Severity of menopausal symptoms on quality of life among working women

Abstract

BACKGROUND:

Menopause is experienced by every woman; some women attain it very early as they reach 42 years old. This happens when there is a dysfunction of follicles. The symptoms experienced by the women vary from mild to severe. The study aims to identify the severity of menopausal symptoms and their effect on the quality of life (QOL) among working women.

MATERIALS AND METHODS:

A cross-sectional research design was used for the study. A total of 93 menopausal working women were selected by using the nonprobability sampling technique. A standardized menopausal symptom rating scale and menopausal quality of life scale were used.

RESULTS:

The mean age of women employees was 49.8 with a standard deviation (SD) of 8.6, and almost half the number of subjects had completed diplomas and graduated. The majority of the women (77.7%) belonged to nuclear families. More than half of the subjects (59.6%) were having above 30,000 monthly incomes. More than three-fourths of the participants were married. Nearly half the number of subjects (46.8%) had completed diplomas, and 47.9% of working women were graduates. Nearly one-quarter of the subjects had severe menopausal symptoms, The most-reported menopausal symptoms were hot flush (57%), sweating (62%), muscle and joint problems (52%), depressive mood (45%), and irritability (51%). About 22.5% of women had a low quality of life. The study realizes that there is a positive correlation (r = 0.71, P = 0.001*) between menopausal symptoms and quality of life.

CONCLUSION:

The study justifies that menopause causes both physical and psychological problems. The stress at the workplace causes more mental disturbance and physical fatigue in working menopausal women, directly affecting their quality of life.

Introduction

Menopause is experienced by every woman; some women attain it very early as they reach 42 years old. This happens when there is a dysfunction of follicles. Menopause is the permanent stoppage of menstrual cycles without any secondary ill health. Some women attain menopause very early age termed perimenopause because of decreased production of estrogen in their bodies. It is been reported that during perimenopause there is decreased function of the ovarian follicle so by this time women experience many symptoms that range from mild to severe, during this time women will have regular periods and they can conceive.[1]

During menopausal age, menopausal symptoms, such as hot flashes, may ease for many women. However, some women continue to experience menopausal symptoms for a decade or longer after the menopause transition. When there is less estrogen in the body, women are at risk of getting health issues related to bone. Lifestyle behavior changes help to manage these symptoms and reduce the risk of worsening symptoms.[2]

The primary health issues of menopause are related to physical, physiological, emotional, social, and sexual concerns. Sometimes it is very difficult to define whether these symptoms are originally from menopause or it is related to the day-to-day life stress of women.[3] To find out the various symptoms of working women and their experiences and how those symptoms influence the quality of life (QOL) and so the investigator initiated this study.

Need for the study

During the menopausal age, women will face a lot of problems because of hormonal changes and these symptoms vary from person to person. However, the influence of this fluctuation varies from one woman to another. The main changes we could observe in this age are severe sweating, changes in menstruation, changes in bowel habits, bladder issues, sleeplessness, physical changes, emotional changes, and sexual issues. Some women will face severe health issues that need health care setup, affecting their day-to-day activities and quality of life.[4]

Many women attain menopause in their early life, which usually disturbs their day-to-day activities as they cannot cope with the signs and symptoms of menopause. About 80% of women face mild to moderate degrees of physical and physiological symptoms that they find difficult to handle. Facing these daily problems leads to less self-esteem and poor quality of life, so women will usually be worried in this situation.[5] So, the researcher found that it is necessary to identify the root cause and their quality of life during this age.

Material and Methods

Study design and setting

In this project, a descriptive cross-sectional research design was used to check the severity of menopausal symptoms, which was conducted in a NABH-accredited hospital, in Mangalore, Dakshina Kannada, India.

Study participants and sampling

A total of 93 menopausal working women were selected by using the nonprobability sampling technique. Using the formula, N = 4pq/l² where p = proportion in the population processing characteristic of interest q = (p − 1) and l = acceptable error, Taking 10% at 95% confidence interval[4] (CI) the sample size, N = 4 × 0.367 × 0.633/0.1 × 0.1 = 92.92.

Data collection tool and technique

The baseline proforma, standardized menopausal symptom rating scale and standardized menopausal quality of life scale were used. The menopausal symptom rating scale consisted of 27 items on areas such as physical, psychological, somatic, sexual, and genito urinary symptoms. Menopausal symptoms were categorized and evaluated as none, mild, moderate, severe, and very severe. The reliability of the translated menopausal rating scale was calculated using Cronbach alpha with a value of 0.98 and the menopausal quality of life scale showed a reliability of 0.92. The quality-of-life scale had 23 items in the area of vasomotor, physical, psychosocial, and sexual quality of life. Pretesting the tool was performed and the respondents found it easy to understand the items. The average time taken to complete the questionnaire was 30–45 minutes. The study proceeds further by getting permission from the concerned authority. Initially, demographic details were collected from the subjects based on the inclusion criteria through a structured interview schedule. Based on the scores, subjects were categorized as having mild, moderate, and severe symptoms. By using this standardized menopausal quality of life scale, women employees were categorized into the high, moderate, and low quality of life.

Ethical consideration

The study is registered under the institutional ethics committee (Ref. No. FMIEC/CCM/530/2020. Additionally, informed consent forms were obtained from the study subjects, and the study purpose was explained.

Statistical methods

Descriptive statistics were used to analyze the demographic variables. Karl Pearson’s formula was used to find a relation between menopausal symptoms and the effect of these impacts on quality of life that was tested at a 0.05 level of significance, the Chi-Square test was used to detect the association.

