DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School INTRODUCTION Background of the Study The woman’s body is a complex, ever changing barricade of systems. It undergoes series of changes, and yet they still manage to overcome the bodily aftermaths. Though the years, many are still wondering about the women’s cycle. Only those who experience these changes and cycle can be able to describe thoroughly the phases they have gone through as a woman. Many have undergone various phases, and many have not been able to experience much. According to the Association of Reproductive Health Professional survey, there are about 66% of women who are very or somewhat worried that it just doesn’t seem natural to not have their periods, and 89% are very/somewhat worried that there might be long-term health effects if their period is late or delayed. In fact, many OB/GYNs say that a monthly period is not medically necessary. According to Pilliteri (2007), menarche is the first menstrual period of girls. It may come as early as 8-9 years old and may come as late as 17 years old. At this age, teen should have enough knowledge to what their body do. Adding to that, Davidson et. al. (2008) stated that, two years before menarche, a girl experiences numerous of changes in her physical aspect as her body develops. 1

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School According to Mayo Clinic, menstrual cycle is the monthly consecutive changes happening in a woman’s body and prepares the core for the potential of pregnancy. The process called ovulation allows conception and implantation of a new life and it renews a uterine tissue that will be responsible for development. (Pilliteri, 2007) Each moth, one of the ovaries releases an egg. Changes in the hormone prepares the uterus for pregnancy. And if the ovulation takes place and egg wasn’t fertilized, the lining of the uterus sheds off. That is when menstrual period takes place. The average menstrual cycle is about 28 days from the beginning of menstrual flow to the next, but it differs from woman to woman. Adding to this, it is not peculiar for cycles to be as short as 23 days or as long as 35 days. (Speroff ; Fritz) With this, through the years, women are still experiencing different pains during their menstrual cycle. Some examples of pain would include abdominal cramps, backaches, headaches, muscle stiffness and breast tenderness. These symptoms either help them or worsen their condition. These physical and psychological symptoms may affect a number of women (Edited Vol. Aldred 1997). Throughout the duration of menopause, a series of behavioral, physical and emotional alterations may evolve and be a source to make these women undergo excruciating to moderate complaint of pain and agitation. It is basically a a different series of changes that is related to menopause that may occur within a woman’s body. (Pilliteri, 2007) 2

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DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School Menopause As defined by MedicineNet, menopause is when no menstrual period for the succeeding 12 months have occurred. Also, there are no biotic causes that can be diagnosed. However, they can also be capable of producing an offspring if 12 successive months have passed without a period. Needless to say, when ovaries are beginning to decline, their production of sex hormones progesterone and estrogen, menopause essentially occurs. Because of the sudden halt of these cells, menopause is the reason why symptoms such as dryness in vagina, and decline in sexual activities occur. Life is a cycle. It doesn’t matter when you started but at some point it will come to an end. Majority of young ladies have their menarche at around the age of 13 years old. Into the bargain, it is expected to stop when women are approximately 45-60 years old. Most of the time, it is around 51 years old when females start to experience this. When you reach your late 40’s, women typically experience the first symptoms of menopause. According to Merriam Webster Dictionary, menopause is the time in a woman’s life when blood stops from flowing from her genitalia. It is the time when a woman is no longer capable of producing an offspring. Different switches in a woman’s body is the effect of menopause and it is based on many factors. Because of the decline in the production of sex hormones in the woman’s ovary, symptoms are just the manifestations of menopause. According to Rotter, Silver (2007), as time progresses, indication of 3

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School change in weight, dryness in the vagina, or hot flushes may occur. Regardless of race, ethnicity, and religion, all will come to this stage of life. Dealing with this life changing experience can cause a lot of stress, leading to a number of emotional and mental depression. Some may suffer sudden physical changes in their body including night sweats, mood swings, hot flushes, and even narcolepsy. These factors indicate peri-menopausal symptoms, and it differs among women. Experiencing these can cause drastic changes in the lifestyle a n d v i e w s o f w o m e n . O n e o f t h e p o p u l a r c h a n g e s d u r i n g t h e menopausal phase, is the abrupt change in mood or e m o t i o n . S c i e n t i f i c a l l y, this is caused by fluctuations in the hormone levels, as the ovaries starts to lose its capability to fertilize. A number of women may feel u p s e t b e c a u s e o f t h e sudden twist that they are experiencing. Others will change their view on how they perceive life. And one can feel burden with regards to the emotional, physical and mental aspect. Some side effects of being menopausal include depression, irritability, and avid discomfort. Nowadays, the health status of women undergoing this stage has become one of the primary concerns in late adulthood. Women are likely to feel vulnerable at this stage. They may perceive a situation to be minor or major, and may feel irritable, sad, or emotional in an unique manner. Observation studies have found that mood swings or emotional fluctuation is a common side effect. At a certain point, women would feel one thing and suddenly, the circumstances change to the opposite. Dealing with 4

