The factors associated with the quality of life among postmenopausal women

Perceived lack of behavioral control is a barrier to a healthy lifestyle in post-menopause: a qualitative study

INTRODUCTION

Menopause is a natural phase in a woman's life, but the quality of life and health of postmenopausal women are often compromised by unhealthy lifestyles. Therefore, it is crucial to identify the factors that influence their well-being. The main objective of this study is to explore the barriers to a healthy lifestyle among Iranian postmenopausal women.

METHODS

Qualitative exploratory research was conducted among postmenopausal women aged 45-65 years in three different health centers located in urban areas with varying economic level in a central city of Iran. These areas represented upscale, downtown, and downscale areas with different economic statuses (wealthy, relatively wealthy, and less wealthy). Nine focus group discussions were held, focusing on managing menopausal symptoms, physical activity, and healthy nutrition. Each topic was discussed separately in a different health center, with 10 women participating in each session. Data analysis was conducted using Graneheim and Lundman's method.

RESULTS

The study revealed a prominent theme, "perceived lack of behavioral control as a barrier to a healthy lifestyle in post-menopause." Two categories, "False attitudes" and "Perceived inability to engage in behavior," were derived from 26 codes related to managing menopausal symptoms. Furthermore, a category, "Perceived inability to engage in behavior," was formed from 11 to 13 codes related to physical activity and healthy nutrition, respectively. The theme highlighted that the perceived lack of behavioral control prevented the women from adopting a healthy lifestyle.

CONCLUSION

Improving perceived behavioral control through the modification of attitudes and abilities is essential for maintaining a healthy postmenopausal lifestyle.

General self-efficacy as a moderator between severity of menopausal symptoms and satisfaction with life in menopausal women

The study aimed to determine whether self-efficacy acts as a moderator between the severity of menopausal symptoms and life satisfaction. The research tools were: The Generalized Self-Efficacy Scale (GSES), The Satisfaction with Life Scale (SWLS) The Menopause - Specific Quality of Life (MENQOL), and a standardized questionnaire comprising questions on the participants' characteristics. 516 women using health care services who had menopausal symptoms took part in the study. Self-efficacy (GSES) (r = -0.176; p < 0.001) and life satisfaction (SWLS) (r = -0.106; p = 0.016) were negatively correlated with the severity of menopausal symptoms (MENQOL). The self-efficacy correlated positively with satisfaction with life (r = 0.278; p < 0.001). A low level of self-efficacy was associated with a significant and negative relationship between the severity of menopausal symptoms and satisfaction with life (p = 0.005), while at a high and moderate level of self-efficacy, the severity of menopausal symptoms was not associated with life satisfaction (p > 0.05). Self-efficacy moderates the relationship between the severity of menopausal symptoms and life satisfaction in menopausal women. The moderating function of self-efficacy is that, at its low level, an increase in the severity of menopausal symptoms reduces life satisfaction, while at medium and high levels, an increase in the severity of menopausal symptoms does not reduce life satisfaction.

Effects of Pilates exercises on health-related quality of life in postmenopausal women: a systematic review and meta-analysis

OBJECTIVE

To verify the effects of Pilates exercises on health-related quality of life (HRQoL) in postmenopausal women.

METHODS

A systematic search was conducted in the following databases: PubMed, Embase, CENTRAL, CINAHL, Web of Science, LILACS, SportDiscus, Scielo, and PEDro. Randomized clinical trials (RCTs) that intervened with Pilates and had HRQoL as an outcome were eligible. The methodological quality of each RCT was assessed using the PEDro scale and the certainty of the evidence using the GRADE system. Meta-analyses were conducted by standardized mean difference (SMD).

