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Table of Contents
STUDENT SECTION
Year : 2022  |  Volume : 23  |  Issue : 1  |  Page : 102-105

Menopausal symptoms and coping strategies among menopausal women in selected hospital at Mangaluru


1 Post Basic B.Sc Nursing Student, Father Muller College of Nursing, Kankanady, India
2 Assistant Professor, Department of Obstetrics and Gynaecological Nursing, Father Muller College of Nursing, Kankanady, Mangaluru, Karnataka, India

Date of Submission07-Jun-2021
Date of Decision16-May-2022
Date of Acceptance19-May-2022
Date of Web Publication05-Jul-2022

Correspondence Address:
Reena Wilma Frank
Father Muller Charitable Institutions, Kankanady, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijcn.ijcn_43_21

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  Abstract 


Menopause is one of the most significant events in a woman's life and brings several physiological changes that permanently affect women's lives. In India, menopause is considered a normal phenomenon. Women themselves may not seek medical help for their problems associated with ageing. Therefore, the present study was conducted to determine middle-aged women's commonly reported menopausal symptoms and coping strategies. A descriptive survey design was used, and 100 menopausal women aged 45–60 years were selected and interviewed to assess the menopausal symptoms and coping strategies followed to overcome the same. The results showed that 63% of the subjects had moderate symptoms and 30% had severe menopausal symptoms; these were assessed through the menopausal rating scale. The coping strategies show that 54% of women use a cooler environment to face the hot flash and sweating, 55% of women sit in a comfortable place to relieve their heart discomfort, 47% of women have milk in the night to manage the sleeping problems, 60% women use hot water to relieve Joint and muscular discomfort. Hence, there is a need for improvement of menopausal health status and application of various coping methods, including the establishment of social networks, is warranted to enhance menopausal women's behaviours in different aspects.

Keywords: Coping strategies, menopausal women, menopause


How to cite this article:
Sophia C M, Marngar J, Mol S, D'Souza V, Frank RW. Menopausal symptoms and coping strategies among menopausal women in selected hospital at Mangaluru. Indian J Cont Nsg Edn 2022;23:102-5

How to cite this URL:
Sophia C M, Marngar J, Mol S, D'Souza V, Frank RW. Menopausal symptoms and coping strategies among menopausal women in selected hospital at Mangaluru. Indian J Cont Nsg Edn [serial online] 2022 [cited 2022 Aug 20];23:102-5. Available from: https://www.ijcne.org/text.asp?2022/23/1/102/349818




  Introduction Top


In human life span development, the menopausal phase signifies the normal ageing process that subjects women to move from reproductive to non-reproductive. The menopausal process may extend for a variable period before and after the physiological cessation of menstruation and last many years after that, subjecting women to a complex bio-physiological and psychosocial change.[1] In the general population, the proportion of menopausal women has significantly increased due to an increase in life expectancy. The Population Projections Survey in India reveals that the number of women aged 45 years and above is expected to reach 401 million in 2026 from 96 million at present.[2] The word menopause simply refers to the permanent end of menstruation. Menopause has been considered a significant transition point in women's reproductive and emotional life. Menopause is not a disease but a natural transition in a women's life that results from a decrease in the ovarian production of sex hormones such as oestrogen, progesterone and testosterone. By loss of reproductive potential and transition into later life, she may become a victim of physical and psychological problems.

Physical complaints in order of frequency are as follows: hot flashes, night sweats or chills, disrupted sleep, vaginal dryness, loss of libido, loss of energy, mood swings, increased irritability, loss of skin tone and urinary leakage. Psychological complaints include loss of confidence, depressed mood, irritability, forgetfulness, difficulties concentrating, panic attacks and anxiety.[3],[4] The symptoms of depression and menopause are similar. Some of the menopausal symptoms experienced by these women can be severe enough to affect their normal daily activities. Unfortunately, most of these women are not aware of the changes brought about by menopause.[5],[6],[7],[8],[9] These symptoms are from the depletion of oestrogen levels as women approach the menopausal stage. The common symptoms experienced by them can be grouped as vasomotor, physical, psychological or sexual complaints. Postmenopausal women adopt various coping strategies. Out of them, active physical exercise, awareness of diet and weight with creative activities were helpful during menopause.[10] Unfortunately though the only times most women in India visit the doctor for health-related issues are during pregnancy or when things have gotten out of hand. Indian women themselves may not seek medical help for problems associated with aging; they are hesitant to talk about gynaecological symptoms and suffer in silence. In this context, the present study examines menopausal symptoms by the Menopausal Rating Scale (MRS) and explores the status of coping strategies adopted for relieving menopausal symptoms.

Objectives of the study

  • To assess the menopausal symptoms and coping strategies of menopausal women
  • To find the association between the menopausal symptoms and selected baseline variables.



