|Year : 2020 | Volume
| Issue : 1 | Page : 37-41
Menopause status and its determinants in rural North Karnataka
Sudhirgouda H Patil, Naresh K Tyagi, Jang Bahadur Prasad
Department of Epidemiology and Biostatistics, KAHER, Belagavi, Karnataka, India
|Date of Submission||21-Jun-2019|
|Date of Acceptance||17-Dec-2019|
|Date of Web Publication||23-Jan-2020|
Dr. Sudhirgouda H Patil
Department of Epidemiology and Biostatistics, KAHER, Belagavi - 590 010, Karnataka
Source of Support: None, Conflict of Interest: None
BACKGROUND: Perimenopause symptoms need attention of health.care providers and public health personnel to enable the appropriate healthcare, including improving psychological makeup and for planning for further studies. Hence, the study was undertaken with an objective to study the menopause along with factors affecting the quality of life.
MATERIALS AND METHODS: A cross.sectional study has been carried out to investigate the factors affecting/related with perimenopausal symptoms, during February to July 2016, using proportional to population size inverse cluster sampling. The present study was conducted covering 712 women of age 40-55 years, comprised of 550 menopause, 40 surgical induced menopause and 122 yet to achieve menopause.
RESULTS: The odds ratio (OR) of menopaused women in other than gHindush and gMuslimsh were found higher than the reference group (Hindus). OR of menopause groups was statistically significant with gMildh heart discomfort, gMildh sexual desire, dryness of vagina, hot flushes, physical and mental exhaustion, depressive mood, anxiety, sleep problem, and irritability as compared with their respective reference groups (absence of symptoms). Similar results were exhibited by gMildh physical and mental exhaustion (OR = 2.22; P < 0.05), gModerateh depressive mood women (OR = 2.30; P < 0.05), gSevereh anxiety (OR = 1.84; P < 0.05), gMildh sleep problem (OR = 2.31; P < 0.05), and gMildh irritability (OR = 1.86; P < 0.05).
CONCLUSION: Psycho.physiological changes were seen by heart discomfort, sexual desire problem, irritability, depressive mood, anxiety, hot flushes, sleep problems, physical and mental exhaustion, and dryness of vagina exhibited significantly higher in perimenopause women. Hence, well.planned and calibrated health education and necessary symptomatic treatment must always be arranged for the welfare in the perimenopause period.
Keywords: Emotional changes, menopause, psycho-medical anomalies, rural cross-sectional survey
|How to cite this article:|
Patil SH, Tyagi NK, Prasad JB. Menopause status and its determinants in rural North Karnataka. Indian J Health Sci Biomed Res 2020;13:37-41
| Introduction|| |
Menopause is a physiological condition, defined as the cessation of menstruation for the past 12 months due to the loss of follicular activity of the ovaries. Signs and symptoms of menopause were reported as vaginal dryness, hot flashes, disturbed sleep, urinary problems, and emotional changes.
The distribution of commonly reported menopausal symptoms and their consequences (diseases) was night sweats (83.2%), hot flushes (76.4%), mood swings (72.5%), vaginal dryness (71.4%), irritability (67.5%), fatigue (66.8%), and loss of libido (66.4%). Setorglo et al. reported joint pain (64.4%), weight gain (59.3%), memory lapses (53.6%), and sleep disorders (50.7%) as symptoms and their consequences in the perimenopause period.
Perimenopause period causes physiological changes, with a lot of agony to the women. Hence, the perimenopause women with symptoms, including psychological changes, need the care from healthcare providers and public health personnel. Symptoms and their consequences during menopause visibly flushing, sleeplessness, headache, lack of concentration provide invaluable symptoms for health-care providers and public health personnel to enable the appropriate healthcare. Hence, the study was undertaken with an aim to understand the menopausal agonies, with the objective to study the contribution of socio-psycho and menopause agonies during perimenopause period from 40 to 45 years.
| Materials and Methods|| |
A cross-sectional study comprising 712 rural women age 40–55 years were surveyed, using pre-coded and pre-tested data collection instruments from October 2016 to April 2017, in Rural Belagavi District of North Karnataka, by inverse cluster sampling. Pilot survey was carried out to standardize the data collection schedule.
