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Menopause and hormone replacement therapy from holistic and medical perspectives.

Myths and other issues surrounding menopause are examined on the basis of historical and current literature from medicine, psychiatry, and psychiatric nursing, and on current research. Changes in the psychiatric view of menopause and mental illness reflect a more holistic view of menopause. Some effects of menopause during this normal transitional phase of a woman's life are explored with respect to the developmental, physiological, and cognitive/psychosocial domains. Concepts of menopause as disease or as normal development are discussed as well as issues related to "care or cure" interventions for menopausal women. Evidence supports the need for systematic longitudinal research studies on the use of hormone therapies to provide information on their long-term effects on the menopausal woman. The use of hormone therapies alone or in conjunction with other holistic interventions is discussed. Nurses have a professional responsibility to come to terms with the continuing conflict related to hormone therapies so that they may provide appropriate nursing interventions to celebrate this passage rather than deny it.