A Comparative Study on the Effectiveness of Hormone Replacement Therapy (HRT) and Psychological Therapy (Psychotherapy) on Mood Changes in Women during Menopause
1.0 Aims
The main purpose of this study is to conduct a comparative study between HRT and Psychotherapy and to understand the changes that women experience during climacteric period based on these two therapeutic methods. In this period also, there are changes in the mental health of these women resulting to depression and emergence of other stressors for women. As such, the research will aim at distinguishing the mood-related issues that confront these women while approaching perimenopause and post-menopause whereby the majority of these women experience hormonal and psychological changes.
2.0 Sample Size
The study will sample a target of 100 women whom 50 are undergoing HRT and the other half psychotherapy. Purposive sampling will be used since there are explicit criteria. As such, the respondents should be women, aged 35-45 and undergoing either therapy method. This study will disregard family income, social status, religion and race. These specific demographic requirements have been put in the study so as to make the results more specific.
3.0 Critical Evaluation of Pertinent Concepts
As (2003) puts it, women have differing views regarding menopause as evident on the various expectations, challenges, apprehensions and knowledge about the menopausal period and climacteric periods. He discovered that women to some extent are aware of the physical and psychological changes that follow the menopause but are lacking on knowledge about these changes or self-care activities that could prevent problems or mitigate symptoms. He concluded that interaction is very important in awareness building in addition to feelings of freedom to know and to relate own’s experiences. The idea is central to women’s decision-making in choosing what therapy best suits their condition.
(1999) made mentioned that making an informed decision about whether to participate in a therapy to offset short- and/or long-range effects of decreased estrogen due to menopause is particularly important because of the health-related risks and benefits associated with such therapy< major contributors to the decision are the kinds and sources of information used in arriving at a decision, the decision-making process followed, and whether the decision was informed. There are two basic choices for women as hormonal and non-hormonal therapies.
(1999) clarifies that there are typical climacteric symptoms and atypical symptoms including tiredness, irritability and mood swings and these are being remedied by topical and systemic oral and transdermal HRTs that are generally effective as symptomatic treatment. On the other hand, (2006) found out that HRT has inherent limitations that failed to promote, maintain and enhance the well-being of women. The researchers discovered that vasomotor symptoms prevail during climacteric period with HRT as the main therapy. These include were hot flushes, sweats, irregular menstruation, and cessation of menstruation, irritability and mood changes as well as vaginal dryness, insomnia and depression/anxiety.
One of the non-hormonal therapies is the psychotherapy whereby the Study by (2006) proved that there is a positive effectiveness of cognitive-behavioral interventions for the treatment of climacteric syndrome. However, a separate study points out that there are differences in the diminution as in the absence of symptoms were observed as much after the psychotherapeutic process. They concluded that psychoanalytic psychotherapy is functional for specific patients.
4.0 Preliminary Review of Literature
Mood problems are known to be among the three most common problems associated with menopause as symptoms of tension and depression increase among women in the premenstruum. These symptoms are considered problematic as the main reason that they seek medical interventions. Mood changes and its adverse consequences are among the frequent symptoms. According to , such menstrual transition is largely characterised by underlying endocrine changes that results in specific mood complaints. The indicators of which are hormonal changes related to aging, psychosocial factors, health and lifestyle factors and risk factors for minor and major depression (2004).
(2001) share the same view with reiterating that during perimenopause women become more vulnerable to depression wherein menstrual period lighten and become less frequent. Therefore, insomnia, hot flushes and mood problems are common. Several theories suggest that there are biological effects of hormonal fluctuations on moods especially because ovaries tend to produce less estrogen. Estrogen interacts with the brain to influence moods. Major depression as a mood disorder was tended to affect any person’s ability to experience normal mood states. Some of these are fatigue or lack of energy, restlessness, feelings of guilt or worthlessness, difficulty in concentrating, trouble sleeping and recurrent thoughts of death and suicide.
There are two common treatments for mood problems during menopausal stage: hormonal replacement therapy and psychotherapy. The former refers to the system of medical treatment for women in perimenopausal and postmenopausal periods as it can prevent (further) discomfort and health problems due to the decreased circulation of estrogen and progesterone hormone. In boosting the hormone levels of the patients, estrogens, progesterone or progestin and sometimes testosterone are utilised. There are different types of hormonal therapies such as conjugated equine estrogen and bioidentical HRT. While the former has two types: the interpersonal therapy that deals with understanding of changing human relationship as a contributing factor on mood problems and the cognitive behavioral therapy which focuses on identifying and changing of the pessimistic thoughts and the subsequent relief relating to mood swings. Basically, psychotherapy is relational in nature and aims to approach problems with living as it integrates sense of well-being and reduction of subjective discomforting experiences.
