Abstract
Introduction: Menopausal transition fuels various
physical and psychological changes in women.
No woman experiences the same symptoms as
another woman. This study aimed to describe the
variability and magnitude of menopausal symptoms
experienced by Nepalese women aged over 40
years and to explore lifestyle factors associated
with occurrence of these symptoms.
Material and Methods: A descriptive crosssectional study was conducted among 215 women
attending the clinic of Nobel Medical College
Teaching Hospital. Symptomatic checklist
questionnaire including symptoms commonly
associated with menopause was used as instrument.
Stages of Reproductive Aging Workshop+10
principal criteria were used to classify women of
reproductive stage.
Results: The participants’ response rate was 74.13
%. The mean age at menopause was 47.5 ± 4.4
years. Classical vasomotor symptoms, hot flushes
(48.8%), vaginal dryness (12.1%) and night sweats
(37.2%) were reported less than somatic symptoms
and psychological symptoms. The most prevalent
symptom reported was easy fatigue (87%), aching
muscles and joints (80.9%), hair fall (80.9%).
Significant difference in symptoms like sleep
disturbances (p= 0.04), joint stiffness (p=0.00) and
tingling sensation of limbs (p=0.02) was found
across perimenopausal and postmenopausal group
of women.
Conclusion: The variation in occurrence of
“classical” and “non-classical” symptoms
between Nepalese women and women of other
regions demands more tailored interventions.
Innovative, targeted preventative services like
physiotherapy, rehabilitation, counselling, outreach
clinics, awareness programs related to healthier
perimenopausal lifestyle, health seeking and
prospects of hormonal replacement therapy could
be initiated at community levels to cater their needs.
References
D, Villaseca P. Age of menopause and impact
of climacteric symptoms by geographical
region. Climacteric. 2010 Oct 1;13(5):419–
28. doi: 10.3109/13697137.2010.507886
2. Gold EB, Bromberger J, Crawford S,
Samuels S, Greendale GA, Harlow SD,
Skurnik J. Factors associated with age at
natural menopause in a multiethnic sample
of midlife women. American journal of
epidemiology. 2001 May 1;153(9):865–74.
doi 10.1093/aje/153.9.865
3. Greendale GA, Lee, NP, Arriola ER.
The menopause. The Lancet. 1999
;353(9152):571–80. doi 10.1016/S0140-
6736(98)05352-5
4. HGeneva S. Research on the menopause in
the 1990s. Report of a WHO Scientific Group.
[Google Scholar]. 1996 doi 10.1016/0378-
5122(95)00967-1
5. Rajbhandari S, Subedi RK, Dangal G, Phuyal
A, Vaidya A, Karki A, Tuladhar H, Gurung
BS, Joshi L, Shrestha S. Menopausal health
status of Nepalese women. Higher Education.
2017 Jan 1;246:12-3.
6. Avis NE, Brockwell S, Colvin A. A universal
menopausal syndrome? The American Journal
of Medicine. 2005 Dec 19;118(12):37–46.
doi 0.1016/j.amjmed.2005.09.057
7. Neugarten BL, Kraines RJ. “Menopausal
symptoms” in women of various ages.
Psychosomatic Medicine. 1965 May
1;27(3):266-73. doi 10.1097/00006254-
196512000-00010
8. Ghimire N, Dhakal P, Norrish D, Dangal
G, Sharma D, Dhimal M, Aryal KK, Jha
BK, Karki KB. Menopausal Health Status
of Women of Kapilvastu District of Nepal.
Journal of Nepal Health Research Council.
2015;13(31):182–7. ISSN 19996217. PMID
27005709
9. Rani S. Perceived Health Problems of
Menopause. International Journal of Current
Research. 2017;9(8):55846–8. ISSN: 0975-
833X ISBN 5584655848
10. Avis NE, Stellato R, Crawford S, Bromberger
J, Ganz P, Cain V, Kagawa-Singer M. Is
there a menopausal syndrome? Menopausal
status and symptoms across racial/ethnic
groups. Social science & medicine. 2001
Feb 1;52(3):345–56. ISSN 0277-9536 PMID
11330770.
11. Ashrafi M, Kazemi AS, Malekzadeh F, AMIR
CE, Kashfi F, Eshrati B, Shabani F. Symptoms
of natural menopause among Iranian women
living in Tehran, Iran. Iran journal of
reproductive medicine. 2010;8(1):29–32.
ISSN 16806433 available from https://www.
sid.ir/en/journal/ViewPaper.aspx?id=168656
12. Rajbhandari S, Amatya A, Giri K. Relation of
ethnicity and menopausal symptoms in Nepal.
Journal of SAFOMS. 2013 Jul 1;1(2):50–5.
doi 10.5005/jp-journals-10032-1012
13. Chim H, Tan BH, Ang CC, Chew EM, Chong
YS, Saw SM. The prevalence of menopausal
symptoms in a community in Singapore.