RESULTS

Initially, 760 records were located. After screening, 11 RCTs were included in the systematic review. Five studies presented low risk of bias (PEDro score ≥ 6). Evidence of very low to moderate certainty demonstrated significant effects in favor of Pilates exercises vs control groups for five of the nine HRQoL domains analyzed: bodily pain (SMD = 0.96), physical functioning (SMD = 0.85), social functioning (SMD = 0.45), role physical (SMD = 0.79), and role emotional (SMD = 0.61). Subgroup analyzes demonstrated that Pilates had a positive impact on more domains whens administered for ≥ 48 sessions (eight domains) vs < 48 sessions (three domains); and when administered on equipment (seven domains) vs mat (three domains).

CONCLUSION

Pilates exercises, in general, allowed significant effects to improve HRQoL in postmenopausal women, especially when performed on equipment and when administered for at least 48 sessions. However, no analysis showed high certainty of evidence, and more RCTs of high methodological quality are needed to confirm these findings.

Menopausal wellbeing: navigating quality of life and osteoporosis risk

Background

Multifaceted dimensions influence the quality of life among post-menopausal women. Osteoporosis, a condition characterized by fragile bones, poses a significant risk, potentially leading to fractures and decreased wellbeing. This study aims to assess the quality of life of postmenopausal women, its determinants, and also the risk of osteoporosis among them.

Methods

A cross-sectional study was done among 379 post-menopausal women residing in rural and urban areas of Ernakulam district, Kerala, India. They were selected by probability proportional to size sampling from 10 clusters. Quality of life was measured using MENQOL-I questionnaire and osteoporosis risk assessment was done using OSTA score.

Results

The study participants had a mean age of 60 years, (standard deviation of 6.83 years). On average, menopause occurred at 50.58 years (standard deviation of 4.28 years). The most common symptoms impacting quality of life among postmenopausal women were psychosocial symptoms, followed by physical and vasomotor symptoms. Furthermore, a high proportion (63.6%) of participants were at risk for osteoporosis. History of fracture, concern of falling, marital status and having an insurance, are factors associated with various domains of quality of life.

Conclusion

This study underscores the complex interplay of demographic factors, menopausal experiences, and their impact on the participants' quality of life. The prevalence of psychosocial symptoms and the significant risk of osteoporosis call for tailored healthcare interventions. Postmenopausal women with history of fracture, high concern of fall and single women require special attention. Encouraging women to take up selfcare practices will help during the menopausal transition to have a good quality of life.

Menopausal Status Impact on the Quality of Life in Kazakhstani Healthcare Workers: A Cross-sectional Study

BACKGROUND

Menopausal quality of life (MenQoL) is a common concern that primary healthcare workers often encounter. Menopause has a significant impact on women's health, but studies examining its effect on the MenQoL of menopausal healthcare employees have produced conflicting results.

OBJECTIVE

The aim of this study was to compare the quality of life related to menopausal status (pre-, peri-, or postmenopausal) in healthcare workers from various clinical settings in Kazakhstan.

DESIGN

This was a cross-sectional study.

PARTICIPANTS

In total, 222 menopausal healthcare workers (physicians, nurses/midwives, administrative staff, and cleaners) were enrolled from hospitals affiliated with the University Medical Center (UMC) in Kazakhstan.

MAIN MEASURES

The outcome variable was assessed using the Menopausal Quality of Life Questionnaire (MENQOL), which evaluates MenQoL across four domains of menopausal symptoms: physical, psychological, vasomotor, and sexual.

KEY RESULTS

The most frequently reported menopausal symptoms were physical ones, such as feeling tired or worn out (70.7%), followed by feeling a lack of energy (65.3%) and dry skin (64.1%). The postmenopause group had the highest mean MenQoL score in the vasomotor domain (mean 3.46 ± 1.84). There was a borderline statistical significance when comparing postmenopause and perimenopause groups in the physical domain. The pairwise comparison of mean sexual scores revealed that postmenopause women had the highest average score (3.3 ± 2.36) compared to both premenopause (mean 2.3 ± 1.82) and perimenopause (mean 2.22 ± 1.58) groups (p < 0.05).

