EPIDEMIOLOGICAL PROFILE OF MENOPAUSAL SYMPTOMS AMONG WOMEN IN CHENNAI AGED 40-60 YEARS -A CROSS SECTIONAL STUDY

the chronic illnesses and routine body check-ups, most of the respondents that the budding of diabetic symptoms during menopause time that is after complete cessation of the menstrual cycle. It was also found that some also have symptoms of raise in blood pressure during menopause. From all the tables it that psychological symptoms and somatic symptoms like joint pains and loss of interest in the sex have high significant relation. The study conducted on women residing in chawl(Ashwin Jadhav et al ) , where the average menopause found to be 45.2years. Also found psychological symptoms among the population found to be difficulty in sleeping 42.9%, difficulty in concentration 34.7% followed by nervousness which is about 33.7%, irritability about in 33.4% in respondents. In present study sleep disturbances was (47.8%) also, irritability(36.0%) difficulty in concentration of the things(24.2%).Most of the respondents have a significant association with psychological symptoms. The study on the prevalence of climacteric symptoms (Achala Sahai Sharma et al;) among women in urban and rural areas of Maharashtra. In this study, the most prevalent symptom was found to be muscle and joint pain (81.5%), followed by headache (50%). The least frequent symptom was tense and nervousness, difficulty in concentration(1.0%) others were infrequent. In the present study somatic symptoms also found to be some significant association but, psychological symptoms plays a major role. The joint pain and numbness found in this study is about 39.1% and Numbness is 29.2% respectively. Especially psychological symptoms, most women in the present study reported the conflicts and conflicts with their spouses, also conflicts with their son or daughter. The menopausal symptoms (Ashan et al;) in the tertiary hospital area, in this study author, found that perimenopausal women age which is to be 43.5 years and post menopause to be 48.5byears. In the present study, the average age of menopause


ISSN: 2320-5407
Int. J. Adv. Res. 8(12), 37-46 38 Conclusion: During menopausal period, women experience menopausal symptoms due to lot of fluctuations of hormone levels. Most of the respondents, even literate women lack in knowledge about breast self examination, the awareness should be created to every women in this world. Many of them responded that they had extreme mood fluctuations and joint pains. The significant association between diabetes and hypertension during menopausal time to be identified in large sample in future. The program and public awareness to be focused during upcoming years.

…………………………………………………………………………………………………….... Introduction:-
Menopause is the part of women's life which plays a major role in the second half of the women's life where women face the transition phase from reproductive to the non-reproductive phase of their lives. Menopause is a significant stage marking the end of a woman's reproductive life. Although this process is physiological, it is plagued by a wide range of discomforting features which affects their quality of life 1. Changes of the hormonal internal environment, loss of reproductive potential and transition into later life occur along with several life events, which links mainly with socio-cultural factors 1,2 . There is an increase in the rate of association between depression and anxiety during this menopausal period, where no studies could not clearly define the increased rates with them 2 . Menopause is tshe permanent cessation of the menses.
The term natural menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Natural menopause is recognized to have occurred after 12 consecutive months of amenorrhea, for which there is no other obvious pathological or physiological cause(WHO). Menopause is most likely leading to a risk factor for cardiovascular diseases and osteoporosis. Epidemiological studies have found that age-adjusted mortality is reduced by 2% while uterine and ovarian cancer about 5% with increasing age of menopause 3 .Lower age of menopause in India compared to western countries, women spending almost a third of her life in menopause with more distressing clinical problems 4. The common menopausal symptoms include hot flushes, joint pains, disturbed sleep, anxiousness, irritability, palpitations, depression, headaches, loss of interest in sex, out of these very few articles described psychological disturbance association with menopause. Due to the change in their hormones, there will be some depressive and cognitive impairment. As a post-menopausal are already at risk of osteoporosis and 39 cardiovascular disease and it is also important to address potentially changeable psychiatric problems which the lead medical issues are more difficult to treat 5,6 .
To avoid these medical issues, some women take hormone replacement therapies, which is 2002, WHI showed that HRT could increase the rate of breast cancer, heart attack and stroke. While in 2004 WHI showed, not only women taking oestrogen will have these increase in the rate of cancer and strokes 7 . Some associations also found parity, socioeconomic status, age. Studies have shown that the frequency of symptoms and their stability varies. Some occur frequently during menopause, while others increase progressively from peri-menopause to post-menopause. Hence, the issues related to menopause are very complicated in terms of experience, severity, and dynamics of the symptoms 1 . Studies have shown that the frequency of the symptoms varies over time. Some happen frequently in the peri-menopause and decrease over time, while others increase progressively from peri menopause to post menopause and become more severe towards the end of life. During the menopausal transition, there are a lot of fluctuations in the hormone levels (especially oestrogen) and thus women experience many symptoms and conditions. However, the influence of this fluctuation varies from one woman to another. Apart from the symptoms of menopause, it acts as a risk factor for various chronic diseases like coronary artery diseases, stroke, obesity and hypertension. With this background, this study was undertaken. The main aim of the study is to identify the knowledge of menopause symptoms among women and to compare with epidemiological profile and to find the association of psychological symptoms during the menopausal period.