Maturitas. 2002 Apr 25;41(4):275-82. doi
10.1016/S0378-5122(01)00299-7
14. Acharya D, Gautam S, Neupane N, Kaphle
HP, Singh JK. Health problems of women
above forty years of age in rupandehi district
of Nepal. Int J Health Sci Res. 2013;3(3):29-
36. ISSN 2249-9571
15. Paudel IS, Bhattrai S, Adhikari P, Gautam R,
Singh SB. Gynaecological and other health
problems of postmenopausal women and
their health seeking behaviour in rural Terai,
Nepal. Health Renaissance. 2014;12(2):
87–91. doi 10.3126/hren.v12i2.14106
16. Paudel P, Bhandary S, Byanju J. Factors
affecting menopause in Nepalese women.
Journal of Patan Academy of Health Sciences.
2017 Nov 15;4(2):33–8. doi 10.3126/jpahs.
v4i2.24582
17. Hay AG, Bancroft J, Johnstone EC. Affective
symptoms in women attending a menopause
clinic. The British journal of psychiatry.
1994 Apr;164(4):513–6. doi 10.1192/
bjp.164.4.513
18. Huang KE, Xu L, I NN, Jaisamrarn U. The
Asian Menopause Survey: Knowledge,
perceptions, hormone treatment and sexual
function. Maturitas. 2010 Mar 1;65(3):
276–83. doi 10.1016/j.maturitas.2009.11.015
19. Gyawali S, Subedi SN, Yasmin N, Pandey S.
Health Care Seeking Practice for Menopausal
Problems among Women in Syangja District,
Nepal. International Journal of Health
Sciences Research. 2016;6(8):247-53.
20. Khokar S. Knowledge, attitude and
Menopausal Symptoms Experienced by Women Attending a Tertiary Level Hospital Menopausal Symptoms Experienced by Women Attending a Tertiary Level Hospital, Nabina K. et. al. , Koirala N et. al.
~456~˷
Original Article Medical Journal of Pokhara Academy of Health Sciences Vol 5 Issue 1 Jan-Jun 2022
experience of menopause. Pakistan Journal
of Medical Research. 2013 Apr 1;52(2):42–
7. ISSN 10259589 PMID 19024187
21. Gupta S, Acharya K, Srivastav P, Gurung
PK, Gupta N. An overview of menopausal
symptoms in a district hospital of Nepal.
JNMA J Nepal Med Assoc. 2016 Oct
1;55:93–6. doi 10.31729/jnma.2886
22. Poomalar GK, Arounassalame B. The quality
of life during and after menopause among rural
women. Journal of clinical and diagnostic
research: JCDR. 2013 Jan;7(1):135. doi
10.7860/JCDR/2012/4910.2688
23. Ministry of Health and Population -
MOHP/Nepal, New ERA/Nepal, and ICF
International. 2012. Nepal Demographic
and Health Survey 2011. Kathmandu,
Nepal: MOHP/Nepal, New ERA, and ICF
International. Available at http://dhsprogram.
com/pubs/pdf/FR257/FR257.pdf
24. Ministry of Health - MOH/Nepal, New ERA/
Nepal, and ICF. 2017. Nepal Demographic
and Health Survey 2016. Kathmandu, Nepal:
MOH/Nepal, New ERA, and ICF. Available
at http://dhsprogram.com/pubs/pdf/FR336/
FR336.pdf
25. Harlow SD, Gass M, Hall JE, Lobo R,
Maki P, Rebar RW, Sherman S, Sluss PM,
De Villiers TJ, STRAW+ 10 Collaborative
Group. Executive summary of the Stages
of Reproductive Aging Workshop+ 10:
addressing the unfinished agenda of staging
reproductive ageing. The Journal of Clinical
Endocrinology & Metabolism. 2012 Apr
1;97(4):1159-68.
26. Rahman SA, Zainudin SR, Mun VL. Assessment
of menopausal symptoms using modified
Menopause Rating Scale (MRS) among
middle age women in Kuching, Sarawak,
Malaysia. Asia Pacific family medicine. 2010
Dec;9(1):1-6. doi 10.1186/1447-056x-9-5
27. Marahatta RK. Study of menopausal
symptoms among peri and postmenopausal
women attending NMCTH. Nepal Med Coll
J. 2012 Sep 1;14(3):251–5. PMID 24047028
28. Malik HS. Knowledge and attitude towards
menopause and Hormone Replacement
Therapy (HRT) among postmenopausal
women. JOURNAL-PAKISTAN MEDICAL
ASSOCIATION. 2008 Apr 1;58(4):164.
PMID 18655421
29. Chim H, Tan BH, Ang CC, Chew EM, Chong
YS, Saw SM. The prevalence of menopausal
symptoms in a community in Singapore.
Maturitas. 2002 Apr 25;41(4): 275–82. doi
10.1016/S0378-5122(01)00299-7
30. Woods NF, Mitchell ES. Symptoms during
the perimenopause: Prevalence, severity,
trajectory, and significance in women’s lives.
The American journal of medicine. 2005 Dec
19;118(12):14-24.
31. Zhao D, Liu C, Feng X, Hou F, Xu X, Li P.
Menopausal symptoms in different substages
of perimenopause and their relationships with
social support and resilience. Menopause.
2019 Mar 1;26(3):233–9. doi 10.1097/
GME.0000000000001208