Background: A cross sectional comparative study was conducted in a well populated city named Rawalpindi, which is located in the Northern part of Pakistan. Objectives: This study was aimed to document the comparison of menopausal-related symptoms among educated and non educated women of Rawalpindi, Pakistan. Methods: MRS was used to measure the intensity of menopausal symptoms. 100 educated and 100 uneducated women were selected for study purpose. Pakistan Institute of Medical Sciences, Military Hospital and Combined Military Hospital were selected as a study setting. Findings: Correlation & Fisher exact test was applied for statistical analysis. The intensity of symptoms reported by Educated women as: sleeping problems (93.0%); heart discomfort (80.0%); hot flushes and sweating (70.0%); joint and muscular pain (52.0); depressive mood (63.0%); irritability (42%); anxiety (60.0%). physical and mental exhaustion; (48.0%); sexual problem (61.0%); dryness of vagina (57.0%); and bladder problem (65.0%). The severity of symptoms in uneducated women; sleeping problems (77.0%); heart discomfort (73.0%); hot flushes (69.0%); joint and muscular pain (66.0); depressive mood (71.0%); irritability (58%); anxiety (80.0%). physical and mental exhaustion (70.0%); sexual problem (66.0%); dryness of vagina (70.0%); and bladder problem (83.0%). Conclusions: Somatic symptoms were high in educated women as compare to uneducated women while the prevalence of psychological and Urogenital symptoms were high in uneducated women as compare to educated women.
The phase of womanhood starts from menarche [
Menopause may happen as natural menopause [
Descriptive, cross sectional survey was conducted at Rawalpindi and Islamabad Pakistan. Pakistan institute of Medical sciences (PIMS), Combined Military Hospital and Military Hospital was selected as the study setting. 200 women age 45 to 55 years attending Obstetrics and Gynaecology outpatient & inpatient department were interviewed. Informed consent was taken. The predesigned questionnaire was used to collect the information regarding socio demographic data; Menopausal Rating Scale (MRS) was used.
All the data was analyzed by utilizing Statistical Package for Social Sciences (SPSS) 19.0 version.
Menopause Rating Scale (MRS) which is designed to assess menopause specific health related quantity of life (QoL) to measure the severity of symptoms. The MRS is composed of 11 items and was divided into three subscales: a) somatic-hot flushes, heart discomfort/palpitation, sleeping problems and muscle and joint problems; b) psychological-depressive mood, irritability, anxiety and physical and mental fatigue and c) urogenital-sexual problems, bladder problems and dryness of the vagina. Each of the eleven symptoms limited a scoring scale from 0 - 4 [
Two hundred menopausal women were approached for the selection of participants in the study of which 100 were educated and 100 were uneducated, Results were analyzed through SPSS 19 version and found that the age of women ranged from 45 to 55years and mean age was 50.1. In this study n = 102 (52.0%) were from the age group of 45 - 50 years. n = 98 (48.0%) were from the age group of 50 - 55 years.
Chi square test were used to compare categorical and continuous data, respectively. The items of the MRS are also presented as frequencies (present or not). A p value of < 0.05 was considered as statistically significant. Total score as well as per each subscale of the MRS significantly increased in relation to education. Women with lower educational level presented higher Urogenital and psychological scorings in comparison to educated women. Educated women were having higher scoring of somatic symptoms than uneducated women. There were no other correlations in terms of scores and other socio-demographic data.
According to the results, the correlation between somatic and education is 0.158* which shows a significant association. It means that the education has an impact on somatic symptoms according to the significant at the 0.05 level. Psychological and education shows a strong significance on each other i.e. 0.679**. It means that they have shows an impact on each other at 0.01 level. Psychological and somatic symptoms have also a strong association i.e. 0.316**. And the significant level of Urogenital is 0.347** according to the significant at the
. Marital status of participants
Frequencies | Percentages | |
---|---|---|
Married | 193 | 95.5% |
Widows | 7 | 3.5% |
Total | 200 | 200 |
. Scio-demographic varriables
Education status | Demographic data | Percentages |
---|---|---|
Married | 95.5% | |
Widows | 3.5% | |
Illiterate | 26.0% | |
Madrassa | 21.5% | |
Primary | 2.5% | |
Metric | 11.0% | |
F.A/FSc | 23.0% | |
B.A/BSc | 12.5% | |
M.A/MSc | 4.0% | |
Employment status | House wives | 30.0% |
Self employed | 19.5% | |
Govt& private Jobs | 50.5% | |
Monthly income | <5000 | 20.0% |
5 - 1000 | 31.5% | |
More than 10,000 | 43.0% | |
Don’t know | 5.5% |
N = 200.
