Narratives and how women interpret their symptoms have always been a part of how menopause is exp... more Narratives and how women interpret their symptoms have always been a part of how menopause is experienced. Today, as women feel more accessible to talk about menopause, new narratives are being formed and negotiated - both to menopause and concerning women becoming older. These different narratives mirror the fact that the transitional phase differs from woman to woman and that some women experience many symptoms while others do not seem bothered at all. Some narratives underscore menopause as a transformative period, offering opportunities to adapt to new life roles and highlighting middle-aged and older women as individuals of competence, confidence, and experience. Other narratives center on describing bodily symptoms - primarily "classic symptoms," notably hot flushes, but also the broad array of physical and mental manifestations that may arise from one's early forties to late fifties. In this paper, I will, drawing on two decades of research on the topic, discuss...
Introduction: As a part of a larger study, "Menopause described from the woman's perspective," it... more Introduction: As a part of a larger study, "Menopause described from the woman's perspective," it was the aim to explore whether women have any positive experiences in relation to the menopause and, if so, the nature of these experiences. Materials and methods: In a questionnaire, sent to a random sample of 51-year-old Danish women, an open-ended question concerning the course of menopause was included. A qualitative approach was used in the analyses. Results: Of 393 women who answered the open-ended question 194 women described positive aspects of the menopause. The total number of replies with a positive content was 268. These varied from unspecific statements describing a period of well-being or simply of having no problems at all, and concrete descriptions which primarily dealt with the relief that menstruation had ceased with its associated problems, such as PMS and fear of pregnancy. Lastly, they dealt with the possibility of personal growth and freedom to concentrate on the women's own requirements. Discussion: The positive aspects of the menopause are a relevant field to investigate further, quantitatively as well as qualitatively. It is recommended that, in counselling, doctors include positive aspects and women's own resources to avoid the use of medication and unintentionally inducing a feeling of illness at this time of life.
The aim of this article is to describe the empowerment concept in a medical perspective. The conc... more The aim of this article is to describe the empowerment concept in a medical perspective. The concept originated as a reaction to the oppression of groups and individuals in the USA. Later it was introduced in relation to health promotion. Empowerment implies counteracting oppression of groups and individuals, and being conscious of different positions of power. The concept can be used to describe a goal and a process, as well as a strategy. It implies both the mobilisation of the patient's own power, as well as counteracting oppressive forces. It is concluded that empowerment is particularly important for the most disempowered patients (for instance people who have been given a psychiatric label). Empowerment in the health services is a relevant strategy to achieve fundamental changes in the control and influence of powerless groups, and thereby reduce inequality in health.
The language of risk has many meanings, and in this article we demonstrate a discrepancy between ... more The language of risk has many meanings, and in this article we demonstrate a discrepancy between individually perceived risk and the medical understanding of risk as understood and communicated by general practitioners (GPs). Risk is experienced and interpreted by people in a cultural context, i.e. the same objective risk can be perceived in many different ways and given a different meaning in daily life. GPs' evaluation of risk is made on the basis of our epidemiological knowledge, the medical culture of risk perception and the GP's personal experience and interpretation. The theoretical focus in the article is a synthesis of two theories: patient-centred general practice and theory based in anthropology about risk as culturally and socially constructed. We use empirical data from a qualitative study to illuminate the discussion.
