Communicating change: An ethnography of women\u27s sensemaking on menopause, hormone replacement therapies, and the Women\u27s Health Initiative

As a result of the recent findings of the Women\u27s Health Initiative (WHI), many women who have been on hormone replacement therapies (HRT) have begun to renegotiate their understandings and strategies of this stage of their lives. The WHI findings suggested that the risks of HRT outweighed the benefits for healthy menopausal women. This study examined women\u27s emerging sensemaking regarding HRT and menopause in light of the WHI findings. Seven women in the Tampa Bay area, who were in various stages of menopause, participated in three focus group sessions and two one-on-one interviews to discuss their lives in menopause. Based upon the women\u27s conversations, I constructed individual stories about each of the women. I included my voice in each step of the process, both participating in the focus group and interview discussions and inserting my voice in the women\u27s stories as an interview and focus group participant. I analyzed the stories to determine categories in the w omen\u27s emerging sensemaking. A theme of change emerged in terms of loss, decay, and decline. The women talked about change while discussing personal issues such as children, their bodies, aging, health concerns, and sex. Throughout their discussions, the women spoke about the contradictions and dilemmas they faced as they tried to sort through the conflicting and sometimes contradictory information they have been receiving about the effects of menopause and HRT on their bodies. Emily Martin\u27s medical metaphors, Michel Foucault\u27s ideas on discourse, and Watzlawick, Weakland, and Fisch\u27s theory of change helped me understand the women\u27s sensemaking. Many of the women framed their sensemaking within the biomedical model of health care, using what Martin called the body-as-machine metaphor, thereby making a first-order change, even though they changed from one HRT formula to another, from synthetic to natural HRT, or stopped taking HRT entirely. One woman appeared to make a secon d-order change. Overall, the women felt they had little to guide them as they determined how to take care of themselves in the menopausal stage of their lives