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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 36  |  Issue : 3  |  Page : 437-441

Knowledge and perception of postmenopausal symptoms among postmenopausal women presented at the gynecological clinic of a tertiary health institution in Abakaliki


1 Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, South-East, Nigeria
2 Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki; Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, South-East, Nigeria
3 Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, South-East, Nigeria

Date of Submission12-Jun-2019
Date of Decision07-Aug-2019
Date of Acceptance07-Nov-2019
Date of Web Publication22-Jan-2020

Correspondence Address:
Dr. J I Nwafor
Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/TJOG.TJOG_61_19

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  Abstract 


Introduction: As life expectancy increases, most women spend a larger part of their lives in the postmenopausal state. This period is associated with other medical comorbidities which affect the quality of life. Knowledge and perception of postmenopausal symptoms could help them cope with such a situation.
Aim: To determine the knowledge and perception of postmenopausal symptoms among postmenopausal women presented to the gynecological clinic of Alex Ekwueme Federal University Teaching Hospital, Abakaliki.
Materials and Methods: This was a cross-sectional study carried out at the Gynecological clinic of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Around 408 women were administered structured questionnaires. The information obtained was analyzed using SPSS version 20.
Results: Majority (50%) of the respondents were 50–54 years age group and the least (6.9%) were 55–59 years. The commonest menopausal symptom reported was hot flushes by 300 (73.5%) respondents. Tiredness and vaginal dryness were reported by 188 (46.1%) and 180 (44.1%) respondents, respectively. The knowledge of hormone replacement therapy was low (7.8%). The study showed that 356 (87.3%) women have no knowledge of hormone replacement therapy.
Conclusion: There is a need for educating women in the clinics regarding menopause and hormone replacement therapy which would further enable women to make informed choices about their health postmenopause.

Keywords: Gynecological clinic; knowledge, perception; postmenopause symptoms.


How to cite this article:
Ibo C C, Ajah L O, Nwafor J I, Ekwuazi K E, Okoro O S, Obi C N, Mamah J E. Knowledge and perception of postmenopausal symptoms among postmenopausal women presented at the gynecological clinic of a tertiary health institution in Abakaliki. Trop J Obstet Gynaecol 2019;36:437-41

How to cite this URL:
Ibo C C, Ajah L O, Nwafor J I, Ekwuazi K E, Okoro O S, Obi C N, Mamah J E. Knowledge and perception of postmenopausal symptoms among postmenopausal women presented at the gynecological clinic of a tertiary health institution in Abakaliki. Trop J Obstet Gynaecol [serial online] 2019 [cited 2020 Feb 23];36:437-41. Available from: http://www.tjogonline.com/text.asp?2019/36/3/437/276447




  Introduction Top


The term “menopause” means the final menstrual period. It is derived from the Greek word “menos” (month) plus “pausos” (ending) and represents a watershed in the reproductive life of a woman.[1] It is a transitional developmental period in a woman's life.[2] Menopause is said to have occurred after 12 consecutive months of amenorrhea.[1]

It is an inevitable milestone in the reproductive life of every woman.[3] The mean age at menopause in British women is approximately 52 years.[4] In a study conducted by Ozumba et al. in Enugu Nigeria, the mean age was 47.3 ± 5 years.[5] Moreover, in Nigeria, Okonofua reported the mean age of 48.4 years among women of Yoruba descent and Ande reported the mean age at menopause of 49.8 ± 2.6 years in Benin city.[6],[7] This was similar to a study done by Mustafa and Sabir in Iraq which showed 47.4 ± 4.3 years.[8],[9]

Menopausal symptoms include; mood changes, bloating, aches and pains, headaches, hot flushes, night sweats, tiredness, insomnia, weight gain, depression, irritability, forgetfulness, lack of concentration, urinary frequency, vaginal dryness, and sexual problems. These symptoms vary in severity and character from person to person.[10]