Introduction: Middle-aged women are often faced with the dilemma of whether to use hormone therap... more Introduction: Middle-aged women are often faced with the dilemma of whether to use hormone therapy or not. Until recently, advertisements, as well as, very often, the scientific literature, advocated the use of hormone therapy. The aim of this study was to determine women's use of hormone therapy and its correlation with age, self-rated health status and lifestyle factors. Materials and methods: An anonymous postal questionnaire was sent to 5,300 women over 44 years of age. The public health insurance office in Roskilde County picked 100 women at random for each of the 53 general practitioners who entered the survey in 1998. 72% of the women answered the questionnaire. The data set was statistically analysed using multiple linear logistic regression, taking account of the fact that the data had been obtained through general practitioners. Results: 35% (95% CI 32-38) of the women 50-55 years of age were currently using or had formerly used hormone therapy. As many as 51% (95% CI 46-56) of the women 60-64 years of age were currently using or had formerly used hormone therapy. More than 50% of the women who were using hormone therapy had done so for more than 10 years. The group of women 45-59 years of age with the worst self-rated health status had odds of 5.1 (95% CI 3.0-8.6) of current or former use of hormone therapy as compared with the women with the highest self-rated health status. The odds of current use of hormone therapy were comparable at 2.7 (95% CI 1.5-4.7) for the women with the lowest self-rated health status as compared with the women with the highest self-rated health status. There was a positive correlation between the use of hormone therapy and physical exercise, tobacco use, former use of oral contraceptives and examination of cholesterol level. Discussion: The percentage of women over 44 years of age who currently use or have formerly used hormone therapy in our study is comparable with the results of Danish surveys since 1983. Women 45-59 years of age who use hormone therapy do not have the same high level of self-rated health as that of women aged 45-59 years who have not used hormone therapy.
Introduction: The aim of this study was to determine how many women use alternative medicine to a... more Introduction: The aim of this study was to determine how many women use alternative medicine to alleviate menopausal symptoms and how often they feel relieved of those symptoms. We also examined whether there was a negative correlation between the use of alternative medicine and the use of hormone therapy, as well as whether there was any correlation between the use of alternative medicine and self-rated health status. Materials and methods: An anonymous postal questionnaire was sent to 5,300 women older than 44 years in Roskilde County, Denmark. The public health insurance in Roskilde County picked 100 woman at random for each of the 53 general practitioners, who entered the survey in 1998. 72% answered the questionnaire. Results: 24% (95%; C.I. 22-26%) used alternative medicine either formerly or currently. 54% felt that their symptoms had been relieved by the alternative medicine. More women who had formerly used hormone therapy were using alternative medicine currently or formerly (OR 2.5; 95% C.I. 1.9-3.4 for ages 45-59 and OR 3.9; 95% C.I. 2.6-6.0 for ages 60+) than women who had never used hormone therapy. Some women were using alternative medicine and hormone therapy at the same time, although fewer current users of hormone therapy aged 45-59 years were also using alternative medicine (OR 0.5; 95% C.I. 0.3-0.8) than were those who never had used hormone therapy. Fewer former users of alternative medicine reported good plus very good (OR 0.7; 95% C.I. 0.6-0.9) or very good (OR 0.6; 95% C.I. 0.5-0.8) self-rated health status than those who had never used alternative medicine. Discussion: Women who had formerly used hormone therapy used alternative medicine more often than women who had never used hormone therapy. Women who had formerly used alternative medicine tended to report lower self-rated health status than women who had never used alternative medicine.
In Storstrøm county an investigation was carried out concerning certificates in connection with s... more In Storstrøm county an investigation was carried out concerning certificates in connection with sickness benefit during a period of two months, and the general practitioners and the social-workers were asked about their opinion of and attitude to sickness-certificates. A total of 420 sickness benefit certificates were collected consecutively, and all the social-workers and 85% of the general practitioners participated. About half of the certificates were not completely filled out and only one fifth supplied constructive supplementary information. Forty-five percent of the social-workers and 33% of the general practitioners regarded the certificates as useless when dealing with social medical cases. A systematic followup of patients with long-term sickness is an important task in primary health care, and should be carried out in co-operation with other health- and social-workers.
In Denmark, "medicalization" and "making ill" are words that are used at rand... more In Denmark, "medicalization" and "making ill" are words that are used at random. The first describes a process where normal reactions and parts of life are defined as medical problems and are subsequently dealt with by the health care system. The second word is used in Nordic languages to describe the process of a healthy person being given the feeling of being ill, e.g. as a result of a screening. In the health care debate in Denmark you often find that doctors, researchers and lay people use the words "medicalization" and "making ill" in different ways. The purpose of this paper is to clarify and define these concepts. Based on the literature, different definitions and use of the words are examined. A definition is suggested, and it is argued, that "medicalization" and "making ill" are not synonymous, but that "making ill" is a result of "medicalization". The most notable difference is that "medic...
