"Since I'm a little bit more mature": contraception and the arc of time for women in midlife.

BACKGROUND: Contraceptive methods have rapidly evolved over the past several decades, but little research has explored how women interact with contraception over time. Exploring contraceptive beliefs, perceptions, and attitudes of women in midlife can reveal much about how lived experience affects contraceptive decisions and reproductive health choices. METHODS: Individual, semi-structured interviews were conducted with 20 women between the ages of 40 and 55 who had not reached menopause and did not have a permanent method of sterilization. Data were coded using qualitative descriptive methods. RESULTS: Three major themes were identified: 1) journey toward empowerment; 2) finding the right fit: evolution over time; and 3) anticipating a transition. Past experiences with or fear of side effects and hormones were common reasons to change or avoid certain contraceptive methods. Most participants were happy with their contraceptive method; however, those who were unhappy were more likely to vocalize fatigue at continuing to need contraception as menopause approached. CONCLUSION: Approaching contraceptive counseling from a place that considers the journey with contraception over a reproductive life span will help identify how beliefs, perceptions, and attitudes of women affect their contraceptive practices and choices.

The Role of Helplessness in the Appraisal of Illness Uncertainty in Women With Fibromyalgia.

Fibromyalgia is a chronic pain disorder characterized by uncertainty in etiology, symptomatology, diagnosis, treatment, and outcome. The high level of illness uncertainty that results from fibromyalgia is a risk factor for maladjustment to illness. A cross-sectional survey design was used to examine the relationships among illness uncertainty, helplessness, and subjective well-being in 138 women with fibromyalgia. Multiple regression analyses were conducted to examine a predictive model for mediation. We found illness uncertainty is negatively associated with subjective well-being and that helplessness strongly influences the impact of illness uncertainty on subjective well-being in women with fibromyalgia.