Relationships Between Menstrual and Menopausal Attitudes and Associated Demographic and Health Characteristics: The Hilo Women's Health Study

Abstract

The objective of this study was to examine the relation of menstrual attitudes to menopausal attitudes and the demographic and health characteristics associated with each. This cross-sectional study consisted of a randomly selected sample of 1824 respondents aged 16 to 100 years in multi-ethnic Hilo, Hawai`i. Women completed questionnaires for demographic and health information, such as age, ethnicity, education, residency in Hawai`i, menopausal status, exercise, and attitudes toward menstruation and menopause. Women more often chose positive terms, such as "natural," to describe menstruation (60.8%) and menopause (59.4%). In bivariate analyses, post-menopausal women were significantly more likely to have positive menstrual and menopausal attitudes than pre-menopausal women. Factor analyses were used to cluster attitudes followed by linear regression to identify demographic characteristics associated with factor scores. Asian-American ethnicity, higher education, reporting more exercise, and growing up outside of Hawai`i were associated with positive menstrual attitudes. Higher education, older age, post-menopausal status, growing up outside of Hawai`i and having hot flashes were associated with positive menopausal attitudes. Bivariate correlation analyses suggested significant associations between factor scores for menstrual and menopausal attitudes. Both negative and positive menstrual attitudes were positively correlated with the anticipation of menopause, although negative attitudes toward menstruation were negatively correlated with menopause as a positive, natural life event. Demographic variables, specifically education and where one grows up, influenced women's attitudes toward menstruation and menopause and should be considered for inclusion in subsequent multi-ethnic studies. Further research is also warranted in assessing the relationship between menstrual and menopausal attitudes.

Voices From the Hilo Women's Health Study: Talking Story About Menopause

“…Not surprisingly, pre-menopausal women in this study were indeed anxious about menopause whereas peri- and post-menopausal women had a much more embracing and affirmative attitude. These qualitative findings support previous quantitative results based on structured questions about attitudes toward menopause that were administered through the postal survey sent to this same population (Morrison, Sievert, Brown, Rahberg, & Reza, 2010). Other studies have also found that it is younger pre-menopausal women, and in the case of a British study, younger men as well (Smith, Mann, Mirza, & Hunter, 2011), that had more negative attitudes toward menopause than women who had experienced it (Ayers, Forshaw, & Hunter, 2010, Smith, Mann, Mirza, & Hunter, 2011).…”

Attitudes toward menopause among middle-aged women in Semnan, Iran

“…Some studies have showed that well-educated women have a more positive attitude [24,25]. Some studies have showed that well-educated women have a more positive attitude [24,25].…”

Is Premenstrual Dysphoric Disorder Really a Disorder?

“…Such premenstrual experiences are also accepted in these cultures as normal, not a sign of disease (Epstein 1995). Another study, this time of 1,824 women of different ethnicities in Hilo, Hawai'i, also found that attitudes towards menstruation are influenced by ethnicity (Morrison et al 2010). In stark contrast to negative attitudes towards menstruation in Western cultures (Delaney, Lupton, and Toth 1988;Luke 1997;Lew et al 2005;Linton 2007), 60 percent of women in their study described menstruation in positive terms such as "natural" (Morrison et al 2010).…”

“…Another study, this time of 1,824 women of different ethnicities in Hilo, Hawai'i, also found that attitudes towards menstruation are influenced by ethnicity (Morrison et al 2010). In stark contrast to negative attitudes towards menstruation in Western cultures (Delaney, Lupton, and Toth 1988;Luke 1997;Lew et al 2005;Linton 2007), 60 percent of women in their study described menstruation in positive terms such as "natural" (Morrison et al 2010). Not only this, but the more time that women of ethnic minorities spend living in the United States, the more likely they are to report PMDD (Pilver et al 2011).…”