Medico-social dimensions of menopause: a cross-sectional study from rural south India.

BACKGROUND The quality of life of the increasing ageing population is becoming an important issue in India. There are very little data on the effect of menopause on women, especially from rural India. METHOD A population-based cross-sectional study was conducted on perceptions regarding menopause, prevalence of menopausal symptoms and association of family environmental factors with menopausal symptoms among 100 postmenopausal and 100 premenopausal rural women in south India. RESULTS Fifty-seven per cent of postmenopausal women perceived menopause as convenient. Sixty-nine per cent of them complained of diminishing abilities after menopause. Twenty-three per cent felt that sexual life ends with the onset of menopause. Sixteen per cent reported that their husbands had become disinterested in them after menopause and I1% were apprehensive about the loss of femininity. A higher proportion of postmenopausal women reported hot flushes, night sweats, urge incontinence and other somatic symptoms as compared to premenopausal women. Fifty-four per cent of postmenopausal and 32% of premenopausal women were currently not sexually active. Fifty-nine per cent of postmenopausal and 38% of premenopausal women expressed loss of sexual desire and this difference was statistically significant. There was no significant association between menopause and depression. A poor perceived relationship within the family was shown to have a significant association with depression. There was a significant association between multiple somatic symptoms and menopause. CONCLUSION A significantly higher proportion of postmenopausal women suffer from vasomotor symptoms, urge incontinence, loss of sexual desire and multiple somatic symptoms. They do not link these symptoms with menopause. Poor family environmental factors have a stronger association with depression than menopause. In view of these findings, it is important to determine the feasibility and impact of hormone replacement therapy in preventive health care in rural India.