1. health and fitness
2. women's health

Available online at http://www.bretj.com
INTERNATIONAL JOURNAL OF CURRENT LIFE SCIENCES
RESEARCH ARTICLE
ISSN: 2249- 1465
International Journal of Current Life Sciences - Vol.5, Issue, 3, pp. 506-509, March, 2015
THE FREQUENCY AND SEVERITY OF MENOPAUSAL SYMPTOMS AMONG IRANIAN
MENOPAUSAL WOMEN
Mitra Goodarzi, Sedigheh Sameti and Fariba Falsafi
Islamic Azad University Borujerd Branch, Department of Nursing.
AR TIC L E
I NF O
Article History
th
Received 5 , February, 2015
Received in revised form 17th, February, 2015
Accepted 7th, March, 2015
Published online 28th, March, 2015
Key words:
Menopause, menopausal complaints, quality of
life.
ABS TR AC T
Introduction: It is estimated that about 75% of women experience acute
symptoms after menopause. Some women have severe symptoms that profoundly
affect their personal and social functioning, and quality of life (QOL). In this
study the objective was ddetermining the frequency and severity of menopausal
symptoms in women resident of Borujerd city.
Materials & Methods: This cross-sectional study was conducted through cluster
sampling among 200 menopausal women who referred to different outpatient
clinics. The menopausal symptoms was assessed by using the modified
menopause specific quality of life questionnaire (MENQOL). Data was collected
by face to face interview with subjects.
Results: Most of the complaints were concerned with the hot flushing (95.5%)
and leg pain or cramps (95.5%). Vasomotor symptoms and psychosocial domains
were the highest (4.65 ± 1.79) and the lowest (2.65 ± 1.07) complaints
respectively.
Conclusion: Most of the complaints were concerned with the vasomotor
symptoms in subjects.
© Copy Right, IJCLS, 2015, Academic Journals. All rights reserved.
INTRODUCTION
Menopause is a biological event rising from ovary failure,
for which a diagnosis is retrospectively made after 12
consecutive months of amenorrhea that is not explainable
through pathological causes.1,2
Postmenopausal women are at risk of symptoms and
complications due to the reduction of sex steroids
especially estrogen. It is estimated that about 75% of
women experience acute symptoms after menopause.3,4
The most common symptom of menopause is hot flashes,
which have been very uncomfortable and is predicted to
continue for years.5 Atrophy of urogenital system, heart
and cerebrovascular diseases, osteoporosis, cancer and
endometrial hyperplasia, mood reactions, behavior and
sleep disorders are the major complications of menopause,
which constitute an important cause of morbidity and
mortality in this age group of women in any society.6, 7, 8,
9,10
The duration, severity, and impact of these symptoms
vary from person to person, and population to population.
Some women have severe symptoms that profoundly
affect their personal and social functioning, and quality of
life(QOL).11It is estimated that in 2030 1.2 billion women
will be peri or postmenopausal and this will increase by
4.7 millions a year.12 While the proportion of people with
60 years old age and above in Iran was 5.4% in 1975, it
will increase to 10.5% in 2025 and 21.7% in 2050.
Because the world population is aging, social scientists
consider the 21st century as the century of aging of the
world's population.9 Due to the increased longevity and
life expectancy, the quality of life (QoL) has been
considered as an important tissue.13 Quality of life (QOL)
has been defined by the World Health Organization as the
“individual’s perceptions of their position in life in the
context of the cultural and value systems in which they
live and in relation to their goals, expectations, standards
and concerns”. Various validated tools have been used to
determine the frequency and severity of menopausal
symptoms, one of these tools is the menopause-specific
quality of life questionnaire (MENQOL) proposed by
Hilditch et al.11 Unfortunately, there has been no research
on this relationship in our city. So we conducted a study to
determine the common symptoms of menopause in
women resident of Borujerd city in Lorestan province in
the west of Iran.
MATERIAL AND METHOD
Purposes
In this study the objectives was as follows: 1) The
frequency and severity of women’s menopausal symptoms
in following four domains : vasomotor, psychosocial,
physical and sexual aspects. The study was approved by
Islamic Azad University of Iran, Borujerd branch.
