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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 11  |  Issue : 1  |  Page : 77-80

Prevalence of menopausal symptoms among postmenopausal women of urban Belagavi, Karnataka


Department of Community Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India

Date of Web Publication17-Jan-2018

Correspondence Address:
Dr. M S Shivaswamy
Department of Community Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_204_17

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  Abstract 


BACKGROUND: According to the World Health Organization (1981), natural menopause is defined as no menses for 12 consecutive months with no obvious intervening cause. During the menopause, women may experience vasomotor, psychosocial, physical, as well as sexual dysfunction. Studies on menopausal issues and health demand priority in Indian scenario due to the growing population of menopausal women as a result of their increased life expectancy.
OBJECTIVE: To know the prevalence of menopausal symptoms in the postmenopausal women aged 40–60 years.
METHODOLOGY: A community-based cross-sectional study was conducted between January 1, 2016, and December 31, 2016, using a predesigned, pretested, structured questionnaire based on sociodemographic variables and menopausal symptoms as per the menopause-specific quality of life questionnaire. A total of 345 postmenopausal women aged 40–60 years residing in the field practice area of Urban Health Centre, Ashok Nagar, Belagavi, were selected by systematic random sampling technique and interviewed during house-to-house visit. The outcomes of this study were menopausal symptoms in the postmenopausal women. Data collected in the questionnaire were coded and entered in Microsoft Excel sheet. Values were expressed in the form of frequency and percentages. Tables were prepared. Statistical significance was set at P ≤ 0.05.
RESULTS: In this study, the mean age among study participants was 52.04 ± 5.58 years. Majority 200 (58%) were Hindus, while 266 (77.1%) were literates. The most common menopausal symptoms were of physical domain (75.7%–25.5%), followed by psychosocial domain (63.9%–49.3%) to vasomotor domain (63.5%–55.4%) and least common sexual domain (42.3%–36.2%).

Keywords: Menopausal symptoms, postmenopausal women, urban Karnataka


How to cite this article:
Pathak N, Shivaswamy M S. Prevalence of menopausal symptoms among postmenopausal women of urban Belagavi, Karnataka. Indian J Health Sci Biomed Res 2018;11:77-80

How to cite this URL:
Pathak N, Shivaswamy M S. Prevalence of menopausal symptoms among postmenopausal women of urban Belagavi, Karnataka. Indian J Health Sci Biomed Res [serial online] 2018 [cited 2019 Aug 24];11:77-80. Available from: http://www.ijournalhs.org/text.asp?2018/11/1/77/223425




  Introduction Top


All women who live up to middle age and beyond experience a period of transition from the reproductive to the nonreproductive stage of life, of which the most striking feature is the cessation of menstruation known as menopause.[1] According to the World Health Organization, “natural menopause” is defined as “no menses for 12 consecutive months with no obvious intervening cause, such as pregnancy, lactation, exogenous hormone use, dietary deficiencies, or surgical removal of the uterus or ovaries.”[1],[2] With the general increase in life expectancy worldwide, most women are likely to live for another 20–30 years after menopause, and approximately, one-third of their lives in a state of estrogen deficiency.[3]Commonly, during the menopause, women may experience vasomotor (hot flushes, night sweats, etc.), psychosocial (memory, mood changes, etc.), physical (sleep, urine incontinence, skin changes, weight gain, etc.,) and sexual (vaginal dryness, decrease in sexual desire) dysfunction. Postmenopausal symptoms persist years after the final menstrual period, having been reported more than 10–15 years after the last menses in some women.[4] Although menopause is a universal phenomenon, the prevalence of each of these symptoms varies widely not only between individuals in the different populations, but also between the same populations.

In India, though various studies have been carried out to study menopausal symptoms, majority of them are either hospital based or focus on the rural population with not much work done on urban women. Therefore, this study proposes to assess the prevalence of menopausal symptoms among urban women in Belagavi city of Karnataka state in South India.

Objective

To know the prevalence of menopausal symptoms in the postmenopausal women aged 40–60 years.


  Methodology Top


A community-based cross-sectional study was conducted among postmenopausal women in the field practice area of Urban Health Centre (UHC), Ashok Nagar, Belagavi, from January 1, 2016, to December 31, 2016. Women in the age group of 40–60 years who were permanent residents of the study area for at least past 1 year preceding the survey and also had amenorrhea for at least 12 months preceding the survey were included in the study. Women who fulfilled the above criteria but had undergone medical or surgical menopause or had undergone chemotherapy/radiotherapy-induced ovarian failure or were taking hormone replacement therapy after natural menopause were excluded.