Results

The demographic variables of the subjects [Table 1] show that the mean age of women employees is 49.8 with SD 8.6; almost half the subjects had completed diplomas and graduated. The majority of the women (77.7%) belonged to nuclear families. More than half of the subjects (59.6%) were having above 30,000 monthly incomes. More than three-fourths of the participants were married, 46.8% of the women had completed diplomas, and 47.9% of working women were graduates.

Table 1.

Frequency and percentage of distribution of participants according to baseline variables n=93

Variables	Frequency	Percentage %
Age	49.8±8.6
45-50	50	54
51-55	41	44
56-60	2	2
Educational qualification
High school	4	4.3
PUC/diploma	44	46.8
Graduate	45	47.9
Type of family
Nuclear family	73	77.7
Joint Family	19	20.2
Extended family	1	1.1
Monthly income in INR
5000-10000	3	3.2
10001-20000	23	24.5
20001-30000	56	59.6
30001 and above	11	11.7
Marital status
Married	80	85.1
Unmarried	13	13.8

Assessment of menopausal symptoms

Working women were screened for the severity of menopausal symptoms, and the majority of the women [Figure 1] complained of hot flush and sweating.

Figure 1.

Most frequently identified problems

Impact of symptoms on quality of life

The impact of symptoms was identified by correlating the symptoms and quality scores and found a positive correlation between the two variables.

The most reported menopausal symptoms [Table 2] were hot flush (57%), sweating (62%), muscle and joint problems (52%), depressive mood (45%), and irritability (51%). Almost one-quarter of subjects had severe symptoms, and 32% of women had moderate symptoms [Figure 2]. In the present study, 22.5% of women had low quality [Figure 3]. The mean score of menopausal symptoms was found to be 31.07 with a standard deviation of ± 4.8 [Table 2]. There is a positive correlation between menopausal symptoms and the quality of life among women employees [Table 3].

Table 2.

Overall mean, standard deviation, and mean percentage of menopausal symptoms and quality of life among menopausal working women n=93

Variable	Range	Mean±SD	Std. Error
Menopausal Symptoms	76	31.07±4.8	2.077
Quality of life	42	71.7±11.06	1.2

Figure 2.

Explains that nearly one-quarter of the subjects had severe menopausal symptoms

Figure 3.

Quality of life of working menopausal women

Table 3.

Correlation between menopausal symptoms and quality of life among working menopausal women n=93

Variables	Mean	SD	r	P
Menopausal symptoms	31.07	4.8	0.71	0.001*
Quality of life	71.7	11.06

*=Significant

Discussion

The study shows that there is a peak prevalence in the severity of menopausal symptoms that is affecting the quality-of-life repeated disturbed symptoms in women employees were emotional and somatic problems. This usually affects the day-to-day life. The average age of attainment of symptoms was 49.8 with an SD of 8.6, Nearly half of the women had completed diplomas, and 47.9% of working women were graduates. The majority of the women (77.7%) belonged to nuclear families, whereas 20.2% of women belonged to joint families. The majority of the women (59.6%) had more than 300.00 monthly income. The majority of the women (85.1%) were married. These results are congruent with the study conducted by Singh and Pradhan in south India on menopausal symptoms and their relation to the quality of life. The usual age of attainment of menopause was 48.7 years. More than half of the women employees belonged to the age group of 50-54 years. Ninety-four percent of women were married, 54% were literate and most all the subjects were housewives.[6]

In the present study, hot flashes (57%), sweating (62%), muscle and joint problems, depressive mood (45%), and irritability (52%) were the most commonly observed symptoms among menopausal women. Most one-quarter of the subjects had severe symptoms and 32.2% of women had moderate symptoms. Similar health issues were reported by the rural women in a study conducted by Singh and Pradhan. He explains that many of the women reported that they were having sleeplessness (96.2%), half of the sample had joint pain, sweating (45.6%), urinary problems (9.9%), sexual complaints (33.7), tiredness (40.1%), and irritability (41.7). The women reported more physical and emotional symptoms, and sexual and vasomotor symptoms were less reported.[7,8]

A study conducted by Ahmed et al. revealed that 45.4% of the subjects had less physical activity that is inversely related to menopausal symptoms.[9] Another study conducted by Yisma et al. revealed similar problems faced by women during menopausal age such as hot flush (64%), sweating (63%), and emotional (77%). The study also revealed that there were fewer subjects who reported respiratory and cardiac health issues.[10] The study concluded that women are facing more health-related issues during menopause age that affects their quality of life.[8]

In the present study, 22.5% of the subjects had poor quality of life. Similar findings were observed in the study by Daly et al. on the effect of the severity of symptoms on the quality of life. More than half the number of subjects were aged 45-60 years.[11] Subjects reported getting more ratings for the poor quality of life. There was a significant difference in the quality of life when women received hormonal replacement therapy. The study concluded that sufficient care should be provided during this age when it disturbs the whole activity of the day. Necessary planning like hormonal replacement therapy had a lot of improvements in the women’s lives.[12] Another study was conducted. on menopausal symptoms and quality of life in Bangladesh. The study revealed that 67% were early menopausal women. Many reported that they face weakness and dizziness (80%) and emotional disturbance (82%).[13]

These results suggest that menopausal symptoms are experienced at an early age in women varies from mild to severe. It is necessary to recognize early and get to know the management of the women as early as possible to avoid a worsened situation.[14]

Limitations and recommendation

Non-probability sample size technique was used, so the study has a limited sample size and the investigator is unable to find the prevalence of menopausal symptoms.

Conclusion

The study justifies that menopause causes both physical and psychiatric problems. The stress in the working area causes more mental disturbance and physical fatigue in working menopausal women, directly affecting their quality of life. Lethargy and the inability to meet the demands of the working area often contribute to the deviation in quality of life. Early recognition of the problems and their management is much more important in women’s lives and should be imparted at all levels of health care.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patients have given their consent for their relevant clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.