*Corresponding author: Mitra Goodarzi
Islamic Azad University Borujerd Branch, Department of Nursing
International Journal of Current Life Sciences - Vol.5, Issue, 3, pp. 506-509, March, 2015
Inferential statistics. The descriptive statistics were used to
Research Design and Study Subjects
calculate the mean, percentage, standard deviation, the
In this cross-sectional study 200 peri and postmenopausal
inferential statistics T - student test was used determine
women referred to various outpatient clinics in Borujerd
the severity of menopausal symptoms. Data were analyzed
city from May to August 2014 were randomly selected.
using SPSS software Version 16. A p-value less than 0.05
Natural menopausal women aged 40 to 70 who were
were considered as statistical significant for this study.
eligible and agreed to participate in study were recruited
by cluster sampling method.Women who had changes
Ethical Issues
during the menstrual cycle for at least 7 days of baseline
The study subjects provided a verbal consent. 2) The right
or changes in menstrual flow (less or more than the base
was kept for respondents to refuse study participation in
rate) for the last three months ago were categorized as
all of the research time, 3) Subject’s identification was not
premenopausal women. Women who their last menstrual
revealed, 4) The data were kept strictly confidential, 5)
period had happened at least 12 months before
Acknowledgment of each participants and all of dears who
participating in our research were classified in post
helped us in this study.
menopausal group. Also postmenopausal women were
divided into two groups: 1) early post menopause: women
RESULTS & DISCUSSION
who have experienced menopause for < 5 years. 2) late
According to Table (1) Results indicate that the mean age
post menopause:
women who have experienced
and the mean menopausal age of subjects were 47± 3.75,
menopause for ≥ 5 years. Women with mental illness and
and 56.61± 7.85 years respectively. Most people were
with a history of cardiovascular disease, musculoskeletal
married (75.5%) and the majority of women were
disease, cerebrovascular accidents, and spinal cord injuries
housewives (86%) and illiterate (49.5%).
and also with a history of hormone therapy after
menopause were excluded from the study.
Table (2) suggests common symptoms of menopause.
The most severe symptoms of vasomotor, gastrointestinal,
Instruments
musculoskeletal, skin, and genitourinary and sleep were
The data collection instrument was a questionnaire
respectively: hot flashes (95.5), flatulence (47.5%), pain
consisting two parts: 1 - questions related to demographic
or leg cramps (95.5%), decreased skin tone (86.5%),
characteristics including menopause age, education level,
urinary frequency (77%) and lack of energy (95%).
occupation, marital status, and economic status
In relation to psychosocial and sexual symptoms, the most
satisfaction. 2 - Questions related to investigation the
common symptoms were associated with reduced ability
menopausal symptoms.
to perform tasks (93%) and changes in sexual desire
In order to assess the menopausal symptoms, we used the
(75%).
standard and modified the menopause specific quality of
The findings indicate that the most common symptoms of
life questionnaire (MENQOL) proposed by Hilditch et al.
menopause were vasomotor symptoms with the highest
Subjects’ data was collected by oral interview. This
severity (4.65± 1.79) and psychosocial symptoms had the
questionnaire contained following four domains:
lowest severity (2.65± 1.07) (Table 3).
vasomotor (3 items), psychosocial (7 items), physical (19
items), and sexual (3 items). The systematic scoring for
Menopause is a physiological event that occurs in 95% of
each of the four MENQOL domains was identical. The
women between 39 to 51years. 15 The average age of
seven-point Likert scale used during the administration of
menopause (47± 3.75) in our study was similar to other
the MENQOL was transformed for scoring and data
studies in Iran and Asia. 3, 6, 7, 8
analysis. For each of the 32 items, this seven-point Likert
In our research, flushing symptom has been reported in a
scale ranged from 0 to 6. A “zero” was equivalent to a
high number (95.5 %) that is higher than numbers reported
woman responding “no”, indicating that she had not
in other investigations.9, 12, 13 Higher rates of vasomotor
experienced this symptom in the past month. Scores “one”
symptoms reported in our study can be associated with
through “six” indicated symptoms that the women
factors such as ethnic differences, dietary changes like
experienced and increasing levels of bother experienced
reducing intake of foods rich in Phytoestrogens, women’s
that corresponded to “1” through “6” check boxes on the
lack of knowledge about the food, notable number of
MENQOL. Once each item has been manipulated into a
illiterate women in the study, increased consumption of
0–6 score, each domain was scored by averaging the
western diet among Iranian families like fast food,
manipulated values. Hence, the average for each domain
increasing social deprivation due to inflation and
was constrained between 0 (not at all a problem;
decreasing financial power of families and living on the
respondent selected “no” for each item in the domain) and
psychologically stressful environment. It seems that this
6 (respondent reported experiencing each symptom in the
issue requires further investigation. It is Results are
domain at the highest degree of bother). Content validity
expressed as number and percentage; SD: standard
was used to assess the validity of questionnaire, and
deviation
Cranach's alpha was used to assess the reliability. By
using modified questionnaire, we did a pilot study on 20
Necessary to recall that interaction among genetic, social
menopausal women referring to an outpatient clinic and
and environmental factors are determinant factors of
Cronbach α approved the reliability of questionnaire
women’s experience of menopause. Musculoskeletal,
(0.85).
