Attitudes of Bahraini women towards the menopause: implications for health care policy

Women's knowledge and attitudes to the menopause: a comparison of women over 40 who were in the perimenopause, post menopause and those not in the peri or post menopause

OBJECTIVES

To evaluate women's knowledge and attitudes towards the menopause by comparing three groups of women: perimenopause, post menopause and those women not in either the peri or post menopause (other).

METHODS

A 35 question online survey was advertised on social media to evaluate women's attitudes and knowledge of the menopause. Three groups of women were compared: perimenopause, post menopause and those women not in either the peri or post menopause (other).

RESULTS

Most women were completely uninformed or only had some knowledge of the menopause before the age of 40. Most women thought that the menopause should be taught at school, but over 80% had received no menopause education at school themselves. The most popular sources of menopause information were independent websites and friends. Perimenopausal women were significantly more likely than postmenopausal women to use online resources for menopause information. The perimenopausal and postmenopausal groups had more positive attitudes towards the menopause than the other group. 57.5% of postmenopausal women found the menopause difficult or very difficult. Most women were happy about no longer menstruating, although some expressed sadness regarding fertility loss.

CONCLUSIONS

Most women had limited knowledge and negative attitudes towards the menopause, leaving them unprepared to cope with the physical and psychological changes associated with this stage of life. Improved menopause education is required to improve quality of life during the menopausal transition and a most positive narrative of life postmenopause.

Attitudes toward Menopause in HIV-Infected Cambodian Women

(1) Background: Attitudes toward menopause are believed to play a potential role in the experience of menopause, including its perceived severity. However, the studies available on the perspectives of women living with human immunodeficiency virus (HIV) on menopause in Cambodia are very limited. This study aimed to evaluate the attitudes toward menopause of Cambodian women living with HIV. (2) Methods: A cross-sectional study was conducted among 189 women using a questionnaire titled Attitude toward Menopause Scale and socio-demographics. (3) Results: The study analysis showed that the participants had slightly negative attitudes toward menopause with the mean attitude score of 86.81 ± 10.79 (Range 35–140). Postmenopausal women displayed more positive attitudes than premenopausal women. Older age, higher education, and a non-drinking habit were independently associated with a positive attitude toward menopause. (4) Conclusions: The results suggest the need for a multidisciplinary team of health care experts that would address the special needs of this population marked by the menopausal transition.

Knowledge and attitudes associated with menopause among women aged 45 to 60 years: a pilot study among rural and urban women in Bangladesh

OBJECTIVE

To assess knowledge and attitudes associated with the menopause transition among women in Bangladesh.

METHODS

A cross-sectional survey was conducted among women (age range 45-60 y), 160 participants were selected from both urban and rural settings using a systematic sampling procedure. We used face-to-face interview techniques employing a semistructured questionnaire. Bivariate and multivariate regression analyses were done to assess the associated factors.

RESULTS

Around one-fourth (23%) of the participants did not have a basic understanding about symptoms of menopause. Knowledge about menopause increased proportionately with higher education levels (primary education, risk ratio [RR] = 3.91, 95% confidence interval [CI] = 0.66-22.92; secondary education, RR = 6.10, 95% CI = 1.26-29.41; higher education, RR = 6.74, 95% CI = 1.33-34) and was more common among urban than rural women (P = 0.001). In addition, women who were service holders had greater knowledge about menopause compared with women who worked in the home (RR = 8.67, 95% CI = 1.94-38.58). Most of the women (96%) suffered from different kinds of depression during the menopause transition. Key barriers to gaining knowledge about menopause included access to information (63%), social stigma (57%), and shame (52%).

CONCLUSIONS

Menopause is a neglected issue in Bangladesh. Accurate and appropriate information regarding premenopause and menopause can help women cope with this life transition. Social and familial support may also play a role in minimizing isolation and depression. Public health messaging to increase awareness and knowledge about menopause should be undertaken to overcome the stigma and shame associated with menopause in Bangladesh. : Video Summary:http://links.lww.com/MENO/A556.