Sample size was calculated using the formula Z 2P (100−P)/P2 (Z = 1.96 for 95% confidence interval, P = estimated prevalence, taken as 69.1%,[5] d = absolute error taken as 5%).

Thus, n = 1.962 × 69.1 (100 − 69.1)/52 = 329;

Taking 5% nonresponders, corrected sample size = 329 + 16 = 345.

Systematic random sampling method was used to select eligible participants (As estimated from the Community Need Assessment Approach Survey 2015–16, total population of UHC, Ashok Nagar, was 32,132 and total postmenopausal woman in 40–60 years was 3,192. k = total target population/sample size = 3192/345 ≈ 9). Thus, every 9th women of target population was interviewed till the sample size was achieved.

Written informed consent was obtained from all participants before start of the interview for data collection. Ethical clearance was obtained from the Institutional Ethics Committee for Human Subject's Research of J. N. Medical College, Belagavi. Participants benefitted by the health education given during the study regarding appropriate management. In case of requirement of treatment, they were eligible for the free services available at UHC Ashok Nagar, Belagavi, and if necessary, referred to Dr. Prabhakar Kore Charitable Hospital, Belagavi for further management.

Data collection instrument

A predesigned, structured questionnaire based Sociodemographic variables and menopause specific quality of life (MENQOL) questionnaire was used to interview eligible participants by house-to-house visit. Maximum three attempts (two follow ups after initial attempt) were made to sought interview with eligible participant before excluding that participant. MENQOL questionnaire is a validated instrument used to measure health-related quality of life in middle-aged women in the years beyond the onset of menopause. It consists of 29 items grouped into four domains: vasomotor (1–3), psychosocial (4–10), physical (11–26), and sexual (27–29). For frequency of the MENQOL symptoms, participants were asked to rate whether or not they had experienced the symptom in the past month. If the answer to an item is yes, it was counted as presence of that particular symptom. The main outcome of this study was menopausal symptoms among the study participants.

Data analysis

Data collected in the questionnaire were coded and entered in Microsoft Excel sheet. Values were expressed in the form of percentages, mean and standard deviation. Tables were prepared. Statistical significance was set at P ≤ 0.05.


  Results Top


Overall, the mean age among 345 study participants was 52.04 ± 5.58 years. As seen in [Table 1], the number of participants, i.e., 95 (27.5%), were in the age group of 51–55 years. Least number of participants, i.e., 66 (19.1%), belonged to the age group of 40–45 years. Majority 200 (58%) were Hindus, while 139 (40.3%) were Muslims. Among them, most of the participants 209 (60.6%) had studied till 10th standard. Majority (67.2%) of the participants were homemakers.
Table 1: Sociodemographic profile of study participants

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[Table 2] shows the frequency of vasomotor symptoms among study participants which varied from 219 (63.5%) for “sweating” to 191 (55.4%) for “hot flushes”.
Table 2: Frequency of self-reported vasomotor symptoms among study participants

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As seen in [Table 3], the most common psychosocial symptom was “feeling depressed, down, or blue” 217 (63.9%), while the least common symptom was “feeling anxious or nervous” 170 (49.3%).
Table 3: Frequency of self-reported psychosocial symptoms among study participants

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[Table 4] shows that overall, sexual domain had lesser frequency of symptoms ranging from 146 (42.3%) for “dryness of vagina” to 125 (36.2%) for “decreased sexual desire.”
Table 4: Frequency of self-reported sexual symptoms among study participants

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[Table 5] depicts physical symptoms as per MENQOL. Maximum frequency was for “feeling tired or worn out” 261 (75.7%) and the least frequent symptom was “increased facial hairs” 88 (25.5%).
Table 5: Frequency of self-reported physical symptoms among study participants

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In the present study, as per MENQOL Questionnaire, the most common menopausal symptoms were of physical domain – “feeling tired or worn out” 261 (75.7%), “aching in muscles and joints” 251 (72.8%), “decrease in stamina” 228 (65.8%), and “low backache” 221 (64.1%), followed by psychosocial domain – “feeling depressed, down, or blue” 217 (63.9%) to vasomotor domain – “sweating” 219 (63.5%). The least common symptoms were “increased facial hair” 88 (25.5%) to “dry skin” 118 (34.2%), “decrease in sexual desire” 126 (36.2%) to “changes in appearance, texture, or tone of skin” 133 (38.6%).


