Introduction: Some women, cope with their perimenopausal period gently, others are exposed to numerous physical and mental problems. Some of the most common problems related with perimenopausal period are accelerated aging processes and loss of attractiveness. Such changes may have a significant impact on women’s quality of life, the level of happiness and satisfaction, also, on how they perceive themselves and surroundings, and on mood changes.

Aim of the Study: A survey was conducted to analyze the impact of aesthetic medicine treatments on perimenopausal women’s life, satisfaction and feelings.

Materials and Methods: The study involved randomly chosen 196 respondents aged 41-59, who benefited from aesthetic medicine treatments in aesthetic medicine practices in Poland.

Results: The average age of perimenopausal women using aesthetic medicine treatments was 48 years. The respondents were satisfied people, virtually in all areas of their lives. The least important conditions for their happiness were education (27%) and strong character (24%). 14% of the women were unhappy with their marriage. The patients rarely felt the lack of self-confidence (69%), and unhappiness (68%).

Conclusion: For the perimenopausal women benefiting from aesthetic medicine treatments, the most important prerequisites for happiness were children (95%), health (82%) and successful marriage (78%). Most of these patients were highly satisfied with their lives (83%), with personal relationships (82%) and with themselves (73%), much less frequently they felt lack of confidence and unhappiness.

Gal?ba A (2020) The Impact of Using Aesthetic Medicine Treatments on Life, Satisfaction and Feelings of Perimenopausal Women. Med J Obstet Gynecol 8(1): 1129.

• Perimenopausal age
• Aesthetic medicine
• Treatments
• Patients’ level of happiness
• Satisfaction
• Feelings

Perimenopausal period is often very difficult for many women. This is due to the fact that women begin to think more seriously about aging in the physical sense. With time, the secretion of 17-beta-estradiol is reduced, and its deficiency contributes to changes within the dermis, epidermis and the subcutaneous tissue. Deficiency of estrogen leads to a reduction in the amount of collagen, elastin, hyaluronic acid, and capillaries and also leads to decreased activity of the sebaceous glands and sweat glands and loss of subcutaneous tissue. There is a greater loss of flexibility, tightness and also skin dryness and roughness occur [1-6]. The aging process is accelerated. All these changes that occur in woman’s body may have a significant impact on quality of her life, on the level of happiness and contentment, on how she perceives herself and the surroundings and on her feelings. Thanks to the aesthetic medicine treatments we can slow down the process of skin premature aging, and also change one’s appearance to more favorable and in accordance with today’s beauty cannons [1,7].

The following study demonstrates the impact, of aesthetic medicine treatments correcting the visible aging changes on a face and other parts of the body, such as: hands, shoulders and necks, on life satisfaction and feelings of perimenopausal women. The aging changes include: wrinkles, folds, furrows, slack, dry, rough skin, hyperpigmentation, phthisis of subcutaneous tissue, phthisis of face adipose tissue, and loss of lip redness, etc.

The study involved 196 randomly chosen perimenopausal women aged 41-59, who benefited from aesthetic medicine treatments (needle mesotherapy, chemical peels, facial fillers using products containing cross-linked hyaluronic acid, and treatments used for wrinkles correction using botulinum toxin type A) in aesthetic medicine practices in Poland.

In the study the standardized Dermatology Life Quality Index (DLQI) questionnaire was also used. We used here an official interpretation of the DLQI form accepted by the author, Professor A.Y. Finlay [8,9]. For multiple comparisons, Scheffeg’s and Bonferroni’s methods, together with experts system were used [10].