Emirati Women's Knowledge about the Menopause and Menopausal Hormone Therapy

The aim of this study was to investigate the knowledge of Emirati women aged 30-64 about menopause, menopausal hormone therapy (MHT), and their associated health risks, and additionally, to determine the relationships between Emirati women's knowledge about menopause and their sociodemographic and reproductive characteristics. A community-based cross-sectional study was conducted of 497 Emirati women visiting five primary healthcare centers in Dubai. Data were collected using a questionnaire composed of sociodemographic and reproductive characteristics, menopause knowledge scale (MKS), and menopause symptoms knowledge and MHT practice. The mean menopause symptoms knowledge percentage was 41%, with a standard deviation of 21%. There were significant differences in the mean knowledge percentage among categories of education level (p < 0.001) and employment (p = 0.003). No significant differences in the knowledge percentages were found among categories of menopausal status. "Pregnancy cannot occur after menopause" was the statement with the highest knowledge percentage (83.3%), while the lowest knowledge percentages were "risk of cardiovascular diseases increases with menopause'' (23.1%), "MHT increases risk of breast cancer'' (22.1%), and "MHT decreases risk of colon cancer'' (13.9%). The knowledge of Emirati women about menopause, MHT, and related heart diseases was very low; therefore, an education campaign about menopause and MHT risks is needed to improve their knowledge for better coping with the symptoms.

Spouses' perceptions of and attitudes toward female menopause: a mixed-methods systematic review

Objective: Menopausal women experience physical and psychological discomfort, which may be affected by their spouses' perceptions of and attitudes toward menopause. The purpose of this review is to summarize men's perceptions of and attitudes toward female menopause in different cultural contexts.Method: A sequential integrated design method was used in this mixed-methods systematic review. PubMed, Web of Science, PsycINFO, Cochrane, Embase, China National Knowledge Infrastructure, and the Wanfang database were searched. Studies on spousal perceptions of and attitudes toward female menopause were included in the analysis.Results: A total of 12 articles met the inclusion criteria. Men have little knowledge of menopause and health-care status. Men have different attitudes toward wives' changes during menopause. A large proportion of them cannot cope with these changes, possibly due to poor knowledge about menopause; aging and disease; psychological changes; religious and other internal factors; and external factors, including family life, work stress, and wives' menopausal symptoms. In addition, spouses' perceptions of and attitudes toward menopause may affect women's menopausal symptoms, attitudes toward menopause, and marriage relationships.Conclusion: Although there was little evidence, it seems that male spouses' perceptions of and attitudes toward female menopause are important factors affecting menopausal women's quality of life.

Emirati women's attitudes towards menopause: Implications for health care policy

Objectives

To investigate the attitudes of Emirati women aged 30–64 years towards menopause and determine the relationships between these attitudes and their sociodemographic and reproductive characteristics.

Study design

A community-based cross-sectional study was conducted with 497 Emirati women attending five primary health care centres in Dubai using a multistage stratified and clustered random sampling technique. Emirati women were interviewed face-to-face via a structured questionnaire with two parts: sociodemographic and reproductive characteristics and the attitudes towards menopause scale.

Results

The mean ± S.D. of age was 42.06 years ± 8.716 (median 40 years). Mean age at menopause for the study sample (N = 436) was 49.94 years ± 4.593 (median 50 years). Of the respondents, 36.6% had completed high school, and 41.4% had graduated from university. Approximately, 70.8% of the women were premenopausal, 13.1% were perimenopausal and 16.1% were postmenopausal. Sixty-four percent of the respondents had never used oral contraceptive pills, while 32.9% were past users; 44.6% were employed outside the home. Mean average attitudes score ± S.D. was 2.42 ± 0.26 (minimum score of 1 indicates very negative attitudes, maximum score of 4 indicates very positive attitudes). Statistically significant differences in mean average attitudes score were noted for employment and menopausal status, and mean average attitudes score was positively correlated with age. Premenopausal women held more positive attitudes towards menopause than peri- and postmenopausal women.

Conclusions

Emirati women displayed neutral to positive attitudes towards menopause and premenopausal women exhibited more negative attitudes towards menopause than postmenopausal women.

The effectiveness of a group-based educational program on the self-efficacy and self-acceptance of menopausal women: A randomized controlled trial

This study aimed to assess the effectiveness of a group-based educational training on the self-efficacy and self-acceptance of Iranian menopausal women using the PRECEDE-PROCEED model. This Randomized Controlled Trial (RCT) was conducted on 80 menopausal women in the age range of 47-55 years residing in the northeast of Iran. The participants were divided randomly into a test group (n = 40) and a control group (n = 40). We found that designing and implementation of a group-based educational training according to the PRECEDE-PROCEED model can significantly enhance the knowledge and performance of the test group with regard to self-efficacy and self-acceptance.