  Discussion Top


A study done in Manipal, Karnataka, in 2009 among 352 postmenopausal women reported mostly physical and psychosocial symptoms such as “aching in muscle and joints” (67.7%), followed by “gets tired easily” (64.8%), “poor memory” (60.5%), “lower backache” (58.8%) to “feeling bloated” (55.1%) as the most common symptoms. Least common symptom was “increased facial hair” (15.3%), which is similar to the present study.[9]

Another study done among 542 postmenopausal women in Riyadh, Saudi Arabia in 2017 also reported similar findings. Most commonly reported symptoms were from physical domain, namely “aching muscles and joints” (82.1%), “decrease in physical strength” (76.6%), and “feeling tired or worn out” 378 (69.7%). Least common symptoms were “dissatisfied with personal life” (5.5%), “increased facial hair” (10.7%), and “vaginal dryness” (11.1%).[10]


  Conclusion Top


The most common menopausal symptoms among postmenopausal urban women of Belagavi were of physical domain (75.7%–25.5%), followed by psychosocial domain (63.9%–49.3%) to vasomotor domain (63.5%–55.4%) and least common sexual domain (42.3%–36.2%).

Strengths and Limitations

The present study used a predesigned validated questionnaire to gather information on frequency of various menopausal symptoms. Even though the present study was conducted in single field practice area, such regional studies will help corroborate data so that health-care providers can plan strategies for the middle-aged women suffering from these menopausal symptoms.

Future Research

Through research on menopausal symptoms like the current study, women can be made aware of their climacteric symptoms and side effects as a result of that transition. Further research conducted on a larger scale can help produce more generalizable findings.

Recommendations

Information education and communication activities to increase awareness about menopause problems among general public, family members, and middle-aged women population should be undertaken. Looking at the national-level, health care in India pays little importance to the menopausal health problems. Reproductive and Child Health Programme should be extended to include postmenopausal women. With rising population of menopausal women in India, a public health program, focusing exclusively on the postreproductive age group, is the need of the hour.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Acknowledgments

The Principal JNMC, Head, Dept of Community Medicine JNMC and Medical Officer Ashok Nagar.



 
  References Top

1.
World Health Organization. Research on the Menopause – Report of a W.H.O. Scientific Group. Technical Report Series 670. Geneva: World Health Organization; 1981. p. 11-32. Available from: http://www.apps.who.int/iris/bitstream/10665/41526/1/WHO_TRS_670.pdf. [Last accessed on 2016 Aug 15].  Back to cited text no. 1
    
2.
World Health Organization. Research on the Menopause in the 1990s – Report of a W.H.O. Scientific Group. Technical Report Series 866. Geneva: World Health Organization; 1996. p. 3-39. Available from: http://www.apps.who.int/iris/bitstream/10665/41841/1/WHO_TRS_866.pdf. [Last accessed on 2016 Aug 15].  Back to cited text no. 2
    
3.
Gold EB, Crawford SL, Avis NE, Crandall CJ, Matthews KA, Waetjen LE, et al. Factors related to age at natural menopause: Longitudinal analyses from SWAN. Am J Epidemiol 2013;178:70-83.  Back to cited text no. 3
[PUBMED]    
4.
Minkin MJ, Reiter S, Maamari R. Prevalence of postmenopausal symptoms in North America and Europe. Menopause 2015;22:1231-8.  Back to cited text no. 4
[PUBMED]    
5.
Joseph N, Nagaraj K, Saralaya V, Nelliyanil M, Rao PJ. Assessment of menopausal symptoms among women attending various outreach clinics in South Canara District of India. J Midlife Health 2014;5:84-90.  Back to cited text no. 5
[PUBMED]    
6.
Hilditch JR, Lewis J, Peter A, van Maris B, Ross A, Franssen E, et al. Amenopause-specific quality of life questionnaire: Development and psychometric properties. Maturitas 1996;24:161-75.  Back to cited text no. 6
    
7.
Lewis JE, Hilditch JR, Wong CJ. Further psychometric property development of the menopause-specific quality of life questionnaire and development of a modified version, MENQOL-intervention questionnaire. Maturitas 2005;50:209-21.  Back to cited text no. 7
    
8.
Van Dole KB, DeVellis RF, Brown RD, Funk ML, Gaynes BN, Williams RE, et al. Evaluation of the menopause-specific quality of life questionnaire: A factor-analytic approach. Menopause 2012;19:211-5.  Back to cited text no. 8
    
9.
Bairy L, Adiga S, Bhat P, Bhat R. Prevalence of menopausal symptoms and quality of life after menopause in women from South India. Aust N Z J Obstet Gynaecol 2009;49:106-9.  Back to cited text no. 9
    
10.
AlQuaiz AM, Kazi A, Habib F, AlBugami M, AlDughaither A. Factors associated with different symptom domains among postmenopausal Saudi women in Riyadh, Saudi Arabia. Menopause 2017;24:1392-401.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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