NURSING PROCESS FOR

WOMEN GOING
THROUGH MENOPAUSE
Catherine May L. Cruz, RN
 The nurse can play an
important role in helping
women cope with the
symptoms of menopause.
Teaching and counseling about
menopause, its symptoms, and
medical and alternative
therapies are foremost in the
arsenal of interventions
available to nurses in this area.
 NURSING DIAGNOSES
RELATED TO THE
SYMPTOMS OF MENOPAUSE
Anticipatory Grieving
related to loss of
childbearing ability
Self Esteem Disturbance
related to physical and
emotional changes
associated with
menopause
Knowledge Deficit related
to normal changes and
symptoms.
Altered Sexuality Patterns
related to hormonal
changes and decreased
vaginal lubrication
NURSING INTERVENTIONS
 HOT FLUSHES AND NIGHT SWEATS

• Adequate hydration
• Adjust the room
temperature.
• Appropriate clothing
• Avoid hot beverages like
coffee and hot tea
• Avoid alcohol
• Avoid direct sun exposure
• Minimize stress.
 HOT FLUSHES AND NIGHT SWEATS

• Try paced respiration at

the beginning of a hot
flash.
• Take slow, deep,
abdominal breaths in
through the nose and
release out through the
mouth.
 HOT FLUSHES AND NIGHT SWEATS

• Prescribed Hormone Therapy

– Systemic Estrogen Therapy
• Non hormone ( prescribed
medications)
1. Gabapentin (Neurontin)
2. Paroxetine (Paxil),Fluoxetine
3. Methyldopa (Aldomet) and
Clonidine(Catapres) Dixarit
• Herbal Remedies/ supplements
– Isoflavones
– Remifemin
Non hormone ( prescribed medications)

1. Gabapentin (Neurontin) - a
drug used to treat epilepsy
and migraine,
2. Paroxetine (Paxil),Fluoxetine
(Prozac), and Venlafaxine
(Effexor) : drugs approved to
treat depression
3. Methyldopa (Aldomet) and
Clonidine
(Catapres) Dixarit : drugs used
to treat high blood pressure,
 Herbal Remedies/ supplements
Isoflavones
• (weak, plant-derived estrogens),
• most commonly found in soy foods
have been found to reduce mild hot
flashes by about 15-30% in some
studies.
• However, many other studies show
no effect at all.
• Note: Eating 1 or 2servings of soy
foods daily (25 grams of soy
protein) may provide greater
benefits than supplements.
• Examples : Low-fat varieties of
tofu, soybeans, or roasted soy nuts
 Herbal remedies/ supplements
Remifemin
• supplement pill containing the herb
“black Cohosh.”
• Women taking a 20-mg tablet twice a
day for 8 to 12 weeks reported
improvement in mild hot flashes, but
not all studies show this positive
effect.
• Side effects include gastrointestinal
upset, typically with first time use.
• In rare cases, the use of black cohosh
appears to cause liver damage.
• Note: Black Cohosh should not be
taken if one is taking HRT.
 VAGINAL DRYNESS
1. Water soluble vaginal lubicants
(such as K-Y Personal
Lubricant,Astroglide, Lubrin, or
Moist Again) decrease friction and
ease discomfort during intercourse.
2. Vaginal moisturizers (such as
Replens or K-Y Long-Lasting Vaginal
Moisturizer) act directly on tissue to
relieve dryness.
Moisturizers may be preferred by
women who have symptoms of
irritation and burning that are not
limited to sexual activity.
Because moisturizers help maintain
an acidic environment, there is a
decreased risk for infection.
 MOODINESS/STRESS RELATED
SYMPTOMS
1.Emotional health during perimenopause requires
a balance between self-nurturing and the
obligations of work and caring for others.
2. Regular Exercise
3. Relaxation techniques: deep breathing, massage
4. Calcium carbonate supplements
(TUMS) which reduced symptoms of food craving,
bloating, water retention and pain
5.Diet that is low in fat, sodium, refined sugar,
alcohol, and caffeine.
Snack on healthful, crunchy foods, such as apples
and raw carrots.
6. Join support groups.
7. Seek professional health when the usual
methods do not work anymore.
 MOODINESS/STRESS RELATED
SYMPTOMS
8. Alternative remedy
• St. John’s wort helps improve the
mood and decrease the level of
depression.
Caution : Do not use the herb with
drugs that alter blood clotting such as
aspirin or Coumadin)..
Many practitioners avoid using this
herb formore than 2 years.
• Another nutrient, omega-3 fatty acid,
has alsobeen found to improve mood.
• Food sources include fatty fish (such as
salmon and trout)
 INSOMNIA
• Reduction of stress
• Sleep routine and sleep hygiene
• Create an environment conducive to
sleep
• Taking calcium supplements at night
instead of daytime to help relax
muscles . Should be taken with
magnesium ( ratio of 2:1 (Calcium:
Magnesium,)
• Acupressure
• Acupuncture
• Massage therapy.
 BLADDER PROBLEMS
• AVOID BLADDER IRRITANTS. Certain foods
and beverages can contribute to
overactive bladder by irritating the
bladder; these include chocolate, tea,
coffee, soft drinks, citrus fruits, fruit
juices, honey, sugar, tomato-based
products, spicy foods, and alcohol.
• NO SMOKING. Apart from the damage
that smoking causes, nicotine can irritate
the bladder. So smokers are urged to quit.
• FLUID RESTRICTION. Limit fluid intake to
about 64 ounces per day, but don’t over-
restrict below that level, as concentrated
urine may irritate the bladder and also
contribute to constipation.
 Bladder Problems
• WEIGHT LOSS. For obese women, weight
loss can reduce incontinence by up to 60%.
• GOOD HYGIENE. Keep genitals clean.
Avoid exposure to urine for long periods.
• PADS. With severe incontinence, use
absorbent pads instead of menstrual pads,
as they provide better absorbency and
better skin protection.
• KEGEL EXERCISES. Urogenital muscle
exercises that are sometimes helpful for
stress incontinence.
• VAGINAL CONES. Small cone-shaped
device held in the vagina have been shown
to help a woman determine which muscles
to contract and relax for Kegel exercises
 Bladder Problems
• ELECTRICAL STIMULATION. Painless
therapy that retrains the pelvic floor
muscles used in urination.
• BIOFEEDBACK. A technique that teaches a
woman to mentally isolate and control a
bodily function (in this case, to contract the
pelvic floor muscles).
• TIMED VOIDING. A technique for
overactive bladder in which a woman
schedules times to go to the bathroom and
gradually increases the length of time
between trips, thereby training the bladder
to hold more and empty less often.
• MEDICATIONS. A variety are available for
different causes and types of incontinence.
• SURGERY
 OSTEOPORISIS
• ERT
• Allendronate (Fosamax) – Prevents
bone resorption.
– Instructions :
– take in the morning with plenty
of water, 30 minutes before
eating
– Instruct patient to stay upright
for 30 minutes after talking to
avoid reflux and other GI
symptoms
• Calcitonin - causes calcium to go to
the bones
• Calcium – 1500 mg daily
• Vitamin D - 400 to 800 units daily
 HEART DISEASE

• Emotional counselling,
• Lifestyle changes
• Avoid smoking and alcohol
• Stress Reduction
• Nutritional Management
• Annual physical
examination and Blood
cholesterol determination