CONCLUSIONS

Menopausal status has influence on the MenQoL of healthcare workers. The study findings could have important implications for policymakers as they provide insight into the factors influencing the quality of life of menopausal healthcare employees. Creating a more menopause-friendly work environment may not only enhance the well-being of healthcare personnel but also improve their overall job satisfaction and performance.

Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use

OBJECTIVE

To compare weight loss response and changes in cardiometabolic risk markers in postmenopausal women using semaglutide with and without menopause hormone therapy (HT) use.

METHODS

Retrospective cohort study of postmenopausal women treated with semaglutide for overweight or obesity for ≥3 months. Endpoints: total body weight loss percentage (TBWL%) at 3, 6, 9, and 12 months after semaglutide initiation; and percentage of women achieving ≥5% and ≥10% TBWL and changes in cardiometabolic risk markers (glucose, blood pressure, and lipids) at 12 months.

RESULTS

There were 16 women on HT and 90 on no-HT; mean age 56 ± 8 vs 59 ± 8 yr, P = 0.2 and mean BMI 36 ± 5 vs 39 ± 8 kg/m 2 , P = 0.1; respectively. Among women on no-HT, White race, dyslipidemia, and depression were more prevalent. Women on HT had a higher TBWL% at 3, 6, 9, and 12 months: 7 ± 3% vs 5 ± 4%, P = 0.01; 13 ± 6% vs 9 ± 5%, P = 0.01; 15 ± 6% vs 10 ± 6%, P = 0.02; and 16 ± 6% vs 12 ± 8%, P = 0.04; respectively. After adjusting for potential confounders, this association remained significant across time. At 12 months, a greater percentage of women on HT achieved ≥5% and ≥10% TBWL. Both groups experienced an improvement in cardiometabolic risk markers.

CONCLUSION

In postmenopausal women with overweight or obesity treated with semaglutide, HT use was associated with an improved weight loss response. This association was maintained when adjusted for confounders. Larger studies should be conducted to confirm these results.

Quality of life of Jordanian menopausal working and retired women and its associated factors: a cross-sectional study

OBJECTIVE

Life expectancy of Jordanian women has increased, indicating that the number of women entering menopause age, during the prime of their working life, will also increase. Therefore, assessments of the quality of life (QoL) of working and retired women and factors associated with overall wellbeing, are essential for the provision of quality services and care.

METHOD

A cross-sectional study was conducted with 200 Jordanian women between the ages of 45 to 60 years old. The Utian QOL tool was used to assess the quality of life among menopausal women. Multiple regressions were used to determine predictors for QoL for the whole sample and for each group of working and retired women.

RESULTS

The study shows that the total QoL for women was 77.5 ±14.4, with a significant difference (p=.023) in total QoL and the occupational domain (p=.003) between working and retired women. Employed women with fewer chronic diseases and using frequent preventive measures had a higher QoL compared to others.

CONCLUSION

Working itself might be an important indicator for better a quality of life among menopausal women. Better working conditions and more attention from the health care providers for the menopausal changes and the preventive measures could enhance women's perceived QoL in addition to increasing their productivity.

Quality of life of Jordanian menopausal working and retired women and its associated factors: a cross-sectional study

Objective

Life expectancy of Jordanian women has increased, indicating that the number of women entering menopause age, during the prime of their working life, will also increase. Therefore, assessments of the quality of life (QoL) of working and retired women and factors associated with overall wellbeing, are essential for the provision of quality services and care.

Method

A cross-sectional study was conducted with 200 Jordanian women between the ages of 45 to 60 years old. The Utian QOL tool was used to assess the quality of life among menopausal women. Multiple regressions were used to determine predictors for QoL for the whole sample and for each group of working and retired women.

Results

The study shows that the total QoL for women was 77.5 ±14.4, with a significant difference (p=.023) in total QoL and the occupational domain (p=.003) between working and retired women. Employed women with fewer chronic diseases and using frequent preventive measures had a higher QoL compared to others.

