Menopause is a natural biological event that marks the end of a woman's reproductive years. This transitional phase is characterized by a decline in ovarian function, leading to the cessation of menstruation and a series of hormonal changes. During menopause, women commonly experience a diverse range of symptoms, which can significantly impact their physical, emotional and psychological well-being. These postmenopausal symptoms include but are not limited to hot flashes, night sweats, vaginal dryness, mood swings and sleep disturbances [1,2].

The state of Himachal Pradesh, located in northern India, is home to a growing population of women who have either reached or are approaching menopause. However, the awareness and knowledge regarding postmenopausal symptoms and appropriate care among women in this region remain relatively understudied.

Given the importance of addressing women's health needs during and after menopause, understanding the familiarity with postmenopausal symptoms and care becomes essential for devising effective healthcare interventions. Improving women's knowledge about managing these symptoms can lead to enhanced quality of life and well-being during their postmenopausal years [3,4].

The present research aims to fill this knowledge gap by investigating the level of familiarity with postmenopausal symptoms and care among women attending the outpatient department of Civil Hospital Theog, Himachal Pradesh. Through a comprehensive cross-sectional survey, we seek to identify the extent of women's awareness of menopause-related symptoms and explore their understanding of self-care practices and available medical interventions.

By shedding light on the current state of knowledge and awareness, this study can inform healthcare providers and policymakers in Himachal Pradesh to design targeted and culturally appropriate interventions for better menopausal healthcare support. Ultimately, the findings are expected to contribute to improved healthcare outcomes and overall well-being for menopausal women in the region.

Objectives of the Study

To evaluate the awareness and understanding of postmenopausal symptoms and care among women attending the outpatient department of Civil Hospital Theog.

• Research Approach: Descriptive

• Research Design: Hospital based cross-sectional survey design

• Setting of the study: OPD in Civil hospital Theog, Himachal Pradesh

• Study duration: Between March 2023- June 2023

• Study population: Women aged above 18 years came to OPD 

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

• Sampling Technique: Convenience Sampling technique

• Sampling criteria: First five female patients who came to OPD were selected everyday till the completion of sample size after explaining the purpose of the study. Informed consent was taken from them and confidentiality of the selected participants was also maintained 

• Inclusive Criteria: Female patients who were willing to participate in the study

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

   

Description of Tool

• Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education, family’s monthly income etc

• Questionnaire: The questionnaire contains 20 structured knowledge related questions. 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

• Data collection by under the guidance of supervisors and patients were given 30 minutes time to complete that questionnaire and collected at the end of the prescribed time

• Data analysis with Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage

The goal of the current study was to assess the awareness regarding the risk factors associated with postmenopausal symptoms and care among women attending outpatient department of Civil hospital Theog, Himachal Pradesh.

A total of 400 respondents including 161 (40.25%) were from urban area and 239(59.75%) were from rural area were participated in the study (Table 1).

In the present study 26.75% (107) participants had very good knowledge (16-20 marks) towards postmenopausal symptoms and care, 38% (152) had good knowledge (12-15 marks), 20.75% (83) had fair knowledge (8-11 marks) and 14.5%(58) having poor knowledge (<8 marks) (Figure 1).

Table 1: Knowledge Regarding Postmenopausal Symptoms and Care

Figure 1: Knowledge Score Regarding Postmenopausal Symptoms and Care

The present study aimed to assess the familiarity with postmenopausal symptoms and care among women attending the outpatient department of Civil Hospital Theog, Himachal Pradesh. The findings reveal valuable insights into the level of knowledge and awareness regarding menopause-related issues among women in this region.

The results indicate that a significant proportion of participants 71.75% were able to correctly define menopause and its typical age range of onset. Similarly, a considerable number of respondents 66.25% were aware of common physical symptoms experienced during menopause. However, the level of understanding regarding the significance of hormone fluctuations during menopause 31.25% and the differentiation between perimenopause and postmenopause 33.5% was relatively lower.

Regarding menopausal symptoms and their management, approximately half of the participants were aware of specific lifestyle changes 47.25% and dietary recommendations 50.5% that can alleviate menopausal symptoms. Moreover, a significant number of women knew about managing common menopausal symptoms such as hot flashes and night sweats 47.25% and recognized the importance of pelvic floor exercises 46.75% in managing certain symptoms.