skin, sexual, and psychosocial MENQOL, menopauseStudy Analyses
specific quality of life questionnaire; SD, standard
deviation; score ranges from 2 to 8.
Data analysis was performed using descriptive and
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International Journal of Current Life Sciences - Vol.5, Issue, 3, pp. 506-509, March, 2015
Contrary to our findings, urinary tract symptoms in other
Table1 Sociodemographic characteristics of study
studies have not had high frequency and severity.5 In
participants.
relation to sleep-related complaints, symptom of lack of
Characteristics
N (200) %
Mean ± SD
energy in high frequency and severity (95%) was reported
Age (years)
56.61 ± 7.83
40-49
28
14
which is remarkable and is higher than other studies. 5, 15 it
50-59
97
48.5
is mentioned
60-69
75
37.5
Table 3 Score for each MENQOL domain
Menopause age
47 ± 3.75
Menopausal status
Perimenopause
Postmenopause
Postmenopause (< 5 year)
Postmenopause (≥ 5 year)
Literacy level
Illiterate
Under diploma
Diploma
Academic
Marital status
Married
Divorced
Widow
Single
Occupation
Housewife
Retired
Employed
economic status satisfaction
Complete dissatisfied
dissatisfied
satisfied
Complete satisfied
40
160
61
99
20
80
30.5
49.5
99
65
30
6
49.5
32.5
15
3
151
0
48
1
75.5
0
24
0.5
172
16
12
86
8
6
5
45
146
4
2.5
22.5
73
2
Domain Vasomotor Psychosocial
Mean ± SD
4.65 ±1.79
2.65±1.07
(n = 200)
44.3 ± 4.43
50.48 ± 3.22
Physical
Sexual
2.97±0.89 2.94±1.82
SD: standard deviation
That 40% to 48% of all of
premenopausal and
postmenopausal women have sleep disorders reports. 16,18
The research findings revealed that vasomotor symptoms
were the most common menopausal symptoms. Also
vasomotor and psychosocial symptoms had the highest
and the lowest severity respectively. In Abedzadeh et al
study (2011) in Tehran, obtained scores of vasomotor
(2.82±1.64),
psychosocial
(2.71±1.2),
physical
(2.46±0.99) and sexual domains (2.89±1.73) were lower
than our results. Also research findings of Chedraui and
Colleagues (2010) showed that in the scale MRS, scores
range of somatic, psychological and urojenital symptoms
were
respectively
(7.2±4.5),
(6.9±4.8)
and
(3.9±3.4). Symptoms
of
menopause
among
perimenopausal women were more severe in terms of
Table 2 Frequency distribution and scores of MENQOL items
Symptoms
n
Vasomotor
Hot flushes
191
Night sweats
169
Sweating
181
Psychosocial
Dissatisfaction with personal life
33
Feeling anxious or nervous
180
Experiencing poor memory
159
Accomplishing less than used to
186
Feeling depressed, down or blue
151
Impatience with other people
46
Willing to be alone
84
Physical
Flatulence (wind) or gas pains
95
Weight gain
71
Aching in muscles and joints
183
Leg pains or cramps
191
Low backache
176
Aches in back of neck or head
146
Decrease in physical strength
168
Decrease in stamina
183
Lack of energy
190
Feeling tired or worn out
183
Difficulty sleeping
162
Drying skin
95
numberical
Facial hair
23
Changes in appearance, texture or tone of skin
173
Feeling bloated
116
Frequent urination
154
Involuntary urination when laughing or coughing
86
Vaginal bleeding or spotting
9
Breast pain or tenderness
62
Sexual
Change in sexual desire
150
Vaginal dryness during intercourse
141
Avoiding intimacy
150
Symptoms among women in this study have been reported
with high frequency and moderate or severe degree. These