Factors associated with different symptom domains among postmenopausal Saudi women in Riyadh, Saudi Arabia

OBJECTIVE

To determine factors associated with different symptom domains among postmenopausal Saudi women in Riyadh, Saudi Arabia.

METHODS

In a cross-sectional study, interviews were conducted with 542 postmenopausal Saudi women, comprising sociodemographic history, social support, and the Menopause-specific Quality of Life questionnaire.

RESULTS

The mean age of participants was 58 (±7.0) years, and the mean age at menopause was 49 (±4.7) years. We found that 41% (n = 224), 14.4% (n = 78), 57% (n = 307), and 12.7% (n = 69) of women reported severe/moderate impact of vasomotor, psychosocial, physical, and sexual symptoms, respectively. Multivariate logistic regression revealed that lacking emotional support was associated with severe/moderate vasomotor (adjusted odds ratio [aOR] 1.5, 95% confidence interval [CI] 1.1, 2.3), psychosocial (aOR 2.0, 95% CI 1.2, 3.4), and physical (aOR 1.7, 95% CI 1.2, 2.6) symptoms. Lack of tangible social support was associated with severe/moderate sexual symptoms (aOR 1.9, 95% CI 1.0, 3.4). In addition, women who worked (aOR 1.8, 95% CI 1.1, 3.2), were obese (aOR 2.0, 95% CI 1.0, 4.1), lived in rented accommodations (aOR 3.9, 95% CI 1.2, 13.1), or had a retired spouse (aOR 1.6, 95% CI 1.0, 2.4) had higher odds for moderate/severe menopausal symptoms.

CONCLUSIONS

Establishing educational and counseling programs for postmenopausal women, their spouses, and other family members could improve social support and hence quality of life of postmenopausal women. Effective preventive strategies to deal with modifiable risk factors, such as obesity and work stress, should also be implemented.

Attitudes toward menopause among middle-aged women in Semnan, Iran

BACKGROUND AND OBJECTIVE

The menopause marks a major biological transition in the lives of all women. Understanding the attitude of women about menopause facilitates the implementation of public health policies that focus on improving women's health. This study was designed to determine the attitude of a group of Iranian women toward menopause with respect to sociodemographic variables and menopausal status.

MATERIALS AND METHODS

A cross-sectional study was conducted at Primary Health Centers of Semnan during 2012. A total of 747 women aged 45-60 years were interviewed. Sociodemographic characteristics and attitude toward menopause were collected through a structured pretested questionnaire. The attitude scale consisted of 17 questions, each rated on a five-point Likert scale with a total score of 85 points.

RESULTS

The mean (±SD) age of women was 51.3 (±4.5) years. Women were classified as premenopausal (38.4%), perimenopausal (16.9%), and postmenopausal (44.8%). The majority of respondents (63.5%) were illiterate or have had low level of education (<9 years), and 86.3% were unemployed. The mean (±SD) attitude score was 53.3 (±6.8). Most of the women (71%) had neutral attitude, 22.8% had positive, and only 6.3% had negative attitude toward menopause. Menopausal status, educational level, marital status, place of residency, and employment were not associated with women's attitude.

CONCLUSION

In general, women's attitude toward menopause ranged from neutral to positive. The attitude did not differ significantly on the basis of menopausal status, educational level, marital status, place of residency, and employment.

Is menopausal status related to women's attitudes toward menopause and aging?

The objective of this study was to explore the relationship between menopausal status and attitudes toward menopause and aging. We identified 1,400 Bengali Hindu women aged 40-55 years (early perimenopausal n = 445; late perimenopausal n = 240; early postmenopausal n = 285; late postmenopausal n = 430) from West Bengal, India. Information on attitudes toward menopause and aging was collected from March 2009 to July 2012 using ten agree/disagree statements, of which three were positive, four were negative, and the rest were neutral. We used only the positive and negative statements in the analyses. The participants were given three response options for each statement: (1) agreed, (2) disagreed, and (3) felt neutral. Agreement with positive statements and disagreement with negative statements were scored as 3. The converse responses were scored as 1. Neutral responses were not scored. Thus, the total attitude score for each participant ranged from 7 to 21. Additionally, data on sociodemographic and reproductive variables, menopausal symptoms, and perceptions toward menopause were also collected. Multivariable analyses (ANCOVA) showed that postmenopausal women had more positive attitudes toward menopause and aging than perimenopausal women. Providing balanced information about menopause and aging might help to foster positive attitudes toward menopause.

