The purpose of the study was to develop a substantive theory that described and explained women's responses to premature induced menopause in the context of breast cancer. The study was conducted in the naturalistic paradigm with Grounded Theory methodology, using a constant comparative method to collect, code and analyze the data. Sampling was purposive and theoretical and consisted of twenty-six women with breast cancer who received adjuvant chemotherapy. The majority of women were married, white, well educated, employed and the mean age was 40.6 years ($\pm$3.7). Amenorrhea was experienced by twenty-three women, two women described a perimenopausal pattern of irregular periods and one woman had return of menses after therapy was completed. Women were identified through two oncologists, contacted by letter which explained the purpose of the study and a followup telephone call determined interest in participation. Twenty of the twenty-six participants participated in a single interview, with interviews ranging from forty-five minutes to two hours. To increase interpretation of the data from participant interviews, multiple data sources were used: field notes on reflections and observations, informal discussions with health care providers and media and lay women's writings. The main theme discovered in the data was Carrying On, which explained the women's attempt to assimilate premature induced menopause in the recovery process from breast cancer. There were three patterns of responses to Carrying On: struggling with the experience, tolerating the experience and making the best of it. Women's responses were influenced by degree of perceived vulnerability and the interrelationship of age, knowledge of menopause, meaning of menopause, talking about menopause, awareness of menopause, health care providers, time, attitude toward midlife women's health and illness uncertainty. Balancing, adjusting to symptoms and relying on self were the major strategies used by women in the process of Carrying On. Strategies were designed to protect women's physical, psychological, social and sexual integrity and reflected their actions toward managing the dynamic competition between cancer and menopause in their lives.
Supervisor: Ruth McCorkle. Thesis (Ph.D. in Nursing) -- University of Pennsylvania, 1998. Includes bibliographical references.