Menopausal Symptoms and Quality of Life

The aim of this study was to assess the association between menopausal symptoms and the women’s quality of life (QOL). An exploratory descriptive study was conducted at Faculty of Nursing, university of Alexandria. Subjects of the study included all employees of the previously mentioned setting aged between 40 to 55 years old. Assessment sheet, Menopause Rating Scale and Quality of Life scale are the tools for data collection. Findings revealed that those who had no psychological symptoms reported better quality of life (X=94.50±11.475) than those who had severe psychological symptoms (X=62.64±12.549). The same results were observed with the somatic symptoms and urogenital symptoms, as the mean score of quality of life of those who had no somatic (X=88.00±11.314) or urogenital symptoms (X=83.14±12.104) was higher than who had severe somatic (X=75.31±11.026) or sever urogenital symptoms (X=68.50±12.021). In relation to the total score of menopause rating scale and the total score of quality of life, it was found that better quality of life was reported among those who had no symptoms (X=88.00±11.314) or mild symptoms (X=88.04±11.314). The results also revealed that there were statistically significant differences between the total score of quality of life and the number of living children (p<0.028), medical history of the woman (p<0.041), housing condition (p<0.001), and income (p<0.001). It can be concluded that severity of menopausal symptoms has a negative association with overall quality of life. Increased number of children, presence of health problems, not suitable housing condition, and not enough income were negatively associated with QOL. Most of the quality of life domains are adversely affected by the presence of menopausal changes. Further researches are required to assess the intervention for peri-and postmenopausal women in context of their needs and expectation.

Menopause is gaining an increasing attention because of the growing emphasis on women rights as well as the increase in the life expectancy of women resulting in an increased the number of women attaining the age of menopause.
In developing countries, postmenopausal women constitute 5% to 8% of population, while in Egypt, the density of older females, 50 years or more, is 11.6%. (2)ch woman reacts somewhat differently to the changes in menopausal endocrine function.These reactions are unpredictable and depend -to some extent -on a woman's emotional history, support system within the family, and the fact that the menopausal reproductive-endocrine system may be quite labile during this interval, which may last as long as 10 years . (7,8)lture perspectives also influence  ,3,5) The aim of this study is to assess the association between menopausal symptoms and the women's quality of life.

Study Setting
An exploratory descriptive study conducted at Faculty of Nursing, University of Alexandria.

Subjects
All employees of the previously  (12,13) This scale has been found to have a good reliability and validity . (14,15)The scale is

II. Methods
Official permission to conduct the study was obtained from the responsible authorities.Informed consent to participate in the study was obtained from the subjects.A pilot study was carried out on a sample of 10 subjects who were selected randomly from the previously mentioned setting.
Each subject enrolled at the previous setting was individually interviewed using the previously mentioned tools.Time consumed for each interview ranged from 30 to 45 minutes.The collected data were categorized, tabulated, and made ready for analysis.

Statistical analysis
Statistical analysis was performed using SPSS versaion 11.5 for Windows.
The aim of the present study was to assess the association of menopausal symptoms and the women's quality of life.

RESULTS
The results of the present study suggested that the presence of menopausal symptoms and its degree of severity may have affected adversely the study subjects quality of life (Table 2).
This agrees with Daly et al ., (16) who concluded that QOL was severely compromised by the presence of menopausal symptoms, indicating that the effects of these symptoms might have been underestimated.This may be explained by the fact that well being in general is related to self rated health status, symptoms, stress, vasomotor symptoms, and attitude toward aging and menopause. (16)However, these findings do not agree with O'Dea et al ., (18) and Ledesert et al., (19) who did not find that menopause status was related to the overall well-being.
The findings of the current study summarized that increased number of children, presence of health problems, not suitable housing condition, and not enough income were negatively associated with QOL, (Table 3).These 2. Maternity nursing curricula must entail the concept of quality of life.
3. Increase the awareness of premenopausal women about menopausal changes should be promoted.

Mass media reinforces messages
given by health personnel to women around menopause.
5. Misconceptions about the changes associated with menopause need to be addressed and corrected.8. Health professionals as a group need to be aware of the possible negative impact of the menopausal symptoms on the women's quality of life feeling down, sad, on the verge of tear, lack of drive, and mood swings); irritability (feeling nervous, inner tension, feeling aggressive); anxiety (inner restlessness, and feeling panickly)find their lives significantly disrupted by these symptoms.( 4-6 ) women's responses to menopause as the childbearing years and women face developmental transition and enter a new phase of life.In cultures that value youth and reproductive capacity, menopause signifies loss of socially valued status, which may contribute to depressive symptoms.In culture where older women have heightened social status, as among Native Americans, menopause is not associated with negative reactions.On the other hand, some women view the menopause as a medical problems requiring medical treatment, others, see it as a natural transition to be managed by natural means .(1,2)Themenopause period may have a negative impact on the quality of life of woman.The concept of the quality of life (QOL) has evolved considerably over the last decades yet there is no single, universally accepted definition of quality of life .(9)Tertar(10) et al., conceptualize it as a multifaceted construct that encompasses the individual behavioral and cognitive capabilities, emotional wellbeing and abilities requiring the performance of domestic, vocational and social role.Avis(7) et al., and Revicki et al.,   (11)  refer to the quality of life as a broad range of human experiences related to one's overall well-being.The maternity nurse has an important role in helping women to cope with the symptoms of menopause.
history of the subjects, health history of the children, and health history of the husband.
results are in line with Avis et al .,(7)who concluded that some of the factors associated with subjective well being or QOL in general population included state of health and stress, while other researches has shown that income and health status are not related to QOL. agreed with Futh et al .,(20)who found a marked impairment in QOL domain surveyed in their study.This could be explained by the fact that most of women view menopause as a medical condition requiring medical treatment which adversely affect these domains.Furthermore, lack of knowledge about menopause which may reflect a negative attitude toward menopause which in-turn adversely affects the quality of live.CONCLUSION Based on the findings of the present study, it can be concluded that severity of menopausal symptoms has a negative impact on overall quality of life.Increased number of children, presence of health problems, not suitable housing condition, and not enough income were negatively associated with QOL.Most of the quality of life domains are adversely affected by the presence of menopausal changes.

Others live in the same house
[