INFLUENCE OF THE CONSUMPTION OF FOODS CONTAINING PHYTOESTROGEN ON SEVERITY OF PERIMENOPAUSAL SYMPTOMS AMONG WOMEN IN NJORO DISTRICT, KENYA

ABSTRACT
Going through peri menopause is stressful for any woman and it is often difficult to accept the changes caused by the imbalance in hormone levels in the body during this period. Perimenopause is a transitional phase that occurs before menopause and may have severe physical, emotional and cognitive symptoms. To address this problem, Hormone Replacement Therapy (HRT) has been used to control the symptoms, despite the fact that HRT is associated with breast and uterine cancers. Foods that contains phytoestrogen, a plant derived estrogen, can however be used to control the symptoms with less negative effects. The purpose of the study was to determine the influence of consumption of foods containing phytoestrogen on severity of perimenopausal symptoms among women aged between forty and fifty five years. Quantitative and Qualitative research methods were used in the study. The study employed descriptive survey design and was conducted in Njoro District of Nakuru County. Snowball sampling technique was used to select 118 women in perimenopausal phase. Data was collected using interviews and Focus Group Discussions. The validity and reliability of the instruments was ascertained using content validity and Cronbach coefficient alpha respectively. The reliability based on Cronbach’s alpha was 0.87. Data was analyzed using both descriptive and inferential statistics aided by Statistical Package for Social Sciences (SPSS) version 17.0. The inferential statistics used were spearman’s rho (rs) rank correlation coefficient and Chi-Square to establish the influence of foods containing phytoestrogen consumed by the women on the severity of perimenopausal symptoms, and was tested at 0.05 level of significance. The findings showed that the types of foods containing phytoestrogen significantly influenced the severity of perimenopausal symptoms with nuts and soy products indicating stronger relationship. Similarly the high frequency and duration of consumption of foods containing phytoestrogen significantly reduced the severity of the perimenopausal symptoms. Those who started during childhood and adolescence, 61% of the participants experienced between none to medium levels of severity of the symptoms, while those who started during adulthood, 39% experienced high to very high levels of severity of the symptoms. This study revealed that most of the interviewed women (84%) seemed to be ignorant about perimenopausal phase and the symptoms experienced during this time. The study recommends awareness creation on the perimenopausal phase and its implication; this will empower the women to take control over their lives during this difficult phase in their lifespan. It can be done through health institutions, women groups and schools.

CHAPTER ONE
INTRODUCTION
Background Information
Perimenopause, a period just prior to the cessation of menstrual flow in women, is a transitional phase of life that many women go through (Cherry & Cherry, 1999). It is inevitable and natural. Also referred to as climacteric or turning point, perimenopausal period is a time of important physical, emotional and psychological changes in a woman’s life. During this phase, symptoms such as hot flash, memory loss, vaginal dryness, irritability insomnia and many others are experienced in different degrees, that is, from low, medium, high to very high. These symptoms may occur gradually, usually between the ages of forty or forty five and fifty five years, however, the symptoms can exhibit from as early as twenty five to as late as seventy years (Rajeev, 2009; Mandenhall, 2009). Being the period when the women have active lifestyle; various responsibilities such as community development activities, taking care of the family, having adolescent children and they may also have jobs to keep outside the home, the severity of the symptoms experienced are likely to affect their lives and these activities. In addition to the changes and symptoms, the women’s relationships within and outside the home may be affected. (Wambui, 2006; Henkel, 2001). However, how a woman will adapt to any change depends largely on the health of her total being, that is, physical, emotional and cognitive. Some women go through this phase unnoticed; others mildly and about 10-30% go through it painfully (Cherry& Cherry, 1999).

According to Ojeda (1990), the attitude of the women during this time can also be linked to cultures of different societies. Studies show that the stereotype of an irrational woman during this phase is not universal and the negative reaction to common physiological pressure such as menstruation, perimenopause and menopause are culturally engendered. Depending on individual binding sites for estrogen, hormone dependent symptoms may predominate or lack altogether. Cherry & Cherry (1999) assert that most women are ignorant about this phase of life, although many experience the symptoms associated with it. Because of this ignorance, many women seek medical attention assuming that symptoms experienced are as a result of some other ailments.

The imbalance brought about by lack of progesterone and estrogen hormones during perimenopause period cause a wide range of physical, emotional and cognitive symptoms; and duration of these symptoms varies from woman to woman. Physical changes are in the menstrual cycle, vaginal dryness, hot flashes and sleep disorders. Emotional and cognitive changes include mood swing, memory loss, loss in sexual arousal, irritability and many others, causing frustration and helplessness (Rajeev, 2009). To alleviate these problems, hormone replacement therapy (HRT) has been used, and though medical doctors prescribe treatment by giving oral tablets, questions arise particularly from the women about their effect and safety, especially when they have to take them for the rest of their lives. These drugs have also been associated with diseases such as breast and uterine cancers (Beck, 2003; Henkel, 2001).

To avoid the negative effect of HRT, certain foods and nutritional supplements that contain phytoestrogen, a plant derived estrogen have been cited as possible natural alternatives (Rajeev, 2009; Pamplona, 2009). However, La Marca (2010) argues that, phytoestrogen-rich diet has to begin in childhood if it is to protect a woman from perimenopausal disorders and the risk of breast cancer. According to Cherry & Cherry (1999), symptoms of perimenopause can be controlled by the consumption of Mediterranean diet that features a high intake of vegetables, legumes, fruits and cereals. Women in the Eastern countries consume these foods, and hence do not experience severe perimenopausal symptoms. Vegetarian diets that include, Soy, peanuts and sweet potatoes contain plant hormone phytoestrogen which takes the place of the body’s estrogen when levels decrease, easing symptoms of perimenopause and osteoporosis (Omoni & Aluko, 2005). High fiber diets found in whole meal cereals, pulses and vegetables have also been found to be beneficial in preventing many ailments including perimenopausal symptoms. Other recommended nutrients during perimenopause include; Vitamins A, B, C, D and E, magnesium, calcium, zinc and boron (Ludington & Diehl, 2001).