Narratives and how women interpret their symptoms have always been a part of how menopause is exp... more Narratives and how women interpret their symptoms have always been a part of how menopause is experienced. Today, as women feel more accessible to talk about menopause, new narratives are being formed and negotiated - both to menopause and concerning women becoming older. These different narratives mirror the fact that the transitional phase differs from woman to woman and that some women experience many symptoms while others do not seem bothered at all. Some narratives underscore menopause as a transformative period, offering opportunities to adapt to new life roles and highlighting middle-aged and older women as individuals of competence, confidence, and experience. Other narratives center on describing bodily symptoms - primarily "classic symptoms," notably hot flushes, but also the broad array of physical and mental manifestations that may arise from one's early forties to late fifties. In this paper, I will, drawing on two decades of research on the topic, discuss...
Introduction: As a part of a larger study, "Menopause described from the woman's perspective," it... more Introduction: As a part of a larger study, "Menopause described from the woman's perspective," it was the aim to explore whether women have any positive experiences in relation to the menopause and, if so, the nature of these experiences. Materials and methods: In a questionnaire, sent to a random sample of 51-year-old Danish women, an open-ended question concerning the course of menopause was included. A qualitative approach was used in the analyses. Results: Of 393 women who answered the open-ended question 194 women described positive aspects of the menopause. The total number of replies with a positive content was 268. These varied from unspecific statements describing a period of well-being or simply of having no problems at all, and concrete descriptions which primarily dealt with the relief that menstruation had ceased with its associated problems, such as PMS and fear of pregnancy. Lastly, they dealt with the possibility of personal growth and freedom to concentrate on the women's own requirements. Discussion: The positive aspects of the menopause are a relevant field to investigate further, quantitatively as well as qualitatively. It is recommended that, in counselling, doctors include positive aspects and women's own resources to avoid the use of medication and unintentionally inducing a feeling of illness at this time of life.
The aim of this article is to describe the empowerment concept in a medical perspective. The conc... more The aim of this article is to describe the empowerment concept in a medical perspective. The concept originated as a reaction to the oppression of groups and individuals in the USA. Later it was introduced in relation to health promotion. Empowerment implies counteracting oppression of groups and individuals, and being conscious of different positions of power. The concept can be used to describe a goal and a process, as well as a strategy. It implies both the mobilisation of the patient's own power, as well as counteracting oppressive forces. It is concluded that empowerment is particularly important for the most disempowered patients (for instance people who have been given a psychiatric label). Empowerment in the health services is a relevant strategy to achieve fundamental changes in the control and influence of powerless groups, and thereby reduce inequality in health.
The language of risk has many meanings, and in this article we demonstrate a discrepancy between ... more The language of risk has many meanings, and in this article we demonstrate a discrepancy between individually perceived risk and the medical understanding of risk as understood and communicated by general practitioners (GPs). Risk is experienced and interpreted by people in a cultural context, i.e. the same objective risk can be perceived in many different ways and given a different meaning in daily life. GPs' evaluation of risk is made on the basis of our epidemiological knowledge, the medical culture of risk perception and the GP's personal experience and interpretation. The theoretical focus in the article is a synthesis of two theories: patient-centred general practice and theory based in anthropology about risk as culturally and socially constructed. We use empirical data from a qualitative study to illuminate the discussion.
