ABSTRACT
Menopause refers to the period of dramatic hormonal changes
accompanied by various symptoms which may have implication on women‘s health.
This study examined the implication of menopausal symptoms on women’s health in
Ibadan, Oyo state Nigeria. A cross sectional descriptive research design was
used for this study. Twenty basic schools in Ibadan North Local Government
(IBNLG) area of Oyo State Universal Basic Education Board (SUBEB) were selected
using multistage random sampling technique and 300 eligible women were
recruited. Data were collected using structured questionnaire and analysed
using SPSS software version 21 to produce descriptive and inferential
statistics. Findings from the study revealed physical, mental exhaustion and
sexual problem as the most common and most severe symptoms experience. Physical
and mental exhaustion as well as sexual symptoms were also the highest reported
distressful symptoms. However, majority of the study participants reported that
the symptoms experiences were not distressful. Role performance and social
functioning domain of health was perceived as not good by majority of the study
participants. Age and menopausal status had significant relationship with
number of symptoms experiences. Finally, the findings of this study have far
reaching implication on work performance and productivity as middle aged women
working in basic schools under the IBNLG area of Oyo State may not be able to
function optimally. Hence, policy makers may find the findings of this study
useful in the formulation of policies on increase health expenditure of middle
aged women.
CHAPTER ONE
INTRODUCTION
Women’s health deserves particular attention as they are
significant members of the society that play key role in the growth and
development of every ntion. Numerous studies have been conducted on menopausal
symptoms experience across the globe and a few within Nigeria (Fuh, Wang, Lee,
Lu & Juang, 2003; Agwu, Umeora & Ejikeme, 2008; Al-Olayet et al., 2010;
Gharaibeh, Al-Obeisat & Hattab, 2010; Ande, Omu, Ande & Olagbuji, 2011;
Setorglo, Keddey, Agbemafle, Kumordize & Steiner-Aseidu, 2012; Yanikkerem,
Oruc Koltan, Tamay & Dikayak, 2012; Mustafa & Sabir, 2012). However,
findings obtained from those studies may be inappropriate and unreliable for
health professional caring for working midlife women in Ibadan, Oyo state
Nigeria due to various geographical variations which may differ from those
experienced by women in Nigeria. Also, Armstrong Symptoms Experience Model
reveals that examining the symptoms experience could help understand the
implication of those experiences on the domains of health (Peterson &
Bredow, 2009). Hence, this study investigates the implication of menopausal
symptoms on women’s health in Ibadan Oyo state Nigeria.
Background to the Study
Women generally live longer than men but this longevity is
not necessarily a reflection of good or healthier life compared to men (WHO,
2009). Women spend one third of their life experiencing various health challenges (WHO, 2009). These unhealthy lives could be traced to the
numerous roles they perform in the society which include: economical
productivity, procreation, professionals, and other ascribed roles as African
women. Women’s health has become an urgent priority for the World Health
Organisation. The WHO (2009) classified women within the ages of 45-60 as women
outside the reproductive age and women of 60 years of age and beyond as older
women.
The middle age period (45-60) in women coincides with the
period of dramatic hormonal changes called menopause (Oyediji, Amodun,
Atulomah, Thomas & Ojo, 2011). Menopause is a physiological event that all
middle age women experience (Ande, Omu, Ande & Olagbuji, 2011). It is also
important to note that, menopause, is accompanied by various symptoms
(Jack-Ide, Emelifeonwu & Adika, 2014; Oyediji, Amosu, Atulomah, Thomas
& Ojo, 2011). The menopause symptom rating scale classified symptoms
experience during menopausal transition using 3 main domains which are:
somatic, psychological and urogenital domain (Al-Olayet et al., 2010; Lee et
al.,2010; Chuni & Sreeramareddy, 2011; Elsabagh & Abd Allah, 2012; da
Silvar & D’Andretta Tanaka, 2013; AlQuaiz, Siddiqui, Tayel & Habib,
2014; Chou, Wun & Pang, 2014; Joseph, Nagaraj, Saralaya, Nelliyanil &
Jagadish, 2014).
