Every woman will eventually experience menopause at some point in her life. Women all over the world now have to spend almost 1/3rd of their lives in menopausal years. As a result, menopause is currently a problem for maintaining and enhancing women's health [1-2].

Menopause is a combination of two Greek words, meno (monthly), and pause (stop), it means the stopping of the menstruation and the ending of fertility Technically it is the permanent cessation of menses. By convention the diagnosis of menopause is not made until the individual has had 12 months of amenorrhoea. Menopause is not just the cessation of menstruation, it is the ‘depletion of ovarian follicles’ leading to decrease in ovarian hormones [3-5].

Menopause occurs during a crucial time in a woman's life when there is a lot of social transition and it also coincides with the "Empty Nest Syndrome," in which women find themselves alone after their children leave the house and experience an increased frequency of psychosomatic symptoms [1,6,7]. Knowledge regarding the menopause may differ from one female population to another. These differences have been related to female age, parity, socio economic, cultural, educational, and geographical factors [8,9]. A number of studies have done in different parts of the India on menopausal knowledge among females but such studies are limited in hilly state of Himachal Pradesh having different type of customs and cultural pattern. The study was an attempt to identify the level of knowledge about menopause and occurrences of problems related to menopause so that a more culturally focused, relevant, education plan as a health promotion intervention can be taken up.

Objectives of the Study

To evaluate the knowledge regarding Menopausal Phenomenon among menopausal women in a hilly state of Himachal Pradesh.

• Research Approach -Descriptive

• Research Design-Cross-sectional survey design 

• Study area: Hilly state of Himachal Pradesh

• Study duration- between October 2021 to December 2021

• Study population- Menopausal women as specified by the definition who has had amenorrhoea of 12 months or more

• Sample size- 400 Menopausal women assuming 50% have adequate knowledge regarding Menopausal phenomenon, 5% absolute error, 95% confidence level, and 5% non-response rate

• Sampling Technique- convenience & snowball Sampling technique

• Study tool: A google form questionnaire consisting of questions regarding socio-demography and Menopausal phenomenon was created. The questionnaire was initially pre-tested on a small number of menopausal women to identify any difficulty in understanding by the respondents

   

Description of Tool:

• Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more

• Questionnaire: The questionnaire contains 20 structured Menopausal phenomenon’s knowledge related questions having three options (yes, no, don’t know). The participants have to choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80% (16-20) =very good,60-79% (12-15) =Good,41-59% (8-11) =Fair, <40% (< 8) = poor

• Validity of tool - by the experts in this field

• Inclusive Criteria- who were willing to participate in the study

• Exclusion Criteria: who were not willing to participate in the study

• Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like WhatsApp groups, Facebook, Instagram and LinkedIn in both rural and urban area of Himachal Pradesh till the 400 responses were collected. Responses were then recorded in a Google Excel spreadsheet

• Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage.

• Ethical Considerations- Participants confidentiality and anonymity were maintained

Present study was done to evaluate the knowledge regarding Menopausal Phenomenon among menopausal women in a hilly state of Himachal Pradesh. A total of 400 respondents including 150(37.5%) were from urban area and 250(62.5%) were from rural area were participated in the study. Among the participants of the majority 240(60.0%) were between 51-60 years, 165(41.25%) were Middle pass, 366 (91.5%) were employee, 380(95.0%) were married and 383 (95.75%) were Hindu (Table 1).

Table-1: Socio-demographic characteristics of study participants

In the present study 16(4%) Menopausal women had very good knowledge (16-20 marks) towards Menopausal phenomenon, 156(39%) had good knowledge (12-15 marks), 192(48%) having fair knowledge (8-11 marks) and 36(9%) having poor knowledge (<8 marks) (Table 2).

Table 2: Responses of the Participants to Various Statements on Menopausal Phenomenon

With the increase in life expectancy women are spending a larger share of their lives in menopausal period. Therefore, they should be armed with knowledge about Menopausal Phenomenon keeping in mind quality of life issues. In the present study 16(4%) Menopausal women had very good knowledge (16-20 marks) towards Menopausal phenomenon, 156(39%) had good knowledge (12-15 marks), 192(48%) having fair knowledge (8-11 marks) and 36(9%) having poor knowledge (<8 marks).

