SILVA D.V. R. A experiência da menopausa precoce em mulheres com câncer de mama com idade inferior a 45 anos [The experience of premature menopause induced by breast cancer treatment in women under 45 years old]. Doctoral Thesis. Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto (SP), 2022.
Available on: https://doi.org/10.11606/T.22.2022.tde-18082022-101827
Abstract: The increased incidence of breast cancer in young women under 45 years of age and the chronicity of the disease has aroused the need to better understand the repercussions of treatment in order to offer a health care that meets the specificities of young women with breast cancer. Premature menopause is among the aspects with an important impact on young women’s lives. Thus, the present study aimed to understand the process of mourning resulting from premature menopause induced by breast cancer treatment in women under 45 years old. To achieve the proposed objective, a qualitative study was carried out through a clinical-qualitative approach and content analysis. We used the open interview and the Drawing-and-Story Procedure as the main tools for data collection, complemented with a questionnaire of sociodemographic data and clinical data. The data were analyzed considering the framework of grief as a Psychosocial Process and psychodynamic theories allowed a more profound understanding on subjective aspects of grief process resulting from the premature menopause induced by breast cancer treatment. The data analysis allowed the identification of five categories: Devastated body and the attack on identity support: “I don’t recognize myself”; Need to familiarize yourself with the new body: “Is it normal to feel this?”; All of me: “My whole body has changed”; Suffering associated with infertility: “It’s my Achilles tendon”; and “Like fire and ice”: vicissitudes of sexual desire creating mismatches in the relationship with the intimate partner. It was possible to identify many symbolic losses resulting from the experience of premature menopause that were relevant to young women in treatment. The set of body changes weakens the identity base of being a young woman and anticipates some experiences related to aging. Some losses could be elaborated, while others presented complicated grief characteristics because they were not integrated into a new identity. The psychodynamic aspects identified in the context of breast cancer treatment and consequent early menopause, showed a regression of basic needs, such as need for protection and care, as well as feelings of guilt, ambivalence, fear of loss, fear of death and unprotection. Constructive trends such as the search for autonomy, personal development and the desire to recover health were also observed. It is expected that the knowledge produced will contribute to a better understanding of symbolic grief resulted from the experience of premature menopause induced by breast cancer treatment, so that comprehensive health care for young women with breast cancer considers the repercussions of menopause on the health and life of these women assisting in the elaboration of such mourning.