Menopausal Symptoms Among Post Menopausal Women Aged 40-60 Years Residing in an Urban Area Of Belagavi – A Community Based Cross-Sectional Study

Abstract

According to the WHO (1981), natural menopause is defined as no menses for 12 consecutive months with no obvious intervening cause. During the menopause, women may experience vasomotor, psychosomatic, 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 due to increased life expectancy. As many women are choosing to avoid hormonal treatment it is increasingly important to identify other evidence-based interventions with one possible treatment option being physical activity. Objective: The objectives of this study were to know the prevalence of menopausal symptoms in post-menopausal women aged 40-60 years and to study the association of physical activity with menopausal symptoms. Methodology: A community based cross-sectional study was done between 1 st January 2016 to 31 December 2016 using predesigned, pretested, structured questionnaire based on sociodemographic variables, obstetrics and gynaecology history, menopausal symptoms (Menopause specific quality of life) and physical activity (International Physical Activity Questionnaire). 345 post-menopausal 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. vi | P a g e st Outcome: Abstract The primary outcomes of this study were menopausal symptoms in post-menopausal women and their association according to different variables (socio-demographic and obstetrics & gynaecology). Secondary outcome was association between physical activity variables with the menopausal symptoms. Data analysis: Data collected in the questionnaire was coded and entered in Microsoft Excel sheet. Values were expressed in the form of percentages, mean and standard deviation. Chi- square test, Analysis of Variance, Pearson’s Correlation and Multiple linear regression analysis (unadjusted and adjusted) were used to determine association and relationship between different variables. Tables and Graphs were prepared. Statistical significance was set at p ≤ .05 Results: In this study, the mean age at menopause among study participants was 52.04 ± 5.58 years. Majority 200 (58%) were Hindus, while 266 (77.1%) were literates. 201 (58.2%) belonged to SES classes IV and III combined. As per the Asian Standards of BMI, majority 190 (55.1%) women were overweight or obese. The mean age at menopause among 345 study participants residing in the urban area of Belagavi, Karnataka was 45.53 ± 4.34 years. More than half of the participants had duration of less than 5 years since final menstrual period with the mean duration since menopause among study participants being 6.51 ± 5.06 years. 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% vii | P a g e Abstract - 55.4%) and least common sexual domain (42.3% - 36.2%). Domain wise mean score was 3.74 ± 2.42, 3.55 ± 1.37, 3.19 ± 1.15, 2.16 ± 1.37 for Vasomotor, Psychosocial, Physical and Sexual domains respectively. Overall mean MENQOL score was 3.16 ± 1.25. All menopausal symptoms of all domains were seen most commonly in less than five years duration since menopause. Most common symptoms in less than five years of age were vasomotor, while in later years after menopause most common symptoms were psychosocial and physical. Conclusion: Higher mean MENQOL score was found to be significantly associated with participants of lesser age, schedule tribe, labourers, mixed diet, obese, divorced or separated, delayed menarche, age at marriage more than 30 years, higher age at first pregnancy, delayed menopause, relatives with delayed menopause, higher parity, scanty discharge and abnormal lower abdominal pain. Duration of less than 5 years since final menstrual period had highest severity in all domains and total MENQOL score. Significant association was found between domain scores and level of physical activity. Both low and high physical activity were associated with more severe menopausal symptoms in respective domain score and overall mean score when compared to moderate physical activity level