes towards HT and HT use. Educational level and occurrence of cold sweats/hot flushes did not contribute to the explanation. A shift from a mainly positive attitude towards HT and increasing HT use in the 1990s to a largely negative attitude and decreasing use became evident in 2002-03. Grounded theory analysis of interviews and open-ended questions revealed that the women dealt with uncertainties during menopause with the process: Keeping my ways of being. The intensity of this process and the use of its three stages: Preserving present ways of being, Limiting changes and Reappraising, were considered dependent upon the important Personal calculation process, in which the women used their individual explanatory beliefs and evaluations of need.