Secondary Logo

Institutional members access full text with Ovid®

Perspectives and decision-making about menopausal therapies in women who had bilateral oophorectomy

Siyam, Tasneem, BScPharm, MSc1; Ross, Sue, PhD, MBA2; Shandro, Tami, MD, CCFP, FCFP, NCMP3; Hagen, Shelly, RD, NCMP4; Battochio, Lori, RN, NCMP5; Yuksel, Nesé, BScPharm, PharmD, FCSHP, NCMP6

doi: 10.1097/GME.0000000000001069
Original Articles
Buy
SDC

Objective: The aim of the study was to explore the process of decision-making about menopausal treatments in women who have had surgical menopause as a result of bilateral oophorectomy (≤50 y).

Methods: We used a descriptive qualitative research design. Women who had a surgical menopause were purposefully selected from the Edmonton Menopause Clinics. Focus groups were held, each with six to nine participants. All sessions were audio-recorded and transcribed verbatim. Data were analyzed using qualitative content analysis.

Results: We conducted five focus groups from June 30 to July 21, 2016 (N = 37). One-third of the women had the surgery within the last 5 years. Almost all women had a concurrent hysterectomy (97%) and were current users of hormone therapy (70%). Four main themes identified were “perceptions of surgical menopause,” “perceptions of received support,” “being my own advocate,” and “concept of adequate support.” Women shared that the experience was worse than their expectations and did not believe they were given adequate support to prepare them to make therapy decisions. Women had to “be their own advocates” and seek support from within the healthcare system and outside to cope with their health issues. To make an informed decision about treatments postsurgery, women expressed a need to learn more about the symptoms of surgical menopause, treatment options, resources, avenues for support, and stories of similar experiences, preferably before the surgery.

Conclusions: We identified several modifiable deterrents to decision-making in early surgical menopause which can help inform the development of a patient decision aid for this context.

1Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada

2Department of Obstetrics & Gynecology, Royal Alexandra Hospital, Edmonton, Alberta, Canada

3Lois Hole Hospital for Women Menopause Clinic & Grey Nuns Community Hospital Menopause Clinic, Edmonton, Alberta, Canada

4Grey Nuns Community Hospital Menopause Clinic, Edmonton, Alberta, Canada

5Lois Hole Hospital for Women Menopause Clinic, Edmonton, Alberta, Canada

6Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada.

Address correspondence to: Nesé Yuksel, BScPharm, PharmD, FCSHP, NCMP, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 3-171 Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta, Canada T6G 1C9. E-mail: nese.yuksel@ualberta.ca

Received 8 November, 2017

Revised 26 December, 2017

Accepted 26 December, 2017

Funding/support: This research has been funded by generous supporters of the Lois Hole Hospital for Women through the Women and Children's Health Research Institute (WCHRI).

Financial disclosure/conflicts of interest: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (forms available upon request) and declare no support from any organization for the submitted work, and no financial relationships with any organizations that might have an interest in the submitted work in the previous three years. NY has provided continuing education and/or participated in Advisory Boards/Consult Meetings for Pfizer Canada and Aspen Pharmaceuticals. TS has provided continuing education and/or participated in Advisory Boards/Consult Meetings for Pfizer Canada.

Ethical approval: The study was approved by the University of Alberta Human Research Ethics Board (ID#: Pro00054435).

© 2018 by The North American Menopause Society.