Hormonal changes at menopause are associated with numerous physical and psychological symptoms such as vasomotor symptoms, sleep disturbance, mood alterations, depression, urinary tract infection, vaginal atrophy, and increased health risks for several chronic disorders including osteoporosis, cardiovascular diseases, and loss of cognitive function.[11],[12] These symptoms were found to be less common in societies where menopause is viewed as positive rather than negative events.[13]

Unlike menstruation or conception, menopause has not been a major topic of discussion among the public, very little information has been circulated to increase their knowledge on the subject.[14] Menopause receives very little attention especially in Africa because most women feel it is a phase that every woman must go through.[15]

Because of the steady increase in life expectancy, many women now live well into their 80s and beyond.[6] Women can now expect to live over a third of their life after the menopause and consequently over the last 40 years or so, there has been an increasing interest in the effect of the menopause on long-life health.[16]

A lack of knowledge of menopause causes a wrong or negative perception towards it.[17] This, in turn, leads to a negative attitude towards menopause. On the other hand, if the knowledge about menopause is adequate among women, there would be the correct or right perception which can lead to a positive attitude towards it. There is a need for documentation of concerns and issues specific to types, patterns of postmenopausal symptoms, and lifestyles among postmenopausal women that presented to Gynecological clinic in Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA). This study evaluates the knowledge and perception of postmenopausal symptoms by postmenopausal women presented to gynecological clinical at AEFUTHA for better understanding of their reproductive issues and needs.


  Materials and Methods Top


Study area

This study was carried out at the Gynecological clinic of Alex Ekwueme Federal University Teaching Hospital Abakaliki. The hospital, formerly known as Federal Teaching Hospital, Abakaliki, is in the centre of the state capital. It receives a referral from neighboring states of Benue, Enugu, Cross-River, and Abia.

Study design

This was a cross-sectional study undertaken between January 15, 2018, to December 14, 2018. The study participants were postmenopausal women aged 50 and above attending the outpatient department in the hospital. Women who were postmenopausal and gave consent to participate in the study were included. Participants who declined consent to enroll were excluded from the study.

Sample size calculation

A sample size of 422 was calculated using Daniel's formula [18] of n = Z 2 P(1-P)/d 2 and prevalence of menopausal symptoms by Nigerian women (64.5%) was reported by Adewuyi and Akinade.[11] Z = 1.96 d = 0.05 and attrition rate of 20%.

Data collection and analysis

Data were collected using a semi-structured questionnaire. The questionnaire comprised three sections; section A contained questions on sociodemographic characteristics of participants, section B contained questions on knowledge and perception of menopausal symptoms, and section C contained questions on hormone replacement therapy.

Each of the questionnaires was coded before entering the data into the computer and analyzed using IBM SPSS Statistics for Windows, version 20.0 (Armonk, New York, IBM Corp, USA). Descriptive statistics were presented in frequency, percentages and mean/standard deviations where necessary.

Ethical approval

Ethical approval was obtained from the ethics committee of the hospital before embarking on this study.


  Results Top


Of the 422 questionnaires administered, 408 (96.7%) were correctly filled, returned and analyzed.

[Table 1] shows the sociodemographic characteristics of the respondents. The majority (50%) of the respondents were 50–54 years and the least (6.9%) were 55–59 years age group. Majority of the women were para 5 and above (60.8%). A total of 328 (80.4%) of the respondents were married while 19.6% were widows. Three hundred (73.5%) respondents resided in the urban area and 62.7% had secondary school level of education.
Table 1: Sociodemographic characteristics of the respondents