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School these troubling side effects, women have forged techniques to adapt and c o p e with the reality. Each person has their own way in dealing with the stressors in their environment. With all these changes affecting the lifestyle of w o m e n , researchers and medical professionals have become more eager to figure out which possibilities and practices will allow for menopausal women to overcome such changes. According to a research, there are more than half of 100% of women that described menopause as an irksome experience. One of the women quickly learned the menopause symptoms she would have to face and discovered just as fast that she actually had a say in how she felt both physically and emotionally. As menopause comes along, different symptoms related to menopause can manifest including in inconsistency in menstrual periods, sleeplessness, changes in weight, moodiness and etc,. As women approach to their ages (mid to late forties), they may begin to experience symptoms that can appear unusual and frightening. They undergo series of life process called menopausal period. (Cedars ; Evans in Pilliteri 2007). According to Davidson et. al.,(2008), it is also known t h a t t h e o n s e t occurs when estrogen levels drop because of the loss of ovarian function. Furthermore, it is influenced different factors such as human’s overall h e a l t h , weight, nutrition, lifestyle, culture, and genetic factors. Jacob (2004) stated that, the end of the women’s reproductive life is when periods are essentially becoming irregular and then stopping altogether at 5

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School once. It is occurred with physical symptoms such as hot flushes, and emotional changes such as mood swing. As women enters menopause, fluctuating hormones is normal from day to day that results to mood swing, hot flushes and other symptoms, including insomnia, irritability, and mood disorders. Adding to that, Charlene Fernandez (2006) reiterated that, menopause is normal to women and the signs and symptoms that she is experiencing. As with menopause, comes with underlying manifestations such as depression. According to American Journal of Epidemiology, biologic and behavioral factors are at risk from experiencing complications. Long term health risk includes osteoporosis, cardiovascular diseases, and stroke. Hackley, et., al (2006) stated that, with menopause is a time where vulnerability of mood development can manifest including depression. Women from reproductive to post reproductive life is a gradual process, changes in menstrual function change as well. Few women will experience more or lesser periods. As stated before, it was due to the fall of estrogen production. According to Smith et, al., (2000), declining of ovarian function begins 10 years before halting of menses. Changes in hormones include decreases in estrogen and progesterone. It declines about 60%. Women experiencing menopause experiences changes in their emotional, mental and physical aspects that occurs during their menopausal period. It varies from women to women but fact can’t be denied that all of women undergoes to this phase. As they face a lot of changes during this time, 6

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School they come up different coping mechanisms in dealing with their situation. But some cannot handle it very well. Women face hard situations and they cope with it by utilizing lifestyle means like following a healthy diet, exercising, support systems like talking to others etc., and reducing stress. One woman named Lori, a mom and a blogger shares her ways to deal with menopause. She stated support systems. It means the way on how other people support with the changes in her body. She stated that, “Learning to take care of yourself is simple. Doing it is another thing.” Different views and opinions regarding to menopause are stated. Some may view it as a negative aspect in their life, some may accept it to the fact that it is normal in the woman’s life. It is a natural phenomenon that all woman have to go through with life. It is a matter of how woman deal with the challenges that life may give them. In order to cope with it, women’s physical, mental and emotional will eventually adapt and change with time. This study will convey the results that have gathered from the questionnaire answered by women in Sambal Ilaya Lemery, Batangas. The main subject is to know the coping strategies of women experiencing menopause. The aims of this study was to find out if mood swings is a natural occurrence on women on menopause, if there are factors that may lead women to change their mood, if there is a difference on the mood swing experienced on their peri-menopausal and post-menopausal, and the different ways/strategies 7

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School on how women cope on their menopause. The study will be achieved by completing the objectives: 1. To know the factors that would lead to change their mood 2. To know the difference of mood swing during peri/post menopausal period 3. To know the coping mechanisms of women experiencing menopause Statement of the Problem The purpose of this research is to determine whether or not, the changes of mood is a natural occurrence for women experiencing peri/post menopausal, and which coping strategies allow them to cope with the best. At this stage of the research, the factors of menopausal period will be generally defined as the possible causes of mood fluctuation of women during peri/post menopausal, and the coping strategies they utilize to overcome such changes. This research aims to answer the following questions: 1)What are the factors that would lead them to change their mood? 2)How would the women distinguish mood swings during post/peri menopausal? 3)What are the methods/strategies of women in coping up with mood fluctuations during post/peri menopausal? 8

