Risk perception in women: a focus on menopause.

Deeks, Amanda; Zoungas, Sophia; Teede, Helena

OBJECTIVE To investigate risk perceptions in relation to menopausal experiences, comparing premenopausal women's expectations to actual experiences of menopause, including perceptions of symptoms, fears, risks of future illnesses, and side effects of symptomatic treatments. DESIGN This was a cohort study using surveys in a random sample of Australians participating in an Australian Health Report series, supported by Pfizer. This article focuses on perceptions about menopause of 710 women. RESULTS Peri- and postmenopausal women experienced more fatigue, sleeplessness, fluid retention, and bloating than premenopausal women expected to experience. Perimenopausal and postmenopausal women rated menopause as the "first day of the rest of [my] life" significantly more than premenopausal women. All women perceived that menopause had an impact on aging and weight gain, but more premenopausal women feared loss of sexuality (55%), loss of femininity (39%), and the inability to have more children (37%). Perceptions of illnesses differed from actual incidence, with 27% of all women perceiving breast cancer and 11% perceiving heart disease as a health risk, compared with actual female mortality figures of 3% and 41%, respectively. Perceptions of the effects of hormone therapy were inaccurate, with 53% of all women expecting a reduction in hot flushes, 44% expecting that hormone therapy increased breast cancer, and 23% expecting that hormone therapy decreased fractures. CONCLUSIONS This study suggests a difference between perceptions of symptoms, fears, risks of future illnesses, and side effects of symptomatic treatments at menopause and actual experience. Because risk perception influences health-related behaviors, visits to healthcare providers, and treatment decisions and can be modified through education, an understanding of risk perception is clinically important. Further research is needed.