Statistical analysis of educated and non educated women
Statistical analysis of educated and non educated women
Items | Symptoms | Educated | Non educated |
---|---|---|---|
●Somatic | 76% | 69% | |
1 | Hot flushes | 78% | 69% |
2 | Heart discomfort | 80% | 73% |
3 | Sleeping problems | 93% | 77% |
11 | Joint and muscular pain | 52% | 66% |
●Psychological | 53% | 70% | |
4 | Depressive mood | 63% | 71% |
5 | Irritability | 42% | 58% |
6 | Anxiety | 60% | 80% |
7 | Physical & mental exhaustion | 48% | 70% |
●Urogenital | 61% | 73% | |
8 | Sexual problems | 61% | 66% |
9 | Bladder problems | 65% | 83% |
10 | Dry vagina | 57% | 70% |
The Overall difference among educated and non educated women
The Overall difference among educated and non educated women
Correlation | ||||
---|---|---|---|---|
Education | Somatic | Psychological | Urogenital | |
Education | 1 | |||
Somatic | 0.158* | 1 | ||
Psychological | 0.679** | 0.316** | 1 | |
Urogenital | 0.347** | 0.258** | 0.410** | 1 |
N = 200, *Correlation is significant at the 0.05 level (1-tailed), **Correlation is significant at the 0.01 level (2-tailed).
0.01 level. It shows a positive strong significant on education. On the other hand the correlation between Urogenital and somatic symptoms are 0.258** which is highly significant which shows that the Urogenital has a strong significant impact on somatic, and also Urogenital and psychological symptoms are also shows a strong significant association i.e. 0.410** at 0.01 level.
Menopause is a serious public health problem in developing countries and is associated with age, education, sexuality, depression and sexual problems. Recent studies also provide strong evidence that menopausal symptoms are associated with somatic, psychological and sexual problems [
In present study the most prevalent symptoms reported by Educated women include, sleeping problems (93.0%); heart discomfort (80.0%); hot flushes and sweating (70.0%); joint and muscular pain (52.0); depressive mood (63.0%); irritability (42%); anxiety (60.0%). physical and mental exhaustion; (48.0%); sexual problem (61.0%); dryness of vagina (57.0%); and bladder problem (65.0%). The most prevalent symptoms reported by uneducated women, sleeping problems (77.0%); heart discomfort (73.0%); hot flushes and sweating (69.0%); joint and muscular pain (66.0); depressive mood (71.0%); irritability (58%); anxiety (80.0%); physical and mental exhaustion (70.0%); sexual problem (66.0%. (70.0%); and bladder problem (83.0%).
Symptoms reported from different regions of Pakistan were also different. In our study frequency of menopausal symptoms varied from 21.08% to 75.66% commonest symptom reported were Backache, Body ache and Insomnia 653 (75.66%), 576 (66.74%) and 544 (63.4%) respectively. Similar symptoms were reported in another study from Hyderabad Sindh [
Another study conducted by Zöllner YF In Germany (2005) on menopausal symptoms; the most prevalent symptoms reported were joint and muscular discomfort (80.1%); physical and mental exhaustion (67.1%); and sleeping problems (52.2%). Followed by symptoms of hot flushes and sweating (41.6%); irritability (37.9%); dryness of vagina (37.9%); anxiety (36.5%); depressive mood (32.6%). Other complaints noted were sexual problem (30.9%); bladder problem (13.8%) and heart discomfort (18.3%). this difference is existed due to cultural & environmental variations among these two countries.
A cross-sectional study Conducted in 2007on Malaysian women the reported symptoms were: joint and muscular discomfort (80.1%), physical and mental exhaustion (67.1%) and sleeping problems (52.2%). This was followed by symptoms of hot flushes and sweating (41.6%), irritability (37.9%), dryness of vagina (37.9%), anxiety (36.5%), depressive mood (32.6%), sexual problem (30.9%), bladder problems (13.8%) and heart discomfort/palpitation (18.3%). This study is also congruent to present study.
The prevalence of menopausal symptoms found in this study that intensity of somatic symptoms were high in educated women as compare to uneducated women while the prevalence of psychological and Urogenital sym- ptoms were high in uneducated women as compare to educated women.
The authors would like to acknowledge the partial support of the University of Health Sciences Research Committee for this study; and would like to thank Ms. Yasmeen Saggu my supervisor & Ms. Mansoor Ghani Coordinator University of Health Sciences. I also great thankful to Ms. Waqaslatif and Miss Anum Afandi for continue support regarding statistical analysis.
There were number of limitations in this study:
· The use of convenience sampling limits to Rawalpindi and the results can not be generalized to other parts of the country.
· Limited sample size was not enough to validate the finding.
· Limited time of the study is a big limitation.
· Budgetary constraint.
This study has some important implications in nursing practice and nursing education. The findings of this study provide information that may help and guide nurses and other health care professionals about the individualized need and psychological support of menopausal women.