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[Table 2] shows the knowledge of the respondents concerning menopause and postmenopausal symptoms. About 272 (64.7%) respondents said that they have heard of menopause. In addition, regarding the definition of menopause 200 (49%) of the respondents answered inability to conceive while 148 (36.3%) responded it was the absence of menses for more than 1 year, 56 (13.7%) responded its painful, and 4 (1.0%) alluded to the fact that they did not know. Most (98%) of the respondents said they know some of the signs and symptoms. The commonest menopausal symptom reported was hot flushes by 300 (73.5%) of the respondents. Tiredness and vaginal dryness were 188 (46.1%) and 180 (44.1%) respondents, respectively. Urinary frequency and dyspareunia were reported by 172 (42.2%) and 80 (19.6%) respondents, respectively. It should be noted that the respondents could choose multiple symptoms they felt. Nearly 16 (3.9%) thought it was a disease while 184 (45.1%) thought it was life-altering. Moreover, 228 (55.9%) believed it did not make someone fat. Most of the respondents, about 348 (85.3%) believed that it is important for health professionals to educate the public on menopause and that it would have an impact on the management of its symptoms.
Table 2: Awareness and perception of menopausal symptoms among respondents

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[Table 3] shows that 356 (87.3%) of the women did not know what hormone replacement therapy (HRT) is, while 32 (7.8%) knew the meaning of HRT, and 20 (4.9%) responded that it is a drug that causes menopause. About 32 respondents (7.8%) believed it is used in well-selected patients to treat postmenopausal symptoms, 20 (4.9%) believed that it causes cancer while 26 (6.4%) responded that it prevents osteoporosis.
Table 3: Knowledge of hormone replacement therapy (HRT)

Click here to view



  Discussion Top


Menopause and its symptoms have continued to be relegated to the background in the health policies of most institutions in sub-Saharan Africa.[19] One of the reasons for this is the failure of affected women in society to complain. Another reason is that some are not empowered to seek knowledge and access to available health facilities.[20]

This study reveals the knowledge and perception of perimenopausal and postmenopausal women concerning menopause and its symptoms as well as about HRT at the Gynecological clinic of AEFUTHA.

Most of the respondents (50%) were between the ages of 50–54 years. This was similar to a study in Jos among primary school teachers wherein the highest age was between 51–55 years.[21] The 64% respondents who have heard of the word menopause in this study was similar to the study by Ande et al. (66%)[19] but differed from a Chinese report that showed more people had in-depth knowledge of menopause (99.2%).[22],[23],[24] Most (62.7%) of the respondents did not know the meaning of menopause, while 49% of them said it was the inability to conceive, 13.7% said it was painful menstruation. These show the need for more enlightenment.

Concerning the postmenopausal symptoms, hot flushes which are vasomotor symptoms were reported by 300 (73.5%) respondents. This is within the range of 20 to 80% found in western countries as reported by Nelson.[25] Kahansim et al. in Jos reported low backache (76.1%) and muscle pain (74.5%) as the commonest while hot flushes were the third with 51.1%.[21] Tiredness and vaginal dryness were second and third most reported in this study but were fourth and seventh in the study at Jos.[21] These symptoms were associated with the decreased estrogen production that arises in relation to menopause.[21]

Most of the respondents (86.3%) viewed menopause as a normal process of ageing. This contrasted with the study by Kahansim et al. among primary school teachers in Jos were 99.1% saw it as a physiological process.[21] This could be due to the difference in the level of education between the two groups of respondents. A total of 45.1% reported that it was life-altering. This contrasts with a study by Ozumba et al. in Enugu where 70% felt that it was frustration.[4] Around 95% of women believed that having the knowledge of menopause can help them manage the symptoms better which was in accordance with the study reported by Shakila et al. in Sri Lanka.[26]

Hormone replacement therapy (HRT) has been one of the most broadly prescribed medications in recent centuries to relieve menopausal symptoms and has demonstrated long-term joint protection as well as slowing of cardiovascular and neurological deterioration.[27],[28] Nearly 7.8% awareness regarding HRT observed in this study was similar to 7.3% and 8% reported in Benin city and Jos, respectively but differed from 12.9% reported in Pakistan.[3],[19],[26]


  Conclusion Top


In conclusion, the knowledge and perception of menopause among women attending Gynecological clinic at AEFUTHA, is above average and positive, however, that regarding HRT is low. There is a need for education of women in the clinic on menopause and HRT which would enable women to make informed choices about their health during this period.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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