Nonetheless, both therapies shared a weight of criticisms notably in terms of the methods’ efficacy. For HRT, it was contradicted mainly because of its side effects that include liver diseases, coronary artery disease and venous thombosis. These are even exacerbated when the patient has migraine headaches, history of breast cancer and fibroids and prior urinary diseases. On the other hand, for psychotherapy, these are the skepticism on its curative effects particularly because it takes time to observe changes manifesting the inadequacy of coping dilemmas. As such, the process was perceived to be inappropriate and unneeded. The rationale behind the research is to determine the extent to which each method is to be considered effective and therefore disclose its weaknesses.
5.0 Justification of Methods
Literature review and some surveys will be the only methods to be used in this research for the purpose of presenting the data descriptively. Both methods may help present the current scenario regarding the degree of effectiveness of HRT and psychotherapy that decrease the mood changes in women during their menopause. Surveys provide the researcher information about the views of women about the matter and explore on how these therapies are affecting their being and why they chose to seek such method. Surveys are also conducted to gather data from the field in order to generalize results from a sample to a larger population (, 2000).
Accordingly, it is necessary to provide basic knowledge and descriptions and therefore necessary for the researcher to collate date through reviewing the current literatures. Through literature reviews, information can be useful in the analysis of data because they can help the researcher explain different issues in the study. (2005) of explained that one of the advantages of using literature review as one form of data collection is that it sets the basis for the discussion or analysis or contemplation of implications or anticipation of further research. Literature review can also be useful in understanding the structure of the problem, as well distinguishing what has been done from what needs to be done. Its purpose is to help the research define and clarify important issues.
6.0 Significance of the Study
The results that will be gathered from this study will be beneficial to the women who are currently experiencing mood problems that affecting their familial and social functioning. This study will be significant to the families, medical practitioners specializing in the subject area, therapists, authoritative bodies and the academia in such a way that it can contribute to the delineating the successful therapies on menopausal problems and restructure those that are not effective. By assessing the effectiveness of HRT and psychotherapy, the researcher can formulate plausible recommendations directed towards the importance and limitation of both and in having an informed choice. This study will also be significant not only to the women who are under climacteric periods but also for the rest of the world through its emphasis on the issue.
7.0 Brief Synopsis
Menopause is defined as the final menstruation, directly preceding the permanent cessation of ovarian follicular function. The transition from the reproductive to the non-reproductive phase of life can take many years, frequently characterised by perimenopausal cycle disorders, vasomotor symptoms (hot flushes and night sweats) and urogenital complaints (vaginal dryness, micturition complaints) (1999). According to (2006) during peri- and postmenopause there is a high prevalence of psychological symptoms such as emotional instability, depressive moods, anxiety, sleep disorders, and sexual dysfunction. Aetiologically relevant factors for discomfort are decline of sex hormones and psychosocial factors such as lifestyle, attitude towards menopause, pre-menopausal mental health and sociocultural factors. This comparative research will utilise HRT and psychotherapy as the major remedies that menopausal women are converging into.
8.0 Proposal Brief
This study will use the descriptive approach so as to utilise survey in the study. Since the researcher will also gather information about the present existing condition, it is also pertinent that the researcher will describe the nature of a situation purporting the formulation of rational and sound conclusions and recommendations for the study. In addition, the research will employ a qualitative research method wherein the researcher will seek to find and build theories that would explain the relationship of one variable with another variable through qualitative elements in research. Examples of qualitative elements that do not have standard measures are behavior, attitudes, opinions, and beliefs.
As the study involves an interpretative, naturalistic approach to the subject matter, this means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret phenomena in terms of the meanings that people bring to them. The primary source of data will come from the researcher-made questionnaire and interview questions. The primary data frequently gives the detailed definitions of terms and statistical units used in the study. These are usually broken down into finer classifications. The secondary sources of data will come from published articles, social science journals, theses and related studies on menopause, mood changes, HRT and psychotherapy. Acquiring secondary data are more convenient to use because they are already condensed and organized. Moreover, analysis and interpretation are done more easily.
9.0 References
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