Introduction: Middle-aged women are often faced with the dilemma of whether to use hormone therap... more Introduction: Middle-aged women are often faced with the dilemma of whether to use hormone therapy or not. Until recently, advertisements, as well as, very often, the scientific literature, advocated the use of hormone therapy. The aim of this study was to determine women's use of hormone therapy and its correlation with age, self-rated health status and lifestyle factors. Materials and methods: An anonymous postal questionnaire was sent to 5,300 women over 44 years of age. The public health insurance office in Roskilde County picked 100 women at random for each of the 53 general practitioners who entered the survey in 1998. 72% of the women answered the questionnaire. The data set was statistically analysed using multiple linear logistic regression, taking account of the fact that the data had been obtained through general practitioners. Results: 35% (95% CI 32-38) of the women 50-55 years of age were currently using or had formerly used hormone therapy. As many as 51% (95% CI 46-56) of the women 60-64 years of age were currently using or had formerly used hormone therapy. More than 50% of the women who were using hormone therapy had done so for more than 10 years. The group of women 45-59 years of age with the worst self-rated health status had odds of 5.1 (95% CI 3.0-8.6) of current or former use of hormone therapy as compared with the women with the highest self-rated health status. The odds of current use of hormone therapy were comparable at 2.7 (95% CI 1.5-4.7) for the women with the lowest self-rated health status as compared with the women with the highest self-rated health status. There was a positive correlation between the use of hormone therapy and physical exercise, tobacco use, former use of oral contraceptives and examination of cholesterol level. Discussion: The percentage of women over 44 years of age who currently use or have formerly used hormone therapy in our study is comparable with the results of Danish surveys since 1983. Women 45-59 years of age who use hormone therapy do not have the same high level of self-rated health as that of women aged 45-59 years who have not used hormone therapy.
Introduction: The aim of this study was to determine how many women use alternative medicine to a... more Introduction: The aim of this study was to determine how many women use alternative medicine to alleviate menopausal symptoms and how often they feel relieved of those symptoms. We also examined whether there was a negative correlation between the use of alternative medicine and the use of hormone therapy, as well as whether there was any correlation between the use of alternative medicine and self-rated health status. Materials and methods: An anonymous postal questionnaire was sent to 5,300 women older than 44 years in Roskilde County, Denmark. The public health insurance in Roskilde County picked 100 woman at random for each of the 53 general practitioners, who entered the survey in 1998. 72% answered the questionnaire. Results: 24% (95%; C.I. 22-26%) used alternative medicine either formerly or currently. 54% felt that their symptoms had been relieved by the alternative medicine. More women who had formerly used hormone therapy were using alternative medicine currently or formerly (OR 2.5; 95% C.I. 1.9-3.4 for ages 45-59 and OR 3.9; 95% C.I. 2.6-6.0 for ages 60+) than women who had never used hormone therapy. Some women were using alternative medicine and hormone therapy at the same time, although fewer current users of hormone therapy aged 45-59 years were also using alternative medicine (OR 0.5; 95% C.I. 0.3-0.8) than were those who never had used hormone therapy. Fewer former users of alternative medicine reported good plus very good (OR 0.7; 95% C.I. 0.6-0.9) or very good (OR 0.6; 95% C.I. 0.5-0.8) self-rated health status than those who had never used alternative medicine. Discussion: Women who had formerly used hormone therapy used alternative medicine more often than women who had never used hormone therapy. Women who had formerly used alternative medicine tended to report lower self-rated health status than women who had never used alternative medicine.
In Storstrøm county an investigation was carried out concerning certificates in connection with s... more In Storstrøm county an investigation was carried out concerning certificates in connection with sickness benefit during a period of two months, and the general practitioners and the social-workers were asked about their opinion of and attitude to sickness-certificates. A total of 420 sickness benefit certificates were collected consecutively, and all the social-workers and 85% of the general practitioners participated. About half of the certificates were not completely filled out and only one fifth supplied constructive supplementary information. Forty-five percent of the social-workers and 33% of the general practitioners regarded the certificates as useless when dealing with social medical cases. A systematic followup of patients with long-term sickness is an important task in primary health care, and should be carried out in co-operation with other health- and social-workers.
In Denmark, "medicalization" and "making ill" are words that are used at rand... more In Denmark, "medicalization" and "making ill" are words that are used at random. The first describes a process where normal reactions and parts of life are defined as medical problems and are subsequently dealt with by the health care system. The second word is used in Nordic languages to describe the process of a healthy person being given the feeling of being ill, e.g. as a result of a screening. In the health care debate in Denmark you often find that doctors, researchers and lay people use the words "medicalization" and "making ill" in different ways. The purpose of this paper is to clarify and define these concepts. Based on the literature, different definitions and use of the words are examined. A definition is suggested, and it is argued, that "medicalization" and "making ill" are not synonymous, but that "making ill" is a result of "medicalization". The most notable difference is that "medic...
Uploads