DESARROLLO DEL PROCEDIMIENTO

Half of those present at this workshop were from the same workplace. The informal

format of a led discussion commenced with the educator, Christine, pointing to

menopause as a positive transition involving the end of periods and childbearing for a

woman.

5 An

overview of the physiological changes at menopause, associated

symptoms and the role of hormones in female reproductive processes was presented

and discussed. Attention was drawn to the negative impact of disparaging comments

and horror stories associated with menopause and the group was invited to identify

known symptoms and appropriate self-help remedies. The symptoms included

tiredness, sleep disruption, mood changes, forgetfulness, depression, hot flushes,

5 New Zealand Family Planning educators are lay people trained for their role by the organisation.

vaginal dryness and incontinence while exercising. Diet, and stress reduction were suggested as remedial or relief strategies. The participants were also presented with relevant pamphlets and taken through an exercise aimed at toning the pelvic floor muscles. The evening concluded with a video produced by the English Family Planning Association detailing the menopause experience of three British women.

3.

Women 's Health Action Workshop

The third workshop came to my notice through a national newspaper article about a workshop on

Menopause and

HRT to be held in Auckland on 7 May 1 994. The article claimed that 'menopause [is] a hot topic on the women's health scene [and so] like its predecessor [the workshop is] expected to be booked out weeks ahead' (Coney, 1 994: D2). Organised by Women's Health Action and sponsored by Healtheries (a health food and diet supplement company), the one and a half hour workshop was attended by approximately eighty women. Conducted by Sandra Coney, a feminist journalist and health consumer advocate, the workshop aimed to inform mid-life women about menopause, the risks and benefits of HR T and about the recommendations of the National Advisory Committee on Core Health and Disability

Services ( 1 993b) on the use of HRT .

Coney's informal interactive presentation drew heavily on the arguments and findings in her book,

The Menopause Industry

(Coney, 1 993) . The discussion began with a critical appraisal of drug company and medical promotion of menopause as a deficiency disease. Coney argued that not only does such a view overlook the benefits associated with the end of menstruation but it promotes the idea of menopause as a health hazard. If the health hazard view was adopted women's reliance on medical and pharmaceutical intervention becomes assured and there is an increased potential for economic gain by drug companies and medical professionals in a world with a rapidly ageing female population.

The ' classic' symptoms of menopause were identified (hot flushes and vaginal dryness) and the lack of scientific verification of additional symptoms was pointed out. Indeed, Coney maintained that some symptoms (such as 'unloved feelings ') included in drug company information were drawn from stereotypical views rather than medical

knowledge of middle-aged women and so contributed to the promotion of menopause as a negative event. The discussion also addressed the impact of social and cultural forces on the health and well-being of mid-life women and difficulties associated with ageing in a youth orientated culture. Mention was made, for example, of the pressures on women to confonn to an ideal, teenage body shape and the lack of older women as role models in our society.

Coney's discussion on HRT reiterated her opening argument that the advancement of menopause as a deficiency disease is motivated by money rather than health promotion for mid-life women. Critical of much of the clinical research on the effects of HRT, Coney voiced strong concern at the promotion of benefits and the downplaying of

associated risks. Examples of flawed research involving the role of HRT in the prevention of osteoporosis and heart disease were detailed and participants cautioned on the dubious benefits of blanket treatment of all women. Coney emphasised the need for women to be well informed on issues associated with the use of HRT and pointed to the recommendations of the National Advisory Committee on Core Health and Disability Services

( 1 993b)

report as a valuable knowledge resource. Finally, the benefits of lifestyle adjustments such as diet, exercise and stress reduction were promoted as alternatives strategies for the relief of short-term menopausal symptoms and reduction of the risk of osteoporosis and heart disease in later life.

Manifest Characteristics of the Three Workshops

Characteristic of the Australasian Menopause Society workshop was the emphasis on the physiology of menopause, associated symptoms and longer-tenn health risks. The women attending were urged to adopt a proactive approach through lifestyle change and regular medical monitoring, assessment and treatment. The formal programme of the meeting affirmed the expertllay relationship between presenters and participants, while the use of medical terminology and research results promoted the scientific validity of information and the professional expertise of each speaker. The result was a view of menopause as a health risk necessitating lifestyle adjustment, medical monitoring and management.

In

other words, the Australasian Menopause Society workshop adopted and presented a deficiency disease orientation to menopause.

In contrast, the New Zealand Family Planning Association workshop emphasised

In document Propuesta para la implementación de un sistema de gestión ambiental basado en la norma iso 14001:2004 para la empresa cartavio s a a 2014 (página 114-117)