Numerous researchers have revealed that hot flushes and night
sweats are the cardinal symptoms of menopause, other symptoms include but are
not limited to vaginal dryness, or atrophy and dyspareunia, anxieties,
difficulty in concentrating, mood swing, depression, crying spells,
irritability, loss of cognitive function evidenced by forgetfulness and
increased health risks for several chronic disorders like osteoporosis and cardiovascular disease (Fuh
et al., 2003; Agwu et al., 2008; Al-Olayet et al., 2010; Gharaibeh et al.,
2010; Ande, wt al., 2011; Setorglo et al., 2012; Yanikkerem et al., 2012;
Mustafa & Sabir, 2012).
According to Nisar and Sohoo (2009) the overall health and
wellbeing of mid aged women have become a major public health concern around
the world. The World Health Organisation (1998) defined health as a complete
state of physical, mental and social wellbeing and not merely the absence of diseases
or infirmity. This implies that the measurement of a complete state of health
of an individual should not only be limited to the frequency and severity of
diseases, but the estimation of the total well being of that individual which
includes the physical, psychological (cognitive and emotional), social well
being (WHO QOL Group, 1998).
Unfortunately, in addition to the menopausal symptoms
experiences middle aged women face, diverse challenges ranging from change in
their social roles, the stress of parenting, rebellious or nagging adolescent
children, children leaving home and women having to cope with the sole
responsibility of caring for the household. Others which include caring for
their partner or ageing parents are some of the challenges experienced by
middle aged women. These challenges constitute stressors and result in
diminished physical and psychological health which could worsen their
menopausal symptoms experiences (Rouen, 2009; Kumari, Stafford & Marmot,
2005).
Numerous researches have revealed menopause to be a
significant phenomenon that impacts the quality of life in women (Oyediji,
Amosu, Atulomah, Thomas & Ojo, 2011; Elsabagh & Abd Allah,
2012; Jack-Ide, Emelifeonwu & Adika, 2014). The World Health Organisation
referred to quality of life as an individual perception of their position in
life with respect to their goal, expectation, standards, and concerns within
the context of culture and beliefs of the society in which they live (WHO QOL
Group, 1998; Skevington, Lofty & O’Connell, 2004).
In addition, quality of life of an individual is affected
greatly by that individual’s physical health, psychological state, level of
independence, social relationships, personal beliefs and their relationship to
salient features of their environment (WHO QOL Group, 1998). Similarly,
Armstrong model of symptom experience also revealed that symptoms experiences
have consequences on an individual’s physical functioning, cognitive
functioning, emotional health, social functioning and role performance
(Peterson & Bredow, 2009). Hence, women’s menopause symptoms experience may
have serious implication for their physical, cognitive, emotional, social
functioning and role performance.
It is however important to note that menopausal symptoms
experiences vary in terms of nature, frequency and severity with different
people, different phases of menopausal transition period, support network,
working status, physical activity, education level, sources of menopausal knowledge,
climate, diet, lifestyle, culture and value system, role expectations,
menopausal view and beliefs regarding reproduction and aging
(Abedzadeh-Kalarhoudi, Taebi, Sadat & Saberi, 2011; Sternfeld & Dugan,
2011; Elsabagh and Abd Allah, 2012; Jack-Ide, Emelifeonwu & Adika, 2014).
Armstrong model of symptom experience also revealed that the characteristics of middle aged women
(demographic, individual health and menopausal characteristics) could influence
an individual’s symptoms experience and that these symptoms experience could
have consequences on the individual’s health status and performance.
Hence, this study made use of the symptom experience of
menopausal women a spotlight to determine the implication of menopausal
symptoms on the physical, cognitive, emotional, social functioning and role
performance domains of women’s health in Oyo state, Nigeria.
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