Conclusion

Working itself might be an important indicator for better a quality of life among menopausal women. Better working conditions and more attention from the health care providers for the menopausal changes and the preventive measures could enhance women's perceived QoL in addition to increasing their productivity.

Unveiling the Role of the Work Environment in the Quality of Life of Menopausal Physicians and Nurses

BACKGROUND

There is a lack of scientific evidence regarding the specific challenges faced by menopausal medical professionals in different work settings. This study aims to investigate the relationship between work environment and the menopausal quality of life (QoL) in physicians and nurses.

METHODS

This survey was conducted using the Menopausal Quality of Life Questionnaire (MENQOL) with a sample of 35 menopausal physicians and 95 nurses employed in health facilities in Astana and Kyzylorda cities, Kazakhstan.

RESULTS

Physicians reported a higher frequency of menopausal symptoms compared to nurses. The difference was statistically significant (p < 0.05) for symptoms such as decreased productivity (60.00% vs. 38.20%), flatulence or gas pains (71.43% vs. 48.39%), weight gain (79.41% vs. 61.80%), changes in skin appearance (79.59% vs. 50.00%), and changes in sexual desire (58.82% vs. 33.70%). Physicians with managerial duties had a significantly higher occurrence of vasomotor symptoms compared to non-managerial physicians (mean 3.35 ± 2.14 vs. 1.69 ± 0.89) and also had a higher mean psychological score (mean 3.26 ± 1.28 vs. 2.29 ± 1.19).

CONCLUSIONS

These findings reflect differences between the menopause effects related to work environment for doctors and nurses, and shed light on the specific challenges faced by them during menopause. In addition, it is important to consider socio-demographic and workplace-related factors in investigating their impact on the QoL.

Communication skills training with the transactional analysis approach developed menopausal women's marital adjustment - a quasi-experimental study

Introduction

Communication skills help people have a better life. Due to the changes caused by menopause and their effects on interpersonal communication, it is essential to reinforce communication skills during this period. This study aimed to investigate the effect of communication skills training (CST) using the transactional analysis (TA) approach on menopausal women's marital adjustment.

Material and methods

This quasi-experimental study with a parallel design was performed by the availability sampling method with participation of 46 married menopausal women. Participants were randomly assigned to two groups. The intervention group participated in eight CST sessions with a TA approach. The control group did not receive any psychosocial or educational services. Participants completed the demographic information, Queen Dam communication skills, and Spinner's marital adjustment questionnaire before, at the end of, and one month after the training period. Data were analyzed by descriptive and analytical tests with SPSS22 software.

Results

There was no significant difference in demographics between the groups (p < 0.05). The mean marital adjustment scores were 53.48 ±12.24, 117.70 ±11.15, and 116.52 ±10.73 before, at the end of, and one month after the intervention, respectively. The marital adjustment scores before the intervention did not differ between the two groups but significantly increased after training and in the follow-up period (p < 0.001).

Conclusions

Communication skills training with a TA approach in postmenopausal women improves marital adjustment. Therefore, it is suggested that midwives use this method in comprehensive health centers as an effective method for improving the lives of postmenopausal women.

Impact of Menopause Symptoms on Women in the Workplace

OBJECTIVE

To evaluate the impact of menopause symptoms on work outcomes and to assess the estimated economic impact.

PATIENTS AND METHODS

Women aged 45 to 60 years receiving primary care at 1 of the 4 Mayo Clinic sites were invited to participate in a survey study (Hormones and ExpeRiences of Aging) from March 1 through June 30, 2021. A total of 32,469 surveys were sent, with 5219 responses (16.1% response rate). Of the 5219 respondents, 4440 (85.1%) reported current employment information and were included in the study. The primary outcome was self-reported adverse work outcomes related to menopause symptoms assessed by the Menopause Rating Scale (MRS).

