**1. Introduction**

The study of menopause and the medical care of women at this stage require a multidisciplinary approach, given that the signs and symptoms observed are multiple. Therefore, obtaining reliable data depends on the researcher's training, the experience and specialty of the medical treatment, the instruments used to obtain the information, and the degree of safety and security that the patient has both in the researcher and in the doctor.

Several symptoms have already been described widely; so here, only some will be described that require special mention given the complexity to diagnose or study them, or those of the

Ethical Considerations in Research and Medical Care of Menopause

http://dx.doi.org/10.5772/intechopen.74666

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Sexual dysfunction: In general, menopause is usually perceived as a stage of decline, because signs and symptoms are accentuated with aging. One of the symptoms that usually cause embarrassment in female patient is the sexual dysfunction, which has a final result, the reduction of sexual desire [6]. The events that lead to this can be pathophysiological such as vulvar and vaginal atrophy and lubrication reduction or psychological, due to women who present low self-esteem. Sexual function in this stage is influenced by several factors, such as previous sexual activity, co-morbidities, cultural environment, mental illness, and ethnic origin; for example, the prevalence of sexual desire reduction has been described in 47, 54, 42, and 24% in English, Italian, French, and German menopausal women, respectively. It has also been pointed out that black and Latina women had greater sexual desire than white and Asian women at this stage. Although even women from the same country, but of different ethnic groups, tend to have a different prevalence of sexual dysfunction, as shown in a study carried out in ethnic groups from Iran, that study showed that the prevalence of sexual dysfunction was 75.3 in Arabs, 86.1 in Lors, and 83.2% in Persians [7]. Undoubtedly, the evaluation of the sexual function requires an ethical management by the treating medical personnel, since it must auscultate and interrogate the patient, without the woman feeling

Osteoporosis: It is another important health problem in women postmenopausal, which usually occurs in the late phase but goes unnoticed because it is not painful or by patient's ignorance. This pathology results from the decrease in estrogen production, reduced calcium resorption, increased urinary excretion, reduced vitamin D synthesis, as well as less formation of its active metabolites, decrease in the number of vitamin D receptors. The analysis of the quality of life of women with osteopenia or osteoporosis is important, as it can guide

Obstructive sleep apnea: It is neither a symptom usually asked by doctors nor does the patient report having more episodes in this stage. However, clinical research found a higher prevalence after menopause, and even more, it has been proposed that it predisposes to enuresis, coronary risk, and cardiovascular disease. Enuresis, occurs during the apnea as a result of a negative pressure against the glottis, which causes cardiac distension and greater release of the atrial natriuretic peptide, which finally results in an increased urinary volume and, consequently, enuresis [9]. Then, the knowledge factors to obstructive sleep apnea can also control the enuresis, improve the quality of sleep, and reduce cardiac risk, the mood, and, in general, the well-being. Common risk factors for obstructive sleep apnea and enuresis have been reported, such as obesity, snoring, restless sleep, sleep fragmentation, daytime somnolence, and hypertension; this has not been found in postmenopausal women

As already mentioned, there are several condition factors of the presence and intensity of a certain symptom of menopause and therefore the type of treatment that they will receive to control

major importance, or they have recent advances.

pharmacological and non-pharmacological strategies [8].

**2.2. Influential factors in the symptomatology**

uncomfortable.

(**Figure 1**) [10].

The objective of clinical research is to obtain knowledge to incorporate it systematically in health policies. Specifically, research on women's health began in 1990, when the Office of Research on Women's Health (ORWH) promoted policies and funded research considering the influence of sex and gender on health. After, in 1991, the Women's Health Initiative (WHI) announced, under which menopause was studied to understand the treatment of cardiovascular diseases, cancer, and osteoporosis. In addition to promoting research in women's health methodologically, technically, and more recently, ethical aspects have been analyzed, in order to protect the patient's safety, in the social, psychological, and biological spheres. With respect to medical care, the influence of the sex of treating doctor or nurse has been studied, but no differences were observed; on the contrary, there was only predisposition to give preferential treatment to a family member, when in a hypothetical situation, the life was in high risk. Despite the fact that each gender is characterized by a type of ethical reasoning, is based on caring/protection for women and justice for men. Finally, for the study and medical attention of women, various surveys have been developed, with the aim to evaluate a specific sign or symptom. This fact highlights the importance of studying and attending multidisciplinary to women, given the complexity and diversity of the signs and symptoms.

The application of ethical norms for the investigation and medical attention of women requires that doctors and nurses from their professional formation have to approach to this concept. So also, the political authorities and administrators of economic funds must know the transcendence of ethics in their fields of action.
