Hormone Replacement Therapy the Effects

Hormone Replacement Therapy

The Effects of HRT on Post Menopausal Quality of Life

In this study the effects of the use of HRT on the mental health and well being of postmenopausal women will be assessed. The women will complete an e-mail questionnaire to determine if HRT is enhancing their lives. 1/2 the study participants will use HRT therapy while the control group will not use hormone replacement therapy. The researcher will utilize a longitudinal research design to evaluate the psychosocial effects of HRT on women's mental well being and reported quality of life. The results of this study will provide researchers with direction regarding psychological and psychosocial care for women in the postmenopausal stage of life. The researcher predicts that HRT therapy will have positive benefits on the reported quality of life and mental well being of patients receiving treatment.

Introduction

Menopause can have wide reaching effects on women as they enter middle age. The side effects commonly associated with menopause often have negative psychosocial effects on women (Hlatky, et al. 2002). While the physical side effects and psychosocial side effects of menopause itself have been well studied, relatively little literature exists regarding the mental health and well being of women in the post menopausal phase of life.

It is important when examining the effects of menopause and HRT to examine the "benefits, risks and consequences of hormone replacement therapy" as well as to adequately define and understand the stages of menopause including the post menopause stage to provide health counselors with adequate incentive and information to treat patients accordingly (Baldo, Schneider & Slyter, 2003:311).

Postmenopausal women may experience a host of psychological and psychosocial disturbances resulting primarily from hormonal changes that occur during menopause (Gambacciani, et al. 2005). Multiple studies have explored the physical effects of HRT therapy for post-menopausal women, but few have examined the psychological and mental health benefits HRT may pose for women (Hlatky, et al. 2002).

Purpose of Study

The aim or purpose of this study is a psychosocial evaluation of the mental health effects of HRT on postmenopausal women. The intent of the researcher is to find information that doctors can use to improve postmenopausal care from a psychological as well as physical perspective, to help facilitate a holistic approach to health care.

Background to the Problem

While menopause concerns itself primarily with the "cessation of menstruation" the female body in the menopause and post menopause stage go through various responses including mental responses that may be damaging and impact a woman's quality of life (Blado, Schneider & Slyter, 2003). Women are often considered in the post menopausal stage once menopausal transition is complete; this generally occurs after the age of 55 though may vary from woman to woman (Baldo, Schneider & Slyter, 2003). HRT helps replace hormones lost during menopause during all phases of menopause including the postmenopausal phase; research suggests HRT may help relieve short duration symptoms and may help some long-term symptoms (Baldo, Schneider & Slyter, 2003). There are however risks and benefits associated with HRT therapy (Baldo, Schneider & Slyter, 2003).

There are some studies suggesting that HRT can improve varying side effects of menopause, hence improving the quality of life postmenopausal women report. Gambacciani, et al. (2005) for example conducted a correlational analysis of women on HRT to determine the effects of hormone replacement therapy on disturbed sleep. Their study suggests that women on low dose HRT may benefit by realizing a relief in sleep disturbances while on HRT. Added sleep can improve women's quality of life in multiple ways.

Other studies have confirmed a rising interest in women among the ages of 56-59 years in HRT therapy to improve quality of life and the side effects associated with menopause (Seamark & Blake, 2002). The studies that are available with respect to the psychological well being of women on HRT produce mixed results; a study conducted by Skarsgard, Berg, Ekblad et. al (2000) suggests that estrogen therapy alone will not improve the well being reported by postmenopausal women. This however does not suggest that HRT will not improve the well-being of women, as HRT typically employs use of combined hormonal therapy. It does however emphasize the need for further analysis in the area of psychosocial well being and HRT.

Objectives of Study

To accomplish the goals of this study the researcher will engage in a longitudinal analysis of the effects of HRT on postmenopausal women. The women surveyed will use a self report questionnaire to determine whether HRT has positive, neutral or negative effects on post menopausal women's mental health and well being. The researcher will operate under the following hypothesis: Women undergoing HRT treatment will exhibit positive mental health benefits and an elevated sense of well being. Null hypothesis: Women undergoing HRT will not exhibit positive mental health benefits or an elevated sense of well being.

In addition to field research the author will combine the data gathered from this study with evidence supported from a comprehensive literature review studying the effects of HRT on the reported quality of life on patients during their menopausal and post menopausal years.