Table 3: Knowledge towards Menopausal Phenomenonamong Menopausal

Maximum =20 Minimum=7

In the study conducted by Varuna Pathak et al¹, 70.56% of the menopausal women had average score of KAP followed by 18.18% who had good score, 10.91% had poor score and only 0.35% had scored excellent 32.72% of menopausal women had knowledge of menopausal symptoms. In their study, 39.09%, 52.72% and 22.72% knew that menopause increases risk of cardiovascular, osteoporosis and breast cancer respectively. 16.36% believe that post-menopausal bleeding is abnormal. 58.18% think that indulging in recreational activities and physical exercises are beneficial practices.

Similarly in the study conducted [10], 54.5% related it correctly as stoppage of menses, 40% opined it as a part of aging and 5.5% had no idea about what menopause is while. 84.2% did not have any knowledge about reason behind menopause, 15.8% had knowledge of why menopause occurs out of which 12.1% opined it as aging and 3.6% as turning point /god’s decision.

Another study conducted [3], 45% study population had knowledge about the age of the menopause, while as only 20.8% were aware about the symptoms of menopause [11]. showed that the average knowledge score of subjects was 63.57 ± 10.79. In their study, 8% of the subjects had poor knowledge, 68% had moderate knowledge and 38.5% had good knowledge.

This showed that majority of menopausal women had inadequate knowledge regarding Menopausal phenomenon. Education is a tool that cannot be ignored, and health education plays an important role in increasing knowledge regarding Menopausal Phenomenon among the menopausal population. The awareness towards menopause should be increased by IEC (information, education, and counseling), through various platforms especially the mass media so they have right and proper information about this neglected health issue and help these women to live their postmenopausal years healthier and more active.

Government could concentrate on providing health services to women in post reproductive age group by incorporating national health programs for the health needs of postmenopausal women like screening for early pickup of aging morbidities and malignancies and also enhancing quality of life

1. Pathak, V. et al. “Study to assess knowledge, attitude and practice regarding menopause among menopausal women attending outdoor in tertiary care centre.” International Journal of Reproduction, Contraception, Obstetrics and Gynecology, vol. 6, 2017, pp. 1848–53.

2. Yasmin, N. et al. “Intervention approach to the menopausal women in rural bangladesh.” Bangladesh Medical Journal, vol. 38, no. 1, 2009, pp. 9–14.

3. Ismail, H. et al. “Knowledge and perception of postmenopausal women towards menopause.” International Journal of Research in Medical Sciences, vol. 8, 2020, pp. 3920–23.

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5. Malik, H.S. “Knowledge and attitude towards menopause and hrt among post-menopausal women.” Journal of the Pakistan Medical Association, vol. 58, no. 4, 2008, pp. 164–67.

6. Loutfy, F. et al. “Women’s perception and experience of menopause: a community-based study in Alexandria, Egypt.” Eastern Mediterranean Health Journal, vol. 12, suppl. 2, 2006, pp. 593–606.

7. Thomas, S.E. “Menopause knowledge and attitudes of english speaking caribbean women: Implications for health education.” Californian Journal of Health Promotion, vol. 33, 2005, pp. 167–76.

8. Ferguson, K. et al. “Estrogen replacement therapy: A survey of women’s knowledge and attitudes.” Archives of Internal Medicine, vol. 149, 1989, pp. 133–36.

9. Avis, N.E, and S.M. McKinlay. “A longitudinal analysis of women’s attitudes toward the menopause: results from the massachusetts women’s health study.” Maturitas, vol. 13, 1991, pp. 65–79.

10. More, S. et al. “Knowledge, attitude and experiences of menopause in the postmenopausal women at a tertiary care center: A cross-sectional study.” International Journal of Reproduction, Contraception, Obstetrics and Gynecology, vol. 7, 2018, pp. 4758–61.

11. Noroozi, E. et al. “Knowledge and attitude toward menopause phenomenon among women aged 40–45 years.” Journal of Education and Health Promotion, vol. 2, 2013, pp. 25.