Menopause-related medication use among women age 45-75 experiencing incarceration in North Carolina 2015-2016

• DOI: https://doi.org/10.1108/IJPH-07-2021-0068
• Published date: 27 January 2022
• Date: 27 January 2022
• Pages: 176-184
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Elana Jaffe,David Rosen,Aunchalee Palmquist,Andrea K. Knittel

Menopause-related medication use

among women age 45-75 experiencing

incarceration in North Carolina 2015-2016

Elana Jaffe, David Rosen, Aunchalee Palmquist and Andrea K. Knittel

Abstract

Purpose –This study aims to estimate the prevalence of individuals receiving hormone therapy for

menopause management and the prevalence of underlying conditions that may constrain options for

pharmacologicmenopause management inthe prison context.

Design/methodology/approach –This study reviewed all prescriptions dispensed by the North

Carolina Department of Public Safety between July 1, 2015, and June 30, 2016, for relevance

to menopause management. Relevant medications were those either recommended for menopause

management or those indicated for management of conditions that may complicate menopause

management, as per the 2015clinical decision-support algorithm tool developedby the North American

MenopauseSociety. Analysis was restrictedto women between the ages of 45 and 75.

Findings –Of 1,120 women, a majority(77.8%) were between the ages of 45 and 54. Less than 5% of

individuals in this study wereprescribed estrogen-containing therapy. The most commonly prescribed

medicationsthat may constrain options for menopause treatmentwere related to hypertension and other

cardiovasculardisease or mental health conditions.

Research limitations/implications –The retrospective natureof this data set limits the findings, given

that researchers did not have access to diagnoses or data on polypharmacy. Still, this study indicates

that many women over 45 experiencing incarceration are living with health conditions that may

complicate menopause symptom management with hormone therapy. Future research in carceral

settings must examinethe prevalence of menopause-related symptomsas well as access to and quality

of comprehensivemenopause management.

Originality/value –There is a paucity of literature around themenopause-related needs of individuals

experiencing incarceration. To the best of the authors’ knowledge, no other research has examined

prevalenceof pharmacologic menopause managementamong women who are incarcerated.

Keywords Women’s health, Health in prison, Aging, Incarceration, Menopause

Paper type Research paper

Introduction

The number of women 45 years of age experiencing incarceration in state or federal

prisons has more than doubled since 1999, with 25,337 women in this age group

incarcerated in 2019 (Beck, 2000;Carson, 2020). However, there is a lack of evidence

around the extent to whichmenopause-related health needs are being met in prison andjail

facilities (Schach et al., 2021). Though the experience of menopause varies between

women, many menopausal women report vasomotor symptoms (e.g. hot flashes),

urogenital symptoms (e.g. vaginal dryness), depression, sleep disruption, musculoskeletal

changes and hormonal changes. The average age of menopause is 51, though the median

duration of menopausal symptomsis just over 10 years, often starting years before the final

menstrual period (Kaunitz and Manson, 2015;de Kruif et al., 2016). Menopause symptoms

may be exacerbated for women in prison; social determinants of health prevalent among

(Informationabout the

authorscan be found at the

end of this article.)

Received 31 July 2021

Revised 14 December 2021

Accepted 3 January 2022

The authors acknowledge the

North Carolina Department of

Public Safety for their

assistance providing the data

used in this analysis.

Funding: This work was

supported in part by a

Community Engagement

Fellowship from the Carolina

Center for Public Service.

PAGE 176 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jVOL. 18 NO. 2 2022, pp. 176-184, ©Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-07-2021-0068