  Methodology Top


A non-experimental descriptive survey design was adopted for the present study to assess the menopausal symptoms and coping strategies among menopausal women. Following institutional ethical committee approval, the study was conducted in the gynaecological ward admitted patient's attendees, Obstetrics & Gynaecology (OBG) Outpatient department, and the employees who are of menopausal age 45–60 years working at Father Muller Medical College Hospital, Mangaluru. The sample size was calculated based on the previous studies and that is 94 menopausal women, so a total of 100 were selected using the purposive sampling technique. The women who had not had a menstrual period for the past 12 months and knew to read and write Kannada were selected for the study.

Instrument and data collection

Tool I: Baseline pro forma

The baseline pro forma consisted of seven items to obtain information regarding age in years, education, marital status, number of children, age at menarche, age at menopause and menopause information.

Tool II: Menopausal rating scale

A symptom of menopause was assessed using a standardized MRS developed by Heinemann et al., in 2004, which has 11 items and three categories such as psychological, somatic and urogenital symptoms. After assessing the symptoms further classified as no or negligible, mild, moderate and severe symptoms based on the standardised scale. Reliability and validity of the scale were found to be good across the globe and it was 0.09.[11]

Tool III: Coping strategies adopted by menopausal women

The coping strategies adopted by menopausal women were assessed through the interview method. The checklist was prepared and validated by the experts in gynaecology, which consists of 11 items categorized by three domains: self-copying, medication, and alternatives.

The coping strategies tool was validated by seven experts, two OBG doctors and five nursing professionals for its content. The tool reliability obtained was 0.9.

Data collection procedure

Formal permission was obtained from the hospital administrators after getting ethical clearance from the Institutional Review Committee (FMIEC/CCM/153/2020). Those who meet the inclusion criteria were selected purposively for the study. Selected 100 women were interviewed in Kannada and Malayalam languages after obtaining their consent. Face-to-face interviews were conducted. Interviewers were made sure the participants gave the correct answer whenever there was a doubt or unclear about the questions asked. Menopausal symptoms were assessed using a MRS and were then asked what measures they took to cope with the symptoms by giving the coping strategies checklist. Data were analysed using descriptive statistics such as frequency, percentage and Chi square test using IBM SPSS statistics 23.


  Results Top


Among the women who participated in the study, 45% of the menopausal women belonged to 51–55 years and the mean age is 51.47 ± 4.11 years. 35% of women had secondary level and 32% had obtained primary level education. 20% were illiterate. Among menopausal women, 95% of them were married. The majority (83%) of the menopausal women completed the cessation of menstruation at the age of 41–50 years. The age of the menarche was 14–16 years for 60% and 11–13 for 40% of the women.

[Table 1] shows that, in somatic symptoms, 49% of women reported severe joint and muscular discomfort. In psychological symptoms, 30% of women had moderate physical and mental exhaustion and under urogenital symptoms, 32% of women had a moderate bladder problem.
Table 1: Distribution of menopausal symptoms among women (n=100)

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[Figure 1] reveals that among menopausal women, 30.75% had severe somatic symptoms; 29.75% had moderate psychological symptoms and 47.7% had mild urogenital symptoms.
Figure 1: Cumulative scores of menopausal rating scale

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Concerned with the coping, 54% of women use a cooler environment to face the hot flash and sweating, 55% of women sit in a comfortable place to relieve their heart discomfort, 47% of women have milk at the night to manage their sleeping problems, 60% women use hot water to relieve joint and muscular pain. The majority of women (82%) do not have any problem related to dryness of the vagina. Fifty per cent of women talk to friends when they are depressed, 56% cry to relax to relieve their anxiety and 52% use physical and mental fatigue to facilitate eating energising food. Sharing with friends when anxious (37%) and praying when irritable (27%), were also shared as coping strategies.

The data in [Table 2] show that there is a significant association between menopausal symptoms and baseline variables such as education P < 0.03 and marital status P < 0.03; hence, the research hypothesis is accepted for selected baseline variables.
Table 2: Association between menopausal symptoms and selected baseline variables

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  Discussion Top


The mean age of the women in this study was 51.47 ± 4.11 years, the mean age at menarche was 13.80 ± 1.25 years, and the mean age at menopause was 45.75 ± 3.53 years according to their baseline characteristics. In the subjects' education status, the subjects 35% belonged to the secondary education group, which is the highest score. Based on the number of children, 35% had two children. These findings were congruent with Agarwal et al.'s study on women's menopausal symptoms and coping strategies. Results show that the mean age of the women was 50.38 ± 6.30 and the mean menopausal age was 49.8 ± 4.9 years.[12]