Dermatology Life Quality Index (DLQI), was developed in 1994 and was the first tool dedicated to testing the quality of life in the case of dermatological problems and diseases. DLQI consists of 10 questions related to self-assessment on impact of skin diseases on the various aspects of the patient’s health related to quality of life in the preceding week. DLQI is a simple questionnaire used to measure health and quality of life in adults suffering from skin conditions. It should be noted that DLQI questions deal with the quality of life in terms of the actual dermatological problem. Therefore, patients using treatments in aesthetic medicine do not have a significant skin condition, we can assume that they will not be able to point to specific symptoms or behavior resulting from their condition, hence the answer they provide will be negative. Nevertheless, DLQI is a very popular test of quality of life and should be done, even after assuming that it will not show a clear change in the quality of life and assess it as such from the beginning to be high. In this study, the official translation of DLQI form was used, as approved by the tools developer Professor A Y Finlay, published on the official website of the project [8,9], also described and used by Professor J. Szepietowskiego, Z. Adamski and other co-authors in Clinical Dermatology, in 2004 [11].

The test parameters of the general population is estimated using confidence intervals at a predetermined level of assurance (confidence). Typically, the confidence level is set at 95%. This means 95 percent probability that the confidence interval will cover the unknown value of the estimated parameter [12]. In social studies the fraction of error is estimated (confidence interval ½) to be at a level below 4% and in this study this is 3.99%.

The formula for the minimum sample size for dichotomous variables (and such a study is the vast majority) is given by [13]:

where:

n - sample size;

Z - statistics for the desired level of confidence;

p - an estimate of the expected proportion of the variable of interest in the population;

d - half the width of the desired interval.

Only participants who expressed consent were included in this study. Participation in the survey was voluntary and anonymous. The subjects completed the surveys anonymously. They were informed of the purpose of conducting the investigations and that the resulting data would be used: for scientific research.

The following points were examined:

♦ age distribution;

♦ assessment of the factors necessary for a happy life;

♦ the impact of treatments on women’s life and satisfaction; 

♦ the impact of treatments on women’s sensations.

♦ The age distribution of perimenopausal women benefiting from aesthetic medicine treatments;

The treatments were mostly used by women aged 40-49 years (66%) (Figure 1). The average age was 48 years old. The interest in aesthetic medicine treatments among patients being 50-55 gradually declines, which, however, increases at the age of 56-59. Such an increase in the oldest research group may be associated with a decrease in self-esteem and lack of self-acceptance, which escalates in that age due to accelerated aging.

♦ Evaluation of the factors essential to a happy life, among perimenopausal women benefiting from aesthetic medicine treatments;

People differently perceive happiness. For some, having a lot of money is a condition for happiness, for others enjoying good health, or happy family. Patients were asked to assess importance (1-the least important, 7-the most important) of the individual factors responsible for happiness (Figure 2).

♦ The patients indicated that the most important conditions for happiness were children (95%) and health (82%) as well as a successful marriage (78%) and the social respect (74%). The least important conditions of happiness were friends (35%), the Providence and God (34%), education (27%) and strong character (24%).The impact of aesthetic medicine on life and satisfaction of perimenopausal women.

The patients were asked if the aesthetic medicine treatments influenced their satisfaction in the following areas (systematized according to the assessment of the influence on the satisfaction):

How much do you appreciate

a. your life? 

b. your relationships with the loved ones in your family?

c. your relationships with colleges (friends)?

d. how much do you appreciate yourself?

e. your marriage?

f. your sexual life?

g. your work?

h. your financial situation?

i. your achievements in life?

j. the way you spend your free time?

k. your perspectives for future?

The women could evaluate their satisfaction in the scale from 1 to 5 (1 – I am very satisfied; 2 – I am satisfied; 3 – I am neither satisfied nor dissatisfied; 4 – I am dissatisfied; 5 – I am very dissatisfied) (Figure 3).

♦ The respondents were virtually satisfied people. They were highly satisfied with their life (83%), with the relationship with their family (82%), with colleagues and friends (76%) and with themselves (73%). Satisfaction with friendly relationship was surprising here because it was recognized as the least important condition for a successful and happy life. While the high satisfaction with the family relationships corresponds to the relevant conditions for a successful life as indicated earlier. Children and a successful marriage were indicated on the first and third place, accordingly. This shows that, in fact, perimenopausal women are satisfied with their lives. 14% of the surveyed women are unhappy in their marriage. However, this number is not so high to be contradicting with the previous conclusion. None of the interviewees showed the lack of satisfaction associated with their family relationships as well as relations with friends, work or prospects for the future.The impact of aesthetic medicine on perimenopausal patients’ feelings.