Significance of Study

This study aims to fill the gap in research that currently exists with respect to HRT and its effects on the reported quality of life on postmenopausal women. At this time relatively little empirical research has been generated in this area. One randomized, placebo-controlled double-blind clinical trial suggests that women undergoing HRT have improved mental health as well as fewer symptoms of depression (Hlatky, et al. 2002). This may be the result of HRT itself or the positive impact HRT has on the side effects of menopause including hot flashes and insomnia. It is vital that moving forward researchers differentiate between the two to determine the difference between the two and analyze whether the effects of hormone therapy depend on pre-existing symptoms or whether emotional improvements are the result of HRT in itself (Hlatky, et al. 2002).

Method

Research Design

There are multiple factors the researcher must consider when designing the methodology for this study. The researcher will focus on the historical effects of HRT therapy on women, the potential benefits of HRT from a psychosocial perspective, the potential negative effects of HRT on women's mental health and well being and the nature of studies previously conducted on the effects of HRT in women.

By examining each of these in detail the author will evaluate the foundation for this study. A comprehensive review of the literature will enable the researcher to examine each of these elements in detail and provide a foundation from which the researcher can conduct further analysis and provide adequate data analysis. In addition to this the researcher will engage in field research to provide empirical results related to the effects of HRT from a psychosocial perspective.

To accomplish the field research, the researcher will adopt a longitudinal research design with a psychosocial perspective. Longitudinal research will evaluate the effects of HRT over a designated period of time. Longitudinal research design is often considered superior for assessing multiple participants over varying points in time to investigate defined variables (Powers & Knapp, 1995). Participants will be observed for developmental changes at specific levels (King, 2001).

The primary purposes of such research design include to describe any "patterns of change" that occur and to assess "intra-individual change" in the populations being examined; longitudinal research design can help determine the causal relationships that exist between variables, in this case HRT therapy and women's quality of life (King, 2001:1).

Women participating in the study will receive an e-mail questionnaire assessing the level of satisfaction with HRT and the extent to which HRT has enhanced their lives. 50% of study participants will receive HRT therapy as the independent variable. The control group will represent 1/2 women not on hormone replacement therapy. The researcher hypothesizes that the HRT group will demonstrate an elevated sense of well being. The predicted results focus on the psychosocial perspective. 200 post menopausal women aged 50 -70 years will be recruited and surveyed. Participants will be recruited via an ad posted in a national women's magazine asking for volunteers.

Procedure

Two experimental groups will be developed. 1/2 of the women will take HRT and the 1/2 will not use any HRT. The questionnaire on well being will be rated on a scale of 1-10 measuring the following:

Enjoyment of daily life

Sleep Well.

Awaken Happily.

Socially Active

Diet no sign of anorexia or bulimia.

Anxious.

Sexually active.

Self-esteem.

Level of energy.

Overall satisfaction in life.

Research participants will be assured of their anonymity and the confidentiality of information provided in order to maintain the highest ethical standards when conducting the study. Research participants will also be provided detailed instructions prior to receipt of the email survey and will be asked to sign a written consent affirming that they understand the instructions and provide their consent to participate in this study. Participants will be informed of the purposes of the study and the intended benefits the researcher hopes to gain by conducting this study.

Data Analysis

The researcher will gather all of the information collected from the self report questionnaires and analyze using a variety of techniques including summary, interpretation, classifying and describing. The author will use the data to measure change that occurs among the populations using HRT therapy.

In conducting the study the researcher will undoubtedly run into some obstacles including determining how to measure change in the participants health and well being, examining the extent of change and the attributes of change for purposes of the study (King, 2001). Measuring change is a key concept vital to longitudinal research design (Kind, 2001). As this study is qualitative in nature the data will be presented via narratives, observations and transcripts from the survey to record and measure data appropriately (King, 2001).

The researcher will attempt to explain change and identify causal relationships between the independent and dependent variables. Data managing, reading, describing, interpreting and representing will all be key toward providing adequate data analysis for part of this qualitative longitudinal research analysis

Predicted Results

The purpose of this study is to analyze the effects of HRT on the well being and quality of life reported by post menopausal women. Much of the research currently available on HRT therapy suggests that this study will produce a positive relationship between HRT therapy and women's reported well being.