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Risk perception in women: a focus on menopause

Deeks, Amanda PhD; Zoungas, Sophia PhD, MBBS; Teede, Helena PhD, MBBS

doi: 10.1097/gme.0b013e31812f7b65

Objective: To investigate risk perceptions in relation to menopausal experiences, comparing premenopausal women's expectations to actual experiences of menopause, including perceptions of symptoms, fears, risks of future illnesses, and side effects of symptomatic treatments.

Design: This was a cohort study using surveys in a random sample of Australians participating in an Australian Health Report series, supported by Pfizer. This article focuses on perceptions about menopause of 710 women.

Results: Peri- and postmenopausal women experienced more fatigue, sleeplessness, fluid retention, and bloating than premenopausal women expected to experience. Perimenopausal and postmenopausal women rated menopause as the "first day of the rest of [my] life" significantly more than premenopausal women. All women perceived that menopause had an impact on aging and weight gain, but more premenopausal women feared loss of sexuality (55%), loss of femininity (39%), and the inability to have more children (37%). Perceptions of illnesses differed from actual incidence, with 27% of all women perceiving breast cancer and 11% perceiving heart disease as a health risk, compared with actual female mortality figures of 3% and 41%, respectively. Perceptions of the effects of hormone therapy were inaccurate, with 53% of all women expecting a reduction in hot flushes, 44% expecting that hormone therapy increased breast cancer, and 23% expecting that hormone therapy decreased fractures.

Conclusions: This study suggests a difference between perceptions of symptoms, fears, risks of future illnesses, and side effects of symptomatic treatments at menopause and actual experience. Because risk perception influences health-related behaviors, visits to healthcare providers, and treatment decisions and can be modified through education, an understanding of risk perception is clinically important. Further research is needed.

This observational study investigates women's expectations versus actual experience of menopause. Perception of symptoms, fears, risk of future illnesses and side effects of symptomatic treatments are reported.

From the The Jean Hailes Foundation for Women's Health Research Unit, Monash University Institute for Health Services Research, Melbourne, Victoria, Australia.

Received March 8, 2007; revised and accepted May 30, 2007.

Funding/support: As part of a series of surveys on health in Australia, "The Pfizer Australia Health Report," Pfizer Australia funded the costs generated from the independent marketing company as part of their corporate social responsibility agenda. Pfizer Australia does not manufacture treatments related to menopause, had no influence over the topic or questions asked, and had no direct interest in the findings. The topic of research, development of questions, and interpretation of data remain the intellectual property of The Jean Hailes Foundation for Women's Health.

Financial disclosure: None of the authors has any financial interests or dealings with Pfizer Australia.

Address correspondence to: Helena Teede, PhD, MBBS, Jean Hailes Director Research, Monash Institute for Health Services Research, Locked Bag 29, Monash Medical Centre, Clayton Road, Clayton, Victoria, Australia 3168. E-mail:

©2008The North American Menopause Society