Perception and Experience of Women Facing Menopause in the Town of Mbujimayi in the Democratic Republic of Congo ()
1. Introduction
Menopause, a normal and physiological event in the life of every woman, means the end of menstruation. Hippocrates did not yet speak of hormones but already in the mood wrote “the woman with the flesh looser than the man.” In the XIXth century, the doctors of the time had an obscure vision of menopause and described it as dangerous period which turns the whole life of the woman upside down. In addition to the illnesses caused by the cessation of menstruation, there is the narcissistic injury caused by the loss of femininity [1] .
Menopause is experienced differently by women. For some, it is a liberation; for others, the rules play the role of purifier, their cessation puts the health of the woman in danger, they are their biological clock, they give a reassuring pace to the life of the woman. Menstruation is above all proof that a woman is biologically alive because she carries with her the hope of a motherhood that is always possible. “No woman, recalls Hélène Deutsch, [2] really renounces motherhood as long as a monthly or even irregular blood loss reminds her of this possibility”.
Menopause has become a real public health problem for several reasons: demographic, because the average age of menopause in France is 50 years. It was not until the beginning of the 20th century that life expectancy exceeded the age of menopause. In 2015, according to the report “State of health of the population in France” published by the DREES, the life expectancy of a woman at birth is 85.4 years. In France, in 2015, there were 13 million women over 50, or 39% of the female population. The life expectancy of a woman at age 50 is approximately 36 years [3] .
Doctors around the world indicate that in the DRC with its 400,000 young women who reach menopause each year, many of them do not consult a gynecologist, while menopause is a normal period of life, women can therefore lead to different complications, including diseases such as cervical cancer and breast cancer [4] .
In Mbujimayi, Mboloko [5] in his study had demonstrated that there is troubled and silent menopause that in the event of a complication, women must have recourse to gynecologists, taking drugs to “harmonize” sexual intercourse or other difficulties that may arise after menopause.
For our part, the observation made was of several cases of menopause that women undergo and tend to become abnormal. This prompted us to address this topic entitled: Perception and experience of women facing menopause in the town of Mbujimayi
So we asked ourselves the question: what are the perception and experience of women in the health zone of Diulu when faced with menopause?
2. Methodology
This research tackles the qualitative phenomenological approach by seeking to try to unveil the perceptions and experiences of women facing menopause. The information was collected in a systematic and prospective manner from the respondents in order to allow us to describe the perceptions and the experience of women facing menopause in our community.
The study was carried out in a natural environment, in the city of Mbuji-Mayi more precisely in the DIULU health zone. We used as a data collection instrument a “self report” which included a main question and secondary questions. which were posed according to the conceptual model. Our research concerned married women for two reasons: they experience this phenomenon, they can explain their experiences. The sample size is 21 women. For the data collection instrument, we used the maintenance guide and the phone logger.
3. Result
Table 1 shows that the age group of 55 and over is more represented with 61.9%.
With regard to Table 2, we see that the sample is dominated by married respondents with 66.7%.
Table 3 shows that the level of secondary education is dominant with 42.8%.
Table 4 shows that 47.6% of the respondents were saleswomen.
Development of Themes or Variables of the Study
In relation to the subject of the study, the thematic analysis of the data helps us to identify the following main theme:
1) perception of menopause
・ Meaning of the theme
・ Knowledge of menopause
・ Manifestation of menopause
2) lived through menopause
・ Origin
・ Causes
・ Consequence
Meaning of the theme
We note in this box (Table 5) that the respondents define menopause according to the understanding and perception of each, some define it as the return of age, a stage of life for a woman. Rest Time For A Woman, Punishment From God And Others Define It As A Demonic Problem.
Causes of menopause
In relation to this category (Table 6), the respondents gave the different causes of menopause, in particular sterility, certain gynecological pathologies, hormonal dysfunction, witchcraft.
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Table 1. Distribution of respondents by age.
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Table 2. Distribution of respondents according to civil status.
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Table 3. Distribution of respondents by level of education.
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Table 4. Distribution of respondents by activity.
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Table 5. First theme: perception of menopause.
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Table 6. Second theme: lived d e menopause.
Origin
For this category, our respondents gave their various points of view, for menopause it is a divine punishment, others think it is a disease.
Events
This category shows that the most cited manifestations are: nervousness, hot flashes, menstruation without a schedule, disruption of menstrual dates, lower abdomen pain, drop in blood pressure, dizziness, lack of sexual appetite, back pain, extension of rules.
4. Discussion
4.1. Results in Relation to the Profile of the Respondents
4.1.1. Age
In Table 1, we notice that the age group from 55 years and over holds the top of the block with 61.9% followed then the group of 45 to 54 years with 28.6%. These results agree with the conclusions of UNFPA [6] which stipulate that the age group between 50 years and over is more represented.
4.1.2. Civil Status
On the basis of the results presented in Table 2, With regard to this table, we note that the sample is dominated by the surveyed married with 66.7%. What at one time realized as a concept of globalization. These results are close to those found by Pizzini, L. [7] .
4.1.3. Level of Study
We find that the level of secondary education dominates with 42.8%. We believe that the observed fact can be justified by the fact that traditionally the reproductive function is appropriate to the period of marriage. These results are similar to those of Pizzini, L. [7] who according to him the level of secondary education dominated the pavement.
4.1.4. Activities
Saleswoman activity comes first with 47.6%, housewives 33.4% and unemployed with 14.7%. This heterogeneity shows the various realities in which the population lives. These results are contrary to those of Saka Mj et al. [8] who according to her housewives were represented.
4.2. Results Related to the Themes
4.2.1. P Erception and Experienced Menopause in Women
4 categories of perception emerge from this theme, they are:
・ The meaning of menopause
In view of our results, the respondents consider the menopause as a return of age, the time of rest, while for others it is the sexual intercourse becomes painful and suffocating. For his part, Freud [9] shows that the perception of menopause differs from one environment to another for some it is a taboo, demonic diseases.
・ Cause of menopause
The results of this study indicate that there are different causes of menopause. In connection with this category, the respondents gave the different causes of menopause, in particular sterility, certain gynecological pathologies, hormonal dysfunction, witchcraft, Mbarga, P. [10] Menopause has several causes, mainly of hormonal, demonic and pathological origin.
4.2.2. Vécu of the Menopause
・ Origin of Menopause
According to this study, respondents think in a diverse way. Some believe it is divine punishment, others think it is a disease, for Pizzini, L. [7] menopause exists everywhere and it is more surprising that women themselves perceive menopause positively than menopause. they suffer, on the other hand, Amare, D. [11] consider that during menopause the sexual intercourse becomes painful and suffocating.
・ The manifestations of menopause
The results of the study show that menopause causes many manifestations including nervousness, hot flashes, menstrual periods, disruption of menstrual dates, lower abdomen pain, drop in blood pressure, dizziness, lack of sexual appetite, back pain, prolonged periods. According to Pizzini, L. [7] women victims of menopause are confronted with social problems.
5. Conclusion
Menopause is a real upheaval in a woman’s life. Formerly a taboo subject, the consultant was hardly interested in the disorders of the fifties and had difficulty in apprehending the complications that the cessation of ovarian functions could cause. However, progress in hormonology, women’s complaints amplified by the media, have meant that menopause and the phenomena which are related to it have gradually gone out of the field of action reserved for a few specialists to enter fully into the domain of the doctor generalist. He has become the first point of contact: listening to his patients, he can offer therapy that is both curative and preventive. This role is immense and allows the woman to cross often critical milestone under better conditions.