On the other hand, the knowledge about the role of estrogen in postmenopausal health and the risks associated with hormone replacement therapy was relatively limited 33.5%. Similarly, awareness of the potential effects of menopause on cardiovascular health and preventive measures was found to be modest 39%. Although a substantial proportion of participants were familiar with natural remedies or herbal supplements that may help with menopausal symptoms 60.25%, there was still room for improvement in this area.

One noteworthy finding is that a significant number of women recognized the potential effects of menopause on sexual health and intimacy 57.75%. This highlights the importance of addressing this sensitive aspect of menopause during healthcare interventions.

When comparing our results with other studies, it is evident that the level of familiarity with postmenopausal symptoms and care in this region is similar to, or in some cases, slightly higher than findings from other parts of India [3,4]. However, it is crucial to note that some studies conducted in more urbanized areas have reported higher levels of awareness and knowledge [5,6]. This discrepancy may be attributed to variations in educational levels, access to healthcare resources and cultural factors.

While the overall knowledge level in our study was moderate, there were specific areas where women demonstrated relatively higher awareness. Participants showed better understanding of menopause and its typical age range of onset, common physical symptoms experienced during menopause and the potential effects of menopause on sexual health and intimacy. These findings indicate that women may have access to some information regarding menopausal symptoms, possibly through informal sources or prior healthcare interactions.

However, certain areas of knowledge showed room for improvement. For example, participants exhibited limited understanding of the significance of hormone fluctuations during menopause, the role of estrogen in postmenopausal health and the potential risks associated with hormone replacement therapy. These findings highlight the need for targeted education on the hormonal aspects of menopause and the available treatment options to ensure informed decision-making.

Furthermore, the study identified gaps in knowledge regarding lifestyle changes, dietary recommendations and self-management strategies for common menopausal symptoms. This emphasizes the importance of providing comprehensive information to women, including guidance on maintaining bone health, managing cardiovascular health and addressing vaginal dryness and discomfort. Additionally, promoting awareness about the importance of regular health screenings and the potential effects of smoking and alcohol consumption on menopausal health is crucial.

The findings from this study contribute to the existing literature on menopausal knowledge in India. They underscore the need for multifaceted interventions that address the specific knowledge gaps identified. Educational programs, both within healthcare facilities and through community outreach, can play a significant role in empowering women with accurate and comprehensive information about menopause, its symptoms and the available care options.

Limitations

Limitations of this study include the use of a convenience sampling technique, which may limit the generalizability of the findings. Additionally, self-reported knowledge may be subject to recall bias or social desirability bias. Future research should consider employing a larger sample size and a more representative sampling technique to enhance the external validity of the findings.

In conclusion, this study highlights the importance of assessing and improving the familiarity with postmenopausal symptoms and care among women in Himachal Pradesh. The findings underscore the need for targeted educational interventions to enhance women's knowledge and understanding of menopause. By addressing the identified knowledge gaps, healthcare providers and policymakers can effectively support women during this transitional phase, ultimately improving their quality of life and overall well-being.

1. Santoro, N. et al. "Menopausal symptoms and their management." Endocrinology and Metabolism Clinics of North America, vol. 44, no. 3, 2015, pp. 497-515.

2. Woods, N.F. and E.S. Mitchell. "Symptoms during the perimenopause: Prevalence, severity, trajectory and significance in women's lives." The American Journal of Medicine, vol. 118, no. 12, 2005, pp. 14-24.

3. Sharma, S. et al. "A study of knowledge, attitudes and symptoms of menopause among women in a rural community of north India." Journal of Mid-Life Health, vol. 9, no. 3, 2018, pp. 148-153.

4. Avis, N.E. et al. "The impact of menopause on quality of life." Menopause, vol. 23, no. 4, 2016, pp. 359-361.

5. Abreu, L.C. et al. "Knowledge and attitudes of women regarding menopause: A population study." Revista Brasileira de Ginecologia e Obstetrícia, vol. 41, no. 1, 2019, pp. 35-41.

6. Panthi, B. et al. "Knowledge, attitude and practices on menopause among women attending outpatient departments of a teaching hospital in Kathmandu, Nepal." BMC Women's Health, vol. 20, no. 1, 2020, pp. 1-7.