Menopausal symptoms and quality of life among Saudi women visiting primary care clinics in Riyadh, Saudi Arabia

OBJECTIVES

Menopause is associated with somatic, vasomotor, psychological, and sexual complaints that may affect quality of life. We determined the prevalence and severity of menopausal symptoms and their impact on the quality of life among Saudi women visiting primary care centers in Riyadh, Saudi Arabia.

METHODS

A cross-sectional study was conducted from October to November 2010. In total, 119 women aged 45-60 years were randomly interviewed using a questionnaire. Participants were divided into three categories: premenopausal (n=31), perimenopausal (n=49), and postmenopausal (n=39). The Menopause Rating Scale (MRS) assessed the prevalence and severity of eleven menopausal symptoms. Mean scores of menopausal categories were compared for different symptoms.

RESULTS

The mean age at menopause was 48.3±3 years (median, 49 years). The symptoms reported to be most prevalent were joint and muscle pain (80.7%), physical and mental exhaustion (64.7%), and hot flushes and sweating (47.1%). Somatic and psychological symptoms were highly prevalent in perimenopausal women compared to other groups. The mean overall quality-of-life score was higher in perimenopausal women, while the total MRS score indicated that the symptoms were mild in severity (MRS <9).

CONCLUSION

The prevalence of menopausal symptoms was comparable to previous studies in Asian women; however, the prevalence of classic symptoms of hot flushes and night sweats was lower than reported in Western studies. Saudi women reported an MRS score indicating milder severity of symptoms, reflecting better quality of life and ability to cope with climacteric symptoms.

The relationship between women's attitude towards menopause and menopausal symptoms among postmenopausal women

OBJECTIVES

The purpose of this study is to assess the symptoms of menopausal women as well as the relationship between women's attitude towards menopause and menopausal symptoms.

METHOD

This studied, following a cross-sectional method, included 349 selected postmenopausal women attending health care centers. The data was collected using the attitude toward menopause (ATM) checklist and Menopause-Specific Quality of Life (MENQOL) questionnaires.

RESULTS

The most common menopausal symptoms were physical with joint and muscle pain. The highest mean score belongs to vasomotor symptoms (1.37 ± 1.43), followed by psychosocial (1.32 ± 1.16), physical (1.22 ± 0.96), and sexual (0.91 ± 0.94) symptoms. Attitude toward menopause was significantly influenced by sweat nights, poor memory, and sleeplessness. The marital status and educational level of the husband were the only demographic factors affecting the severity of menopausal symptoms.

CONCLUSION

This study provides deeper insights about the relationship between attitudes towards menopause and menopausal symptoms, which can guide health-care professionals towards providing an optimal package.

Exploring Australian Aboriginal women's experiences of menopause: a descriptive study

BACKGROUND

Despite extensive literature demonstrating differing experiences in menopause around the world, documentation of the experience of menopause in Australian Aboriginal women is scarce, and thus their menopausal experience is relatively unknown. This study aimed to understand Australian Aboriginal women's understanding and experience of menopause and its impact on their lives.

METHODS

The study was an exploratory qualitative study. Twenty-five Aboriginal women were recruited from a regional centre in the Mid-West region of Western Australia using opportunistic and snowballing sampling. Interviews and focus group discussions were undertaken from February 2011 to February 2012 using open-ended questioning with a yarning technique. Thematic analysis was undertaken of the transcribed interviews.

RESULTS

A number of themes were revealed. These related to the language used, meanings and attitudes to menopause, symptoms experienced, the role of men, a lack of understanding, coping mechanisms and the attribution of menopausal changes to something else. The term "change of life" was more widely recognised and signified the process of ageing, and an associated gain of respect in the local community. A fear of menopausal symptoms or uncertainty about their origin was also common. Overall, many women reported insufficient understanding and a lack of available information to assist them and their family to understand the transition.