♦ The women were asked how the aesthetic medicine treatments influenced their feelings. The patients assessed the influence in the scale from 1 to 5(1 – definitely more often; 2 – more often; 3 – neither often nor seldom; 4 – less often; 5 – definitely more seldom (very seldom)) (Figure 4).

The vast majority of the women indicated to be more satisfied (91%), feel more pleasant (87%), more relaxed (85%), more joyful (83%), feel well (80%), to be more daring (75%) and generally more easygoing (74%). In case of the negative emotions there is a situation that is opposite to the previous one; these women rarely feel they lack self-confidence (69%), that they are unhappy (68%), less frequently are nervous (63%) worried (57%), less often they feel sad (53%), feel like crying (51%), or feel depressed (47%). So naturally, it is concluded that the aesthetic treatments greatly improve perimenopausal women’s feelings. Only 5% of them have lost a sense of being well and the same number of patients have lost the sense of being calm. Not necessarily the loss of positive experience must be directly related to the aesthetic treatments. Other life events could have influenced it.

Perimenopausal women benefiting from aesthetic medicine treatments, were asked to complete the survey by providing answers to the following questions:

♦ To what extent, did you experience itching, pain, burning or tingling of the skin, last week?

♦ As expected, these women have no significant dermatologic problems but only minimal skin ailments. Nevertheless before treatments a minimal discomfort was felt by 4 patients, and after treatments only by 1 (Figure 5). To what extent did you feel embarrassed or uneasy because of the condition of your skin last week?

♦ 17 women, before the treatment, had experienced embarrassment with the skin and after the treatment none. DLQI does not allow finding an answer to why such an embarrassment appeared, however, as indicated previously, both cases referred to a slight embarrassment. As before, also here, the indication does not necessarily have to involve serious skin problems. In this case, a significant difference, in the frequency of slight embarrassment with the skin condition before and after treatments, should be noted. With this, one can draw a conclusion that the aesthetic medicine treatments significantly improved patients’ skin self-evaluation (Figure 6). To what extent did the skin conditions influence your social life and the way you spend your free time last week?

There were 3 indications that skin diseases affected the social life before the aesthetic treatments. After the treatments however, these indications have dropped to one person, which places both readings below the statistical error for the test (Figure 7).

♦ Analyzing responders’ answers on the following questions:To what extent did the skin problems disturb you in doing shopping and in doing housework and garden work last week?

♦ To what extent, did the skin problems influence the way you dressed last week?

♦ To what extent did the skin problems disturb you in doing sport last week?

♦ To what extent did the skin problems disturb you in relations with your partner, friends and family last week?

♦ To what extent did the skin problems disturb you in your sexual life last week?

♦ To what extent were the skin treatments problematic for you last week, for example in maintaining order in the house or because it excessively preoccupied your time?

♦ Did your skin problems disable you to work and study last week?

it can be noticed that none of the skin ailments, dermatological ailments had any influence on doing housework or garden-work, they did not disturb social relations with friends and surroundings, did not complicate patient’s sex life, and did not disable women to work and study, nor disturbed in doing sport and had no influence on their clothes. Skin ailments were not present and did not generate problems in a daily life of women benefiting from aesthetic medicine treatments.

It should also be noted that patients who have benefited from the aesthetic treatments are usually healthy people, without significant dermatological disorders. Those are women caring about their appearance, often significantly, and sometimes a small skin change like a blackhead can cause some dissatisfaction with their appearance and what can result from it difficult contacts with friends (embarrassment with own appearance). Thanks to the DLQI it was possible to demonstrate that their quality of life, in dermatological terms, is high and that these treatments significantly enhanced satisfaction with the quality of such women’s skin.