RESULTS

The mean age of the 4440 participants was 53.9±4.5 years, with the majority being White (4127 [93.0%]), married (3398 [76.5%]), and educated (2632 [59.3%] college graduate or higher); the mean total MRS score was 12.1, signifying moderate menopause symptom burden. Overall, 597 women (13.4%) reported at least one adverse work outcome due to menopause symptoms; 480 women (10.8%) reported missing work in the preceding 12 months (median, 3 days missed). The odds of reporting an adverse work outcome increased with increasing menopause symptom severity; women in the highest quartile of total MRS scores were 15.6 (95% CI, 10.7 to 22.7; P<.001) times more likely to have an adverse work outcome vs those in the first quartile. Based on workdays missed due to menopause symptoms, we estimate an annual loss of $1.8 billion in the United States.

CONCLUSION

This large cross-sectional study identified a major negative impact of menopause symptoms on work outcomes and the need to improve medical treatment for these women and make the workplace environment more supportive. Additional studies are needed to confirm these findings in larger and more diverse groups of women.

Factors Determining the Quality of Life of Polish Women during Menopause Based on the Menopause-Specific Quality of Life Questionnaire

BACKGROUND

The aim of the study was to present the process of cultural adaptation to Polish conditions and the validation of a scale assessing the quality of life of Polish women during the menopause and to identify the factors determining this quality of life.

METHODS

The research tools were the menopause-specific quality of life (MENQOL) questionnaire and a standardized interview questionnaire comprising questions on the participants' characteristics. The study involved 516 women using health care services who had symptoms caused by the menopause.

RESULTS

The value of the Cronbach's alpha coefficient was 0.923. The discriminative power coefficients of all the questionnaire items were higher than 0.3. The study confirmed the validity and internal consistency of the Polish version of the MENQOL questionnaire for measuring the quality of life of postmenopausal women, suggesting that the tool can be used for screening menopausal symptoms in women. There was a relationship between general quality of life and age (p = 0.002), marital status (p < 0.001), education (p = 0.021), the impact of professional work (p < 0.001), the impact of physical activity (p < 0.001) and the impact of social life (p < 0.001).

CONCLUSION

In the group of women who took part in the study, the authors observed a lower quality of life during menopause reported by older women who were married/in a stable relationship, with no formal education (no formal education) and who, according to their subjective assessment, negatively evaluated the impact of the accompanying menopause-related symptoms on their work, physical activity and social life.

Socio-cognitive Determinants of Healthy Sleep Behaviors Among Iranian Elderly: Application of the Theory of Planned Behavior

Background: Sleep quality and quantity disorders are among the most important problems in old age. Healthy sleep behaviors are among the best ways to deal with sleep disorders among the elderly. This study aimed to determine the socio-cognitive determinants predicting healthy sleep behaviors among the elderly who had been referred to the retirement centers in Hamadan, Iran. Methods: This cross-sectional study was performed among 288 elderly people who had been referred to the retirement centers in Hamadan, Iran in 2020, and were selected through stratified random sampling. Data were collected online using a self-administered questionnaire with items on demographic characteristics and the theory of planned behavior (TPB) constructs. Data were analyzed by SPSS software (version 16) using Pearson correlation, independent t test, one-way ANOVA, and linear regression tests at the significance level of 0.05. Results: The mean (±standard deviation) age of respondents in this study was 67.2 (±6.3) years. Perceived behavior control (β=0.409), attitude (β=0.251), and subjective norms (β=0.205) were stronger predictors of healthy sleep behavior intention among the elderly, respectively; collectively, they accounted for 28.5% of the variation in sleep health behavior intention. Behavioral intention (β=0.429) and perceived behavioral control (β=0.167) were also predictors of healthy sleep behaviors among the elderly. There was a statistically significant relationship between the educational level and healthy sleep behaviors (P<0.05). Conclusion: It seems that the development and implementation of educational programs based on the TPB for the improvement of attitudes, subjective norms, and perceived behavior control can play an effective role in promoting healthy sleep behaviors and sleep quality among the elderly.

