Experiences of menopause, self-management strategies for menopausal symptoms and perceptions of health care among immigrant women: a systematic review.

OBJECTIVE: To systematically review the published literature relating to experiences of menopause, self-management strategies for menopausal symptoms and health-care needs among immigrant women. METHODS: A systematic literature search of English-language publications was performed using Medline, Embase, PsychInfo, Cinahl and Scopus. Twenty-four papers reporting on 19 studies met our inclusion criteria and investigated immigrant women's experiences of menopause and/or their self-management strategies for menopausal symptoms and/or their perceptions of menopause-specific health care. FINDINGS: Of the 19 studies, 15 reported symptoms experienced during the menopausal transition. Three studies included questions regarding self-management strategies for menopausal symptoms and four enquired about perceptions of menopause-specific health care. Although the heterogeneity of the studies makes comparison difficult, their findings are broadly consistent. Immigrant women reported more vasomotor symptoms and other physical symptoms and poorer mental health than non-immigrant women. The few studies that investigated self-management strategies for menopausal symptoms found that these were influenced by culture and those that assessed perceptions of menopause-specific health care found that they were mostly dissatisfied with the care they had received. CONCLUSION: More research is needed to improve understanding of how immigrant women manage the menopausal transition and how to provide culturally relevant menopause-specific health care.

The environment, hormones, and aggressive behaviour: a 5-year-study in guinea pigs.

This paper summarizes persistent consequences of varying rearing and testing conditions on intermale aggression, endocrine responses, and body weight (BW) in guinea pigs. Pairs of unfamiliar males were placed in chronic confrontations for 3-50 days in 2 m2 enclosures. Their behaviour was recorded in more than 1000 h of observation time. About 900 samples were assayed for plasma glucocorticoid (GC), testosterone (T), and norepinephrine (NE) before and at different times after the beginning of the confrontations. The males were reared either in large mixed-sex colonies (CRM) or with a single female (FRM). When FRM males were confronted, high levels of aggressive behaviour occurred and high degrees of stress were found in losers, especially when the environment was familiar and a female was present. In contrast, CRM males confronted in the same situation, but in a nonaggressive way, showed no changes in GC, NE, and BW. These differences between FRM and CRM developed around puberty. A 50-min agonistic experience with an unfamiliar male around this time shifted the subsequent adult behaviour of a FRM to a CRM pattern. These findings suggest a causal relationship between social experiences occurring around puberty, subsequent behaviour as adults, and degree of stress in chronic social encounters.