Data on menopause anthropometric, menopausal symptoms, and associated psycho-social and menopause symptoms were collected, to study the menopause and its determinants.
Menopause symptoms including vaginal dryness have been graded as none, mild, moderate, severe, and very severe with respect to the status of the patient before perimenopause phase, as perceived by the patients and graded as per Likert's scale. The Ethical Clearance was obtained from Institutional Ethical Clearance Committee via reference number KLEU/Ethic/2015-16/D-118, Dated : 14-07-2015.
The sample size was computed for anthropometric, menopausal symptoms, and associated psycho-social and menopause symptoms, keeping in mind the feasibility. The sample size was computed assuming 95% confidence interval (CI) and 10% expected error in the estimates.
The logistic regression analysis has been used to assess the impact of deterministic variates of perimenopause symptoms. Exponential of the coefficient of logistic regression estimates (eb) is defined as odds ratio (OR) in favor of the symptoms in menopause as compared to premenopause.
95% CI was computed as:
where, “a” is the menopausal women, “b” is not menopausal in reference group, and “c” and “d” are the similar figures for the study group for OR.
Data were cleaned for errors using Microsoft Excel, and analysis was carried out using theIBM, SPSS-22 version, Bangalore, Karnataka, India.
| Results|| |
A home-to-home survey was carried out, covering 712 women of age 40–55, comprising 550 menopausal and 40 “surgically induced menopause,” and using inverse cluster proportion to population size sampling. Hence, to study the determinants of menopause; 712 perimenopause including 40 surgicalinduced menopause women formed the study material.
In [Table 1], menopause by religion reveals OR and the distribution of the study patients by religion. The OR of menopaused women in other than “Hindus'” and “Muslims” was 1.33 times (P<0.01) as compared to “Hindus.” The similar figure was as less as 0.6 times in “Muslims” (P<0.01). The highest proportion of menopausal women was in “Others” (83.9%) and least in “Muslims” (70.35%).
|Table 1: Menopause by religion in rural woman of Belagavi, Karnataka, 2016-2017|
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In [Table 2], menopause by lifestyle diseases reveal OR and the distribution of the study patients in the rural woman by lifestyle diseases. The OR of menopaused women in body mass index (BMI) groups (18.5–24.9) was higher than in BMI groups (30 + and 25–29.9). OR was significantly different at P < 0.05. However, the distribution of patients in menopausal groups by BMI was not statistically different. OR in “Mild” heart discomfort was significantly higher (P<0.001), as compared to without any heart discomfort.
|Table 2: Menopause by lifestyle diseases in rural woman of Belagavi, Karnataka, 2016-2017|
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[Table 3] shows menopause status by sexual problems reveal OR and the distribution of the study patients by sexual desire, dryness of vagina, and hot flushes in the rural woman. The OR of menopaused women in “Mild” sexual desire was significantly higher (OR = 1.6; P < 0.05) as compared to with “None” sexual desire problem. The sexual desire decreased in the other two groups (moderate and severe) to 0.8. The ORs in the dryness of the vagina and hot flushes increased significantly at P < 0.05 as compared to without dryness of the vagina and hot flushes. The distribution of the patients in menopause and nonmenopausal women varied significantly by sexual desire problem (P<0.05) and with hot flushes (P<0.001).