Quality of life of patients with bilateral oophorectomy before the age of 45 for the treatment of endometriosis

INTRODUCTION

The study aimed to evaluate the quality of life and associated factors among women who underwent bilateral oophorectomy (BO) before the age of 45 for the treatment of deep infiltrating endometriosis (DIE).

MATERIALS AND METHODS

This cross-sectional study was carried out in 52 women who were treated from January 2014 to December 2019 in 2 public and private DIE surgical centers in Toulouse. All women answered the Menopausal Quality of Life questionnaire (MenQOL). Mean MenQOL scores were compared according to age at BO, smoking, BMI, level of education, delay between BO and the survey and post-BO hormone replacement therapy (HRT) using Mann-Whitney and Anova tests. Spearman's correlation coefficient was used to analyze the correlations between all the MEnQOL domain scores and clinical variables. The variables associated with the outcomes in univariate analyses with p < 0.2 were jointly evaluated using multiple linear regression.

RESULTS

The mean age at the time of the survey was 43.4 ± 3.4 years while the mean age at BO was 40.5 ± 3.4 years. The mean MenQOL score was 3.96 (± 1.45), with the highest scores in the sexual (4.77) and vasomotor (4.01) domains. BMI and smoking were independently and significantly associated with the mean total MenQOL score, all domain scores being significantly higher in overweight/obese women. A trend towards worse MenQOL scores was found in patients who had BO before the age of 41. We did not find any difference according to whether or not they were taking HRT.

CONCLUSION

This is a first study evaluating quality of life in a specific population of oophorectomized women under the age of 45 using MenQOL for DIE. While BO is effective in relieving pain in women with severe DIE, the induced premature menopause is associated with a poor quality of life, which deserves further attention.

The effect of self-care education program on the severity of menopause symptoms and marital satisfaction in postmenopausal women: a randomized controlled clinical trial

Background

Physiological and psychological changes during menopause can affect the quality of marital satisfaction. The aim of this study was to evaluate the effect of self-care education program on the severity of menopause symptoms and marital satisfaction in postmenopausal women.

Methods

In this randomized controlled clinical trial, 70 postmenopausal women who referred to the gynecology clinic of Baqiyatallah and 502 Artesh hospitals in Tehran, Iran, and met the all inclusion criteria were randomly allocated into two equal groups (intervention and control groups) using block randomization. The intervention group received self-care training program in physical, psychological, social and sexual dimensions in 5 sessions during a week. The control group also had 5 sessions exactly the same as the intervention group, except that they received only routine care and training. Data were collected pre- and post-intervention using Menopause Symptoms' Severity Inventory (MSSI-38) questionnaire and the Revised Dyadic Adjustment Scale (RDAS) questionnaire.

Results

In the control and intervention groups before the intervention, socio-demographic characteristics (P > 0.05), the mean scores of MSSI-38 (P = 0.388) and RADS (P = 0.476) were not statistically significant. However, in the intervention group the mean scores of MSSI-38 (49.88 ± 3.3 vs. 39.33 ± 3.7, P < 0.001) and RADS (35.15 ± 4.3 vs. 49.48 ± 3.2, P < 0.001) after the intervention changed significantly and this change were statistically significant compared to the control group. Significant inverse correlation between severity of menopausal symptoms and marital satisfaction was observed with r = -0.461, P < 0.001.

Conclusion

Our findings indicate that self-care training has a positive effect on the severity of menopause symptoms and also improves marital satisfaction in postmenopausal women. Therefore, we recommend that more attention be paid to providing self-care educational content to improve the marital satisfaction in postmenopausal women.

Clinical trial registration Iranian Registry of Clinical Trials; https://www.irct.ir/trial/49225 (IRCT20200624047910N1), registered (10/11/2020).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01653-w.