symptoms in several researches in Iran and other world
areas had been reported lower than our findings. 3, 5, 6, 12, 13,
14, 15, 16, 17
%
ScoreMean ± SD
95.5
84.5
90.5
5 ± 1.45
4.16 ± 2.89
4.8 ± 2.2
16.5
90
79.5
93
75.5
23
42
1.57 ± 0.6
3.7 ± 1.76
3.20 ± 2.14
4.5 ± 1.5
3.5 ± 2.3
1.87 ± 0.9
2.42 ± 1.9
47.5
35.5
93
95.5
88
73
84
91.5
95
91.5
81
47.5
a11.5
value
86.5
58
77
43
4.5
31
75
70.5
75
2.03 ± 1.98
2.12 ± 1.38
5.16 ± 2.01
5.69 ± 1.06
4.48 ± 2.1
3.53 ± 2.35
3.34 ± 1.87
4.30 ± 1.77
4.70 ± 1.61
4.02 ± 1.73
3.72 ± 2.10
2.19 ± 1.93
that
consistent
1.50 is
± 0.52
3.16 ± 1.5
2.03 ± 1.98
3.72 ± 2.53
2.46 ± 1.96
0.82 ± 0.18
1.57 ± 0.96
with the findings of
2.86 ± 2.04
2.44 ± 1.84
3.52 ± 2.41
Several studies that indicate having more severe
symptoms of menopause in premenopausal women. 6, 19, 15
Several methodological limitations should be considered
when interpreting the findings of this study. First, errors
508 | P a g e
International Journal of Current Life Sciences - Vol.5, Issue, 3, pp. 506-509, March, 2015
associated with any self-report of participants may have
Soy isoflavones, Mediterranean diet, and physical
attenuated the findings, so future prospective studies are
Diaz-Fernandez M. J., Ignacio A., JavierF B. 2010.
needed to verify our finding. Second, the low number of
Soy
isoflavones,
Mediterranean
diet,
and
perimenopausal women in study could affect on study
physicalexercise in postmenopausal women with
results and it requires further research. Third, the sample
insulin resistance. Menopause.17(2):372-378.
size was relatively small due to the nature of used study
8. Lima J. E. M., Palacios S., and Wender M. C. O.
design (cross-sectional study based on a convenience
2012. Quality of Life in Menopausal Women: A
sample).
Brazilian Portuguese Version of the Cervantes Scale.
ScientificWorld Journal. 620519.
CONCLUSIONS
9. Abedzadeh Kalarhoudi M., Taebi M., Sadat Z., and
Saberi F. 2011. Assessment of Quality of Life in
The results of our study showed that the frequency and
Menopausal Periods: A Population Study in Kashan,
severity of vasomotor symptoms were high in subjects.
Iran. Iran Red Crescent Med J. 13(11): 811–817.
Also the cultivars mentioned in relation to symptoms of
10.
Meeta, Digumarti L., Agarwal N., Vaze N., Shah R.,
pain and leg cramps, sleep disturbances, reduced ability to
Malik S. 2013.Clinical practice guidelines on
perform tasks, decrease of skin tonicity and sexual
menopause:
*An executive summary and
disorders were notable that further study about causes of
recommendations.
J Midlife Health. 4(2): 77–106.
frequency and severity of symptoms is required.
11. Heydari J., Khani S., and Shahhosseini Z. 2012.
ACKNOWLEDGMENT
Health-related quality of life of elderly living in
nursing home and homes in a district of Iran:
The authors would like to sincerely thank all persons
Implications for policy makers. Indian Journal of
helping us perform this research and wish good health and
Science and Technology. 5(5)2782-2787.
success for them.
12. Nisar N., Sohoo N.A. 2009. Frequency of
Conflict of Interests: Nil
menopausal symptoms and their impact on the
quality of life of women: a hospital based survey. J
Source of Financial Support: Islamic Azad University
Pak Med Assoc. 59(11): 752-6.
Borujerd Branch.
13. Syed Abdul Rahman S.A., Zainudin S.R., Lee K.,
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