One of the most common reasons for aesthetic treatments is a desire to look more attractive – the above is the main reason for deciding on aesthetic treatment indicated by 86% of the polled women. The second reason is a desire to look young (70%) [1]. Garner in his research presented that the most important reason for the use of aesthetic medicine is an increased dissatisfaction with patients’ appearance [14].The purpose of aesthetic medicine is to achieve patient’s satisfaction, that means to eliminate their complexes and to restore their self-esteem. [1].

Often we don’t even realize that the facial appearance and the body shape of another person have a big impact on our relationship with this person. It’s difficult for us to admit that our assessment of other people’s character traits and behaviors is affected by their appearance [15]. Beautiful people-in accordance with the stereotype “beautiful is good” – are considered to be smarter, more successful, more assertive, more self-confident, and even happier than less attractive people [16]. In the study carried out by Gal?ba A. on 603 patients, over 40% of respondents experienced improvement in social attitude towards them after undergoing aesthetic treatments as a result of which, they became more attractive [1].

Studies carried out by psychologists have shown that people that consider themselves attractive are more extravert and higher evaluate their mental condition [17]. This is related to the fact that pretty people since they were born are gentler judged by their surroundings, they are smiled to and are even considered to be more talented. Such person becomes more confident and enjoys the surroundings and the world [15]. Also patients benefiting from aesthetic medicine are satisfied people, virtually in all areas they were asked about (relationship with the family, with friends, with a spouse, with children, sexual life, material situation, education, job, prospects for the future, lifetime achievements, and way of spending free time). In the study conducted by Gal?ba A. on patients (both sexes), aged 21-61 years [1], most patients were satisfied with their life (85%) and themselves (79% of patients). 91% of respondents who benefited from aesthetic treatments enjoyed their life. The vast majority of aesthetic medicine patients feel more satisfied (89%), more joyful (80%), bolder (80%), more relaxed (76%) and in general are more likely to feel that they are good (76%). Patients using such treatments are less likely to feel that they are unhappy (71%) and that they lack self-confidence (69%). Aesthetic medicine treatments greatly enhance positive feelings of aesthetic medicine patients. For those patients [1], the most important prerequisite for happiness is health (91%), positive attitude and optimism (86%), family, children (84%) and a successful marriage (83%). The least important condition for happiness is the Providence and God (36%), education (18%), a strong character (16%) and friends (15%).

Similar dependencies have been shown in the above studies. Perimenopausal women benefiting from aesthetic treatments are satisfied, virtually in all areas. To the greatest extent they are happy with their life (83%), with relationships with the family (82%) and themselves (73%). These women are generally more satisfied (91%), are more pleased (87%), are more relaxed (85%), are more joyous (83%), feel well (80%) and are bolder (75%). They less frequently feel lack of self-confidence (69%), unhappy (68%), nervous (63%), worried (57%) and sad (53%). For these women the most important prerequisite for happiness are children (95%), health (82%) and successful marriage (78%). The least important conditions for happiness are friends (35%), providence and God (34%), education (27%) and a strong character (24%).

♦ The average age of perimenopausal women benefiting from aesthetic medicine treatments is 48 years;

♦ For these women the most important prerequisite for happiness are children (95%), health (82%) and successful marriage (78%). The least important condition of happiness are friends- 35%;

♦ The Patients are satisfied people, virtually in all areas that they were asked about. They are the most happy with their life (83%), with relationships with loved ones in the family (82%) and themselves (73%). They are unhappy with their marriage (14%);

♦ These women are less likely to feel that they lack self-confidence (69%), that they are unhappy (68%), less frequently are nervous (63%), worried (57%) and less frequently are sad (53%);

♦ These women are more satisfied (91%), are more pleased (87%), are more relaxed (85%), are more joyful (83%), feel well (80%) and are bolder (75%).

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