Association of menopause with osteopenia and osteoporosis: results from population based study done in Karachi.

OBJECTIVE To assess the association of osteopenia and osteoporosis with menopause and compare the health seeking behaviour of women related to menopause in different strata of society. STUDY DESIGN A cross-sectional study. PLACE AND DURATION OF STUDY Three different socioeconomic strata of Karachi from May till August 2004. METHODOLOGY A sample of 925 women, over 35 years of age, was selected from 16 clusters of 250 households (50 houses in each cluster). All apparently healthy women having age between 35 and 50 years were selected in the cluster houses. Those who were not willing to be the part of the study or giving history of taking treatment for any disease for more than 4 weeks were excluded. In-depth interviews were conducted at their houses by the fourth year medical students trained and supervised by the senior faculty of the Medical College. T-scores were calculated to get BMD (Bone Mineral Density) for all the subjects through heel ultrasound. RESULTS A total of 287 women were found to be experiencing menopause. The mean age of menopause was 47.8+4.7 years. Out of those 287 women, 135 (47%) wanted their menses to continue and 235 (82%) had consulted a physician after menopause. There was a significantly lower score of BMD of postmenopausal women (mean=-1.833+0.65) compared to pre-menopausal women (mean=-1.597+0.60, p=0.016). Out of the 925 women interviewed, 53% had consulted a physician for various symptoms related to menopause. The symptoms experienced by pre-menopausal women included lack of sleep (25%), fear of becoming sterile (13%) and urinary incontinence (18%). CONCLUSION The average age of menopause was found to be similar to other studies of the country. Lower bone mineral density was found in greater proportion among older females. Majority needed intervention inclusive of awareness through health education and medication.