Foods containing phytoestrogen such as red and yellow fruits, green leafy vegetables, red and yellow vegetables, peas, cabbage, Irish potatoes, sweet potatoes, beans, fruits, peanuts, soy and soy product are grown, sold and consumed in Njoro District (District Agricultural Office Njoro, 2011). However, the benefits of such foods may be limited because of lack of necessary information on health and nutrition. This study therefore sought to establish the influence of foods containing phytoestrogen on severity of perimenopausal symptoms among women in Njoro district, Kenya. Descriptive survey research design was used to achieve the aim of the study.

Statement of the Problem
Most women start their perimenopausal phase at the age of 40 years, during which time they experience symptoms that adversely affect them physically, emotionally and cognitively. These symptoms result from hormonal imbalance in the body that leads to changes in menstrual cycle, vaginal dryness, changes in a woman’s sex drive, hot flashes, insomnia, headaches, irritability, moodswing and memory loss causing frustration. Depending on severity of the symptoms, the repercussions are significant stress noted on women’s health, families and marital unions in particular. Given that this is the time when these women have active life styles, including many development activities and responsibilities, these symptoms may interfere with their work related activities. This, therefore, requires the right and safe intervention measures.

For a long time, hormone replacement therapy (HRT) has been used as an intervention for the perimenopausal symptoms, but this is associated with endometrial, breast and uterine cancers, which are terminal illnesses. Foods that contain phytoestrogen can be used as safe alternative to hormone replacement therapy to address perimenopausal problem. Research that has been carried out on women in Latin America, Asia, Mediterranean lands and western countries show that, the women in these countries who consume the foods that contain phytoestrogen experience less severe perimenopausal symptoms, while some do not experience the symptoms at all. Foods these women consume are soy and soy products, beans, lentils, peas, cereals, red and yellow fruits and vegetables. Some of the foods mentioned are grown, sold and consumed in Njoro District. However, the influence that these foods have on perimenopausal symptoms has not been established among women in perimenopausal phase in Njoro district. This study therefore, sought to determine the influence of consumption of foods containing phytoestrogen on severity of perimenopausal symptoms among women in Njoro District.

Purpose of Study
The purpose of this study was to determine the influence of the consumption of foods containing phytoestrogen on severity of perimenopausal symptoms among women in Njoro District, Kenya.

Objectives of the Study
The objectives of this study were to:

i. Establish the level of awareness of women aged between 40 and 55 years about the perimenopausal phase in Njoro District.

ii. Establish the perimenopausal symptoms experienced by women in perimenopausal phase in Njoro District.

iii. Establish the types of foods containing phytoestrogen consumed by women in perimenopausal phase in Njoro District.

iv. Establish the frequency and duration of consumption of foods containing phytoestrogen among women in perimenopausal phase in Njoro District.

v. Determine the influence of the types of foods containing phytoestrogen consumed on the severity of perimenopausal symptoms among women in perimenopausal phase in Njoro District.

vi. Determine the influence of the frequency and the duration of consumption of foods containing phytoestrogen on the severity of perimenopausal symptoms among women in perimenopausal phase in Njoro District.

Research Questions
i. What is the level of awareness of women in Njoro District about perimenopausal phase?

ii. What symptoms are experienced by women during perimenopausal phase in Njoro District?

iii. What types of foods containing phytoestrogen are being consumed by women in perimenopausal phase in Njoro District?

iv. What is the frequency and duration of consumption of the foods containing phytoestrogen by perimenopausal women in Njoro District?

v. What is the influence of the types of foods containing phytoestrogen consumed on the severity of perimenopausal symptoms among women in perimenopausal phase in Njoro District?

vi. What is the influence of frequency and duration of the consumption of foods containing phytoestrogen on the severity of perimenopausal symptoms among women in perimenopausal phase in Njoro District?

Significance of Study
The symptoms such as hot flashes, headaches and joint pains that manifest in women going through perimenopausal phase are sometimes confused with diseases such as malaria and typhoid. The determination of the influence of foods containing phytoestrogen on severity of perimenopausal symptoms among women in Njoro District, would not only be useful to the participants (women) themselves, but also valuable to family members of these women, many organizations, and stakeholders that work with groups including the government. The study may open a channel for more detailed research on foods that can actually offer safe alternative to the women.

Assumption of the Study
It was assumed that the women aged between the period 40 to 55 years were experiencing perimenopausal symptoms.

Scope of Study
The study focused on the influence of the consumption of foods containing phytoestrogen on the severity of perimenopausal symptoms. It also looked at the level of awareness about perimenopausal phase among women aged 40 to 55 in Njoro District, the symptoms experienced by the women during this phase, the foods containing phytoestrogen consumed by the women, frequency and the duration of consumption of these foods.

Limitation of the Study
Since non-probability sampling method was used, the findings of this study can only be generalized to women in Njoro District.

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Item Type: Kenyan Material  |  Attribute: 61 pages  |  Chapters: 1-5
Format: MS Word  |  Price: KSh900  |  Delivery: Within 30Mins.
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