Methods:-
A cross-sectional study was carried out among women aged between 40-60years in a community of central Chennai from March 2019-May 2019. Broad age group was chosen to get a clear picture of menopause symptoms. Women who are under hormone replacement therapy and women who had a hysterectomy are excluded from the study. This study was conducted in community women aged 40-60 years was collected by home visits and by some public places. An estimated sample of the study 50% of women between the age of 40-60years with an accepted error of 6% confidence interval was 95% the sample size was about 161. A semi-structured questionnaire was the tool used to assess the menopausal symptoms. The study information technique was collected by direct personal interview. The interview was conducted only after taking oral consent from women. Institutional ethical committee permission was obtained. Confidentiality was assured to women who participated in the study. The study was conducted in local language and confidentiality was of study assured to women throughout the study. The scale used here to access the menopausal symptoms was Greene scale. The modified questionnaire was from American Menopausal society. Descriptive statistics and chi-square was used for analysing using SPSS ver-24.

Results:-
A total of 161 samples were sampled for this study. The mean age of the menopause was 45 years (51-60 years).     The table 5 and figure 2 describes about the knowledge gained during the survey about menopausal symptoms. The above are the frequency percentage obtained for the respective questions. The knowledge about examination of breasts is very low among the respondents.when the age and chronic illness during menopause compared, most of the respondents from second group reported that they have major illness like Diabetes, hypertension after attaining menopause. Not at all A little Quite abit exteremely Comparing heart beating quickly, joint pains, and night sweatsmajority of participants have not expreinced any of these symptoms.

Heart beating quickly
Numbness or joint pains sweating in night

Not at all A little Quite a bit Exteremely
Comparing these symptoms most of the participants reported little of irritability and depression which are 58% and 49% respectively.

Depressed or unhappy
Disturbed sleep 45 about the chronic illnesses and routine body check-ups, most of the respondents answered that the budding of diabetic symptoms during menopause time that is after complete cessation of the menstrual cycle. It was also found that some also have symptoms of raise in blood pressure during menopause. From all the tables it is evident that psychological symptoms and somatic symptoms like joint pains and loss of interest in the sex have high significant relation. The study conducted on women residing in chawl(Ashwin Jadhav et al), where the average menopause found to be 45.2years. Also found psychological symptoms among the population found to be difficulty in sleeping 42.9%, difficulty in concentration 34.7% followed by nervousness which is about 33.7%, irritability about in 33.4% in respondents. In present study sleep disturbances was (47.8%) also, irritability(36.0%) difficulty in concentration of the things(24.2%).Most of the respondents have a significant association with psychological symptoms. The study on the prevalence of climacteric symptoms (Achala Sahai Sharma et al;) among women in urban and rural areas of Maharashtra. In this study, the most prevalent symptom was found to be muscle and joint pain (81.5%), followed by headache (50%). The least frequent symptom was tense and nervousness, difficulty in concentration(1.0%) others were infrequent. In the present study somatic symptoms also found to be some significant association but, psychological symptoms plays a major role. The joint pain and numbness found in this study is about 39.1% and Numbness is 29.2% respectively. Especially psychological symptoms, most women in the present study reported the conflicts and conflicts with their spouses, also conflicts with their son or daughter. The menopausal symptoms (Ashan et al;) in the tertiary hospital area, in this study author, found that perimenopausal women age which is to be 43.5 years and post menopause to be 48.5byears. In the present study, the average age of menopause was found to be 45 years. During the menopausal transition, there are a lot of fluctuations at hormone levels where this varies from woman to another woman. Most common symptoms of severs are fatigue, depression, anxiety, hot flashes, sexual disturbances were common. Here in this study loss of interest in sex and psychological symptoms found to be significant.

Conclusion:-
During the menopausal period, women experience menopausal symptoms due to a lot of fluctuations in hormone levels. From the study, it is concluded that there was high burden of menopausal symptoms in a study population that is most of the respondents had high frequency in psychological symptoms especially tiredness, anxiousness, lack of concentration and irritability. However, the influence of this fluctuation varies from one woman to another. During this period, most of the women complained that they have high conflicts with family. Study of psychological, physical and vasomotor symptoms more common symptoms observed in the present study was fatigue, depression, irritability, joint pains, the sexual disturbance was commonly observed. The epidemiological profile(demographic) showed some significant association was found in economic status and somatic symptoms and also was found in occupation status and menopausal symptoms. Some women are not aware of menopausal symptoms and these conflicts with their partners lead to depression. Most of the women also feel some insecurity and loneliness and fear of death during this period. In the present study, most of the respondents said that they get to diagnosed with diabetes and hypertension after attaining menopause. The significant association between diabetes and hypertension during the menopausal time to be identified in a large sample by researches in the upcoming years. Most of the respondents, even literate women lack knowledge about breast self-examination, the awareness should be taught to every woman in this world. Most of the upper and upper-middle-class society people show a high burden in somatic symptoms and also psychological symptoms. About 1/3rd of women lack in diet pattern during menopause. The program and public awareness to be focused during the upcoming years. Also, many camps to be conducted to spread during menopause.

Conflict Of Interest:
There is no conflict of interest.

Ethical Considerations:
IRB clearance obtained from the TamilNadu Dr.M.G.R Medical university.