CONCLUSION

There are similarities between Aboriginal and non-Aboriginal experiences of menopause, including similar symptom profiles. The current language used within mainstream health settings may not be appropriate to this population if it fails to recognise the importance of language and reflect the attributed meaning of menopause. The fear of symptoms and uncertainty of their relationship to menopause demonstrated a need for more information which has not adequately been supplied to Australian Aboriginal women through current services. While this study is with a select population of Aboriginal Australian women, it reveals the importance of acknowledging differences, particularly in use of language to convey ideas and support Aboriginal women experiencing menopause.

Menopause and the influence of culture: another gap for Indigenous Australian women?

BACKGROUND

There is great variation in experience of menopause in women around the world. The purpose of this study was to review current understanding of Australian Aboriginal and Torres Strait Islander (Indigenous) women's experiences of menopause. The literature pertaining to the perception, significance and experience of menopause from a number of cultural groups around the world has been included to provide context for why Indigenous women's experience might be important for their health and differ from that reported in other studies of Australian women and menopause.

METHODS

A search of databases including Ovid Medline, Pubmed, Web of Science, AUSThealth, AMED, EMBASE, Global Health and PsychINFO was undertaken from January 2011 to April 2011 using the search terms menopause, Indigenous, Aboriginal, attitudes, and perceptions and repeated in September 2012.

RESULTS

Considerable research shows significant variation across cultures in the menopausal experience. Biological, psychological, social and cultural factors are associated with either positive or negative attitudes, perceptions or experiences of menopause in various cultures. Comparative international literature shows that neither biological nor social factors alone are sufficient to explain the variation in experiences of the menopausal transition. However, a strong influence of culture on the menopause experience can be found. The variation in women's experience of menopause indicates that different cultural groups of women may have different understandings and needs during the menopausal transition. While considerable literature exists for Australian women as a whole, there has been little investigation of Australian Indigenous women, with only two research studies related to Indigenous women's experiences of menopause identified.

CONCLUSIONS

Differences in biocultural experience of menopause around the world suggest the importance of biocultural research. For the Indigenous women of Australia, the relative contribution of culture, social disadvantage and poor general health compared with non-Indigenous women to the experience of menopause is unknown. As such, further research and understanding of the experience of Indigenous women around Australia is needed. This information could assist individuals, families, cultural groups and healthcare providers to enhance management and support for Indigenous Australian women.

Psychometric properties of the Tunisian-Arabic version of the Women's Health Questionnaire

OBJECTIVES

The Women's Health Questionnaire has been developed for the assessment of symptom perception in mid-aged women. It explores a range of psychological and physical symptoms and is one of the most used health-related quality of life measures. It was developed in the English language and is available in several other languages. The aim of this study was to evaluate the psychometric properties of the Tunisian-Arabic version of the questionnaire.

METHODS

A Tunisian-Arabic translation of the original version of the Women's Health Questionnaire (36-item WHQ) was produced using the forward-backward translation method recommended by the designers. A total of 1231 women were anonymously recruited from the general population using the quota method of sampling. All women were administered the WHQ as part of a broader questionnaire; 1150 records were finally retained for analysis. Psychometric evaluation was performed for the original version of the WHQ (36 items) and then for the 23-item revised version proposed by the MAPI Research Institute.

RESULTS

The acceptability and comprehensibility of the scale were good. The 36-item version showed overall good reliability, but some subscales lacked internal consistency. The validity was explored by principal component analysis and showed significant differences with the original English instrument and some deficiencies in its dimensional structure. The validity of the 23-item revised version was better. Finally, we suggest some adjustments to improve the reliability and validity of the instrument.

CONCLUSION

The Tunisian-Arabic version of the WHQ is globally reliable and valid, but we recommend the use of an improved shortened version, more specific to mid-aged women.

Examination of midlife women's attitudes toward menopause in Turkey

This study used a cross-sectional descriptive design to examine the attitudes of 154 Turkish women aged ≥ 40 years towards menopause. A questionnaire and the Menopause Attitudes scale were used. The mean score of the attitudes was determined as 34.70 ± 8.56. Most women in the study had negative attitudes towards menopause. The majority of women with positive attitudes were older, well educated and had used hormone replacement therapy (P < 0.05). Using multiple linear regression analysis, age and education level were found to be statistically significant (P < 0.001). A statistically significant difference was found between the women in the premenopausal and menopausal years in terms of sexuality after menopause (P < 0.05). This study suggests that Turkish women 40 years and older have negative attitudes towards menopause and their primary concern in the premenopausal period is sexuality after menopause. Counseling of women on menopause-related issues in gynecology clinics is recommended.