|Table 3: Menopause by sexual problems in rural woman of Belagavi, Karnataka, 2016-2017|
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In [Table 4], menopause status by mental sickness exhibits OR and the distribution by physical and mental exhaustion, depressive mood, anxiety, sleep problem, and irritability in rural woman. The OR of menopausal women was higher in “Mild” (OR = 2.22; P < 0.05) as compared to in the absence of physical and mental exhaustion. Similarly, it was higher in “Moderate” depressive mood women (OR = 2.30; P < 0.05) as compared to none depressive mood women. The OR of menopausal was higher in “Severe” anxiety (OR = 1.84; P < 0.05), “Mild” sleep problem (OR = 2.31; P < 0.05), and in “Mild” irritability (OR = 1.86; P < 0.05) as compared to the absence of anxiety, sleep problem, and irritability groups, respectively.
|Table 4: Menopause by mental sickness in rural woman of Belagavi, Karnataka, 2016-2017|
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| Discussion|| |
Menopause symptoms in order of extent vary with the most common hot flushes, followed by night sweat, vagina dryness, and mood swings. Symptoms and their consequences of menopause provide invaluable input for health-care providers and public health personnel to enable the appropriate healthcare/health-care education. Hence, cross-sectional study comprising 712 rural women of age 40–55 years were surveyed, during October 2016–April 2017, in North Karnataka, by inverse cluster sampling with proportion to population size with an objective, to study the menopause determinants, and hence that the necessary care for menopause women is planned and arranged.
OR of menopaused women in other than “Hindus” and “Muslims” was significantly higher as compared to reference group (Hindus), whereas the similar figure was as least as 0.6 times in “Muslims,” whereas the study from West also reported significant differences by religion though they did not have similar classification.
OR of menopaused women in BMI group 18.5–24.9 was higher as compared to BMI groups of more than or equal to 25, this is note that the study population was rural, not obsessed for diet control or fast food; resulting in slimness or obesity; hence, findings are not in the line of urban populations, as the study comprising only menopause women indicate that the menopause transition was associated with changes in body fat composition.
OR of menopaused women in “Mild Sexual Desire” was highest as compared to with “No Sexual Desire” problem. Whereas the sexual desire decreased in other two groups (moderate and severe), whereas 67.5% of menopausal women were reported sexually inactive by the study from Northern part of India using clinic-based data.
ORs in dryness of vagina and hot flushes were observed significantly higher at P < 0.05 as compared to without dryness of vagina and hot flushes, with significant different distribution of the patients in menopause and nonmenopausal groups by sexual desire problem and hot flushes. Whereas 76.4% hot flushes and 42.3% vaginal dryness and decrease in sexual desire 36.2% have been reported. Similar findings with varying proportion have been reported in symptoms as vaginal dryness and fatigue symptoms.,
OR of menopausal women was the highest in “Mild” disturbed physical and mental exhaustion as compared to “None;” the similar findings have been reported by other researchers. OR in “Moderate” depressive mood was found significantly higher than “None,” the similar findings of 66.8% mood swings have been reported during menopause. Another study indicated 77.9% mood swings during menopause.
In anxiety group, the OR of menopause was significantly higher in “Severe” anxiety group, “Mild” sleep problem, and in “Mild” irritability as compared to “None” anxiety, “No sleep problem,” and “None Irritability” groups, respectively; whereas the similar results were for anxiety (50%), sleep disorder (57.1%), and irritability (67.5%).
| Conclusion|| |
The proportion of menopausal women was higher in other than Hindu and Muslim religions. BMI could not show expected impact on menopause, maybe due to the rural setup of the study. psycho-physiological changes as seen by heart discomfort, sexual desire problem, irritability, depressive mood, anxiety, hot flushes, sleep problems, physical and mental exhaustion, and dryness of vagina exhibited significantly higher in perimenopause women; hence, well planned and calibrated health education along with necessary care are recommended to pacify perimenopause women.
We would like to acknowledge the Honorable Vice Chancellor, Prof. Dr. Vivek A. Saoji, and Prof. Dr. V. D. Patil, the Registrar, KAHER, for permitting and encouraging the research. We sincerely thank Ms. Rupa V. Chougule for extending help in the preparation of the article.
Financial support and sponsorship
Conflicts of interest
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[Table 1], [Table 2], [Table 3], [Table 4]