The present study shows that 49% of women reported severe joint and muscular discomfort. In psychological symptoms, 30% of women had moderate physical and mental exhaustion and under urogenital symptoms, 32% of women had a moderate bladder problem. A similar study assesses menopausal symptoms and coping strategies among middle-aged women of North-Central India. Results showed that 70.6% of them had joint and muscular discomfort, 61.3% had physical and mental exhaustion and 38.6% had a hot flush and sweating.[12]

The coping strategies show that 54% of women use a calmer/cooler environment to face the hot flash and sweating, 55% of women sit in a comfortable place to relieve their heart discomfort, 47% of women have milk at the night to manage their sleeping problems, 60% women use hot water to relieve joint and muscular pain. These findings were similar to another study done by SalihaOzpinar and KivanCevik on women's menopause-related complaints and coping strategies. Results show that 79.1% of the women were using a cooler environment to relieve from hot flush, 43.5% of them had milk before going to bed to induce sleep and 55.6% had paid attention to diet to alleviate joint and muscle disorders.[13]

The association between the menopausal symptoms and selected baseline variables among menopausal women in the present study shows a significant association between menopausal symptoms and baseline variables such as education and marital status P < 0.03. A similar study was conducted by SalihaOzpinar and KivanCevik, on women's menopausal menopause-related complaints and coping strategies. Results showed in socio-demographic characteristics of the participants' age P < 0.05, education P < 0.05, marital status P < 0.05 and knowledge about menopause P < 0.05.[13] Another study was conducted by Agarwal et al., to assess menopausal symptoms and coping strategies among middle-aged women of North-Central India, the results show that menopausal symptoms are having a significant association with somatic symptoms P < 0.001, psychological symptoms P < 0.002 and urogenital P < 0.019.[12]


  Conclusion Top


Menopause is the most common gynaecological problem among the middle-aged group. Therefore, it is necessary to conduct extensive research in this field, using various settings and populations. Research can be done to find out more coping strategies among menopausal women. It will help reduce menopausal symptoms and may improve the physical and psychological health of menopausal women.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Doubova SV, Espinosa-Alarcón P, Flores-Hernández S, Infante C, Pérez-Cuevas R. Integrative health care model for climacteric stage women: Design of the intervention. BMC Womens Health 2011;11:6.  Back to cited text no. 1
    
2.
Population Projections for India and States 2001-2026. Office of the Registrar General and Census Commissioner. New Delhi, India: Government of India; 2006. Available from: http://statehealthsocietybihar.org/survey_reports/Population_Projection_Report_2006.pdf. [Last accessed on 2017 Nov 25].  Back to cited text no. 2
    
3.
Borker SA, Venugopalan PP, Bhat SN. Study of menopausal symptoms, and perceptions about menopause among women at a rural community in Kerala. J Midlife Health 2013;4:182-7.  Back to cited text no. 3
    
4.
Chung-Park M. Anxiety attacks following surgical menopause. Nurse Pract 2006;31:44-9.  Back to cited text no. 4
    
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Nutan P, Mahadeo S. Psychological problems and coping strategies adopted by post-menopausal women. Int J Sci Res 2014;3:293-300.  Back to cited text no. 5
    
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Williams RE, Levine KB, Kalilani L, Lewis J, Clark RV. Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas 2009;62:153-9.  Back to cited text no. 6
    
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Lu J, Liu J, Eden J. The experience of menopausal symptoms by Arabic women in Sydney. Climacteric 2007;10:72-9.  Back to cited text no. 7
    
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Peeyananjarassri K, Cheewadhanaraks S, Hubbard M, Zoa Manga R, Manocha R, Eden J. Menopausal symptoms in a hospital-based sample of women in southern Thailand. Climacteric 2006;9:23-9.  Back to cited text no. 8
    
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Chedraui P, Blümel JE, Baron G, Belzares E, Bencosme A, Calle A, et al. Impaired quality of life among middle aged women: A multicentre Latin American study. Maturitas 2008;61:323-9.  Back to cited text no. 9
    
10.
Shukla R, Ganjiwale J, Patel R. Prevalence of postmenopausal symptoms, its effect on quality of life and coping in rural couple. J Midlife Health 2018;9:14-20.  Back to cited text no. 10
    
11.
Heinemann K, Ruebig A, Potthoff P, Schneider HP, Strelow F, Heinemann LA, et al. The Menopause Rating Scale (MRS) scale: A methodological review. Health Qual Life Outcomes 2004;2:45.  Back to cited text no. 11
    
12.
Agarwal AK, Kiron N, Gupta R, Sengar A, Gupta P. A study of assessment menopausal symptoms and coping strategies among middle-aged women. Int J Med Public Health 2018;5:4470-7.  Back to cited text no. 12
    
13.
Ozpinar S, Cevik K. Women's menopause-related complaints and coping strategies. Int J Nurs 2016;3:69-78.  Back to cited text no. 13
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]



 

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