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School Theoretical Framework/Conceptual Framework Self-Efficacy Model (Bandura, 1977). The study was outlined as a theoretical framework “in which the concept of self-efficacy is assigned a central role, for analyzing changes achieved in fearful and avoidant behavior”. It emphasizes that people have the capability of controlling their own thoughts and behaviors which then, can result to certain outcomes. Also, people who have high assurance to theirselves may create and influence a positive experience. It is similar when undergoing menopause. Imposing the brain and body on positive behavioral structure may allow menopausal women to cope more effectively. Self Care Theory (Dorothea Orem). Three self care requisites are identified which are: Universal Self Care, Developmental Self Care, and Health Deviation Self Care. Universal self care is what our everyday lives need. While developmental self care, is the development of our personality in the society. Lastly, health deviation self care involve the conditions of an illness and the experience. Theory states that, “People should be self-reliant and responsible for their own care..”. It can be connected to menopause because women who are experiencing it should cope with it by their own abilities. It is essential for them because applying coping strategies promote the health, welfare and longevity of life for women experiencing menopause. 9

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School Paradigm The framework in figure 1 is the IPO Model or the framework showing the factors influencing the coping strategies of women experiencing menopause. This constructively shows the pattern of the research. Figure 1. IPO Model Significance of the Study The study hope to construct an understanding on menopause women. Lesser studies were done related to this topic. Hence the researchers assume the study could be of importance of the following: Women. They would be able to understand better their situation later in their lives. They would be able to distinguish their bodily changes and further 10

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School understand their emotions as much as possible. Additionally, this will hopefully help women who seek the answers they are looking for in terms of coping with abrupt mood swings in the menopausal stage. Future Researchers. This study would be helpful to future researches that will allow for more significant information with regards to menopause. Given this new knowledge, the researchers would like to impart this study, and provide essential data with regards to factors affecting the body during menopause and its most common and effective coping strategies. Youth. For the youth all around the world, whose mothers are on the verge, if not undergoing, menopause. They would be educated on the different strategies that they can provide for their mothers. This research would also allow for the youth to understand that it is a natural occurrence for their moms to be in such a stage. They would be knowledgeable that their moms would often undergo physical and emotional distress, which causes abrupt changes in their mood. Additionally, it will allow for the youth to adapt with a new environment, and assist their mothers at that stage of life. Respondents. To be able to understand what they are experiencing. This is to impart that undergoing menopause is normal and that there are several ways and strategies that will help them coping with major changes in the body. Also, this is to allow for them to understand theirselves better and to accept themselves, as human beings undergoing natural occurrences. 11

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School Filipinos. To open the eyes of fellow Filipino people who have lesser or no knowledge with regards to menopause and its resulting side effects. This is to cater to the menopausal population on dealing with sudden outbursts of emotion. Also, this is to help women around the country that have no access to strategies that allow them to control their emotions and later on, provide ample ways and solutions to cope with the sudden changes in their emotions during menopause. Mothers. For mothers who are yet to undergo menopause or would soon have menopause, this research will serve as an informational guide to help them understand the corresponding bodily changes and find ways to deal with the emotional stress in a proper way instead of resorting to violent reactions caused by sudden bursts of emotion. Scope and Limitation of the Study The study will focus on the factors that affect women’s mood during peri/ post menopausal phase. The participants of the research will be limited to women who are experiencing peri/post menopausal at their time. The respondents that will be interviewed should have knowledge with regards to the symptoms of menopause, and have experienced peri/post menopausal side effects. A set of related questions was outlined in each questionnaire and was answered by the interviewee. Some of which are demographics including age, civil status, and subsequently, questions with 12

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School regard to menopausal symptoms, side effects affecting the mood facet, and its corresponding coping strategies. The research was conducted at Sambal Ilaya, Lemery, Batangas. Definition of Terms Depression. Is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. Efficacy. The power to produce an effect. Fluctuation. An irregular rising and falling in number or amount. Hot flush. A sudden feeling of feverish heat, typically as a symptom of menopause. Insomnia. Habitual sleeplessness; inability to sleep. Irritability. The quality or state of being irritable. Menarche. It is when the first menstruation occurred. Menopausal period. Also known as the climacteric, is the time in most women’s lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause. It is the time in a woman’s life when blood stops from flowing from her body. Mood swing. An abrupt and apparently unaccountable change of mood. 13

DE LA SALLE HEALTH SCIENCES INSTITUTE Special Health Sciences High School Narcolepsy. A long-term neurological disorder that involves a decreased ability to regulate sleep-wake cycles. Night sweats. Also known as nocturnal hyperhydrosis, is the occurrence of excessive sweating during sleep. Osteoporosis. A medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D. Ovulation. Discharge of ova or ovules from the ovary. Perimenopausal. It is the period of a woman’s life shortly before the occurrence of the menopause. Postmenopausal. The years after the menstruation. Premenstrual illness. Is a condition in which a woman has severe depression symptoms, irritability, and tension before menstruation. Stressor. It is a chemical or biological agent, environmental condition, external stimulus or an event that causes stress to an organism. Estrogen and Progesterone. Group of steroid hormones that promote the development and maintenance of female characteristics of the body. It is also a steroid hormone released by the hormone-secreting structure that stimulates the uterus to prepare for pregnancy. 14