Social support and stressful life events during mid-life

The association between social support and self-rated health in midlife: are men more affected than women?

Social support from family and friends is recognized as an important social determinant of health, given its protective effects on individuals' physical and mental well-being. While most studies have focused on older adults, investigating midlife health is equally crucial since middle-aged individuals are also susceptible to the harmful health outcomes of inadequate social support from friends and family. This study contributes to the debate by examining whether social support is associated with self-rated health among middle-aged Brazilian adults and how this relationship varies between men and women. Using data from the nationwide Brazilian National Health Survey conducted in 2019, logistic regression models were employed to assess differences in self-rated health, accounting for confounding factors. The sample comprised 31,926 middle-aged adults, of which 52.5% were women. The overall prevalence of poor self-rated health was 40.7%, with a significant difference between men and women. Results from this study suggest that having no friends or family members to rely on, both during good and challenging times, was associated with poorer self-rated health. However, the strength of this association differs by gender, with social support from friends playing a more critical role in women's self-rated health. On the other hand, family support was associated with male self-rated health, particularly for men with three or more family members they can rely on. Future studies should consider cultural and contextual factors to better understand other dimensions of social support and its association with midlife health.

What factors determine whether a woman becomes depressed during the perimenopause?

Perimenopause has long been associated with psychological distress, both anecdotally and clinically. Research has identified this time as a period of increased risk for both first-episode depression and for depression reoccurrence. However, we know that the majority of women do not experience these difficulties during perimenopause. This review examines the current research literature looking at the factors associated with depression during perimenopause, with a view to identifying those factors which are protective and those factors which predict increased risk. From the literature, it is evident that some women have a hormonal vulnerability to mood disorders. However, this does not account for the phenomenon of perimenopausal depression in and of itself. Rather, there appears to be a complex interplay between hormonal vulnerability, the psychosocial resources one has (coping skills and social support), their overall well-being (exercise and other lifestyle factors) and the demands on their coping resources (stressful life events). The complexity of the relationship between perimenopause and depression means that there is a need to look beyond either as a sole explanation of mood during midlife. Education is required for both general practitioners and for women regarding the individual risks of psychological distress during perimenopause, as well as the knowledge of the life factors which we know to be protective.

Influence of psycho-social factors on climacteric symptoms

BACKGROUND

It has been suggested that psycho-social factors may be crucial in the development of climacteric symptoms.

MATERIAL AND METHODS

In order to evaluate the effect of psycho-social and biological factors on menopausal symptoms, Greene (climacterical symptoms), Cooper (psychosomatic symptoms of stress), Smilkstein (family dysfunction), Duke-UNC (social support) and Israel (life events) tests were passed to 300 Chilean women between 40 and 59 years of age. Data were evaluated with ANOVA, chi2 and logistic regression using the Epi-info package.

RESULTS

Perimenopausal women had a significant increase in stress and climacteric symptoms; however comparing with pre and postmenopausal women, tests for life events, family dysfunction or social support did not show any differences. A history of premenstrual syndrome was the main risk predictor f or climacteric symptoms (OR: 3.6, IC: 1.5-8.5; P < 0.03 ), followed by perimenopausal state (OR: 2.9, IC: 1.4-6.0; P < 0.001 ) and negative life events (OR: 2.3, IC: 1.0-5.3; P < 0.05 ). The psycho-social factors were predictors for anxiety and depression; on the other hand, perimenopausal state was a risk factor for somatic and vasomotor symptoms. During premenopause, women with regular cycles and vasomotor symptoms have more psychological symptoms and stress.

CONCLUSION

Climacteric symptoms that appear in the perimenopause are more intense in those women who have a biological predisposition such as premenstrual syndrome and are modulated by psycho-social factors.

A preliminary study of hormone replacement therapy and psychological mood states in perimenopausal women

Hormone replacement therapy (HRT) for perimenopausal women has been suggested to minimize the physical symptoms of menopause and improve mood and psychological functioning; however, the therapy remains controversial. In this study the effects of such therapy (comprising tablets, patches, and implants) on mood states was investigated within a sample of 70 perimenopausal women who were attending a family planning clinic within the Brisbane metropolitan area. On a battery of standardized questionnaires, including the General Health Questionnaire, the Profile of Mood States, the Eysenck Personality Questionnaire, and the Menstrual Distress Questionnaire, those 35 women who were using hormone replacement therapy prescribed by the clinic physician reported significantly lower scores on anxiety, insomnia, and somatic symptoms than did a comparable group of 35 untreated perimenopausal women. These findings provide some tentative support for the beneficial effects of the therapy on physical symptoms and psychological mood states related to the onset of menopause. Given increased life expectancy, there is a growing need for research into issues of aging.

The middle years: women, sexuality, and the self

Nurses caring for women in middlescence need to be aware that this is a period of much change and growth. The years between 35 and 60 years in women are characterized by psychologic growth and alteration in the hormonal environment. Successful negotiation through this developmental stage includes disassembling and evaluating the self, adjusting to the changing self, adapting to alterations in sexuality caused by hormonal shifts, and finally, acknowledging the new self that has evolved. Nurses can play important roles during this tumultuous stage by supporting women as they do the psychologic work necessary for growth, by expanding their view of middlescence beyond menopause, and by including sexuality with other aspects of health promotion and education.

Vasomotor symptoms and well-being in the climacteric years

OBJECTIVES

To determine more closely the relationship between vasomotor symptoms, well-being and climacteric status according to the last menstrual bleeding and according to the women themselves.

METHODS

A population-based cross-sectional study was executed using a postal questionnaire. Well-being of women with and without vasomotor symptoms was compared, for the different menopausal statuses. All 2729 women living in a commuter suburb of Rotterdam aged 45-60 years were approached of whom 1947 (71.3%) responded. Well-being was measured by the Inventory of Subjective Health (ISH) and three subscales of the Sickness Impact Profile (SIP).

RESULTS

The results showed that the relationship between vasomotor symptoms and well-being was dependent on climacteric status. Pre- and (middle and late) postmenopausal women with vasomotor symptoms more often experienced a relatively lower level of well-being compared to women without these symptoms. However, when the prevalence of vasomotor symptoms is as its peak, i.e. in late perimenopause, a difference in the level of well-being between women with and without vasomotor symptoms was absent.

CONCLUSIONS

It is concluded that well-being and vasomotor symptoms were inversely related in all menopausal statuses except for the (late) perimenopausal phase. For this no somatic explanation seems plausible. A more social scientific explanation is suggested.

The menopause viewed in relation to other life events--a study performed in Belgium

In order to study the impact of the menopause and hysterectomy in relation to other life events, a study was carried out in Belgium in a random sample of 510 women over 18 yr of age. It was found that these 2 life events are not perceived as being important. Comparison of the findings with those of an earlier unpublished study performed by the International Health Foundation on the same subject indicates that there has been a decrease in the perceived severity of the 2 life events. This could mean that, in the intervening period, socioeconomic status and emotional problems have acquired greater importance, although the change in attitudes might also be partly explained by the fact that the respondents were younger.