Key findings:

The study in District Sirmaur, Himachal Pradesh, assessed menopausal women's awareness. Among 400 respondents, 69.5% knew menstruation stops suddenly at menopause, 30.75% believed thin women menopause sooner, 71.75% experienced hot flashes, and 78% believed symptoms are preventable. 66.75% recognized menopause increases osteoporosis risk, and 79.25% endorsed benefits of recreational activities and yoga. Overall, 31% had very good knowledge, 41.25% good, 16.5% fair, and 11.25% poor. 

What is known and what is new?

Menopause is a natural phase in women's lives marked by hormonal changes and various physiological, psychological, and social effects. However, experiences and awareness of menopause vary due to cultural and geographical differences. This study highlights the variable levels of knowledge among menopausal women in District Sirmaur, Himachal Pradesh, regarding menopause. While some aspects are well-understood, there are persistent misconceptions, emphasizing the need for targeted educational programs to promote accurate information about menopause and its effects.

What is the implication, and what should change now?

The study conducted in District Sirmaur, Himachal Pradesh, highlights the variable levels of knowledge among menopausal women regarding menopause. While some aspects are well-understood, there are persistent misconceptions. This underscores the importance of targeted educational programs to promote accurate information about menopause and its effects. Healthcare providers and policymakers should consider implementing such programs to improve the quality of life and overall health outcomes for menopausal women in the region.

The menopausal phenomenon, a natural and inevitable phase in a woman's life, marks the cessation of reproductive functions and signifies the transition from the reproductive to the non-reproductive stage. Menopause is characterized by a range of physical, psychological, and social changes due to hormonal fluctuations, primarily the decline in estrogen levels. This period often brings about a variety of symptoms, including hot flashes, night sweats, mood swings, and vaginal dryness, which can significantly impact the quality of life and well-being of menopausal women. [1-3]

Despite its universal nature, the experience of menopause varies widely across cultures, socioeconomic backgrounds, and geographical locations. In India, where approximately 65% of women are projected to be above the age of 45 by 2030, menopause holds particular significance due to its potential influence on the overall health and social dynamics of this demographic. It is essential to recognize that menopause is not solely a medical event but also a socio-cultural phenomenon that intertwines biological changes with societal attitudes, beliefs, and practices. [2-5]

Limited awareness about menopause can lead to a multitude of health challenges for women, ranging from undiagnosed health issues to psychological distress. Empowering women with accurate information about the physiological changes and potential health risks associated with menopause is crucial for promoting their overall well-being. Additionally, involving menopausal women in informed decision-making regarding their health can contribute to better health outcomes and a higher quality of life. [4-6]

Himachal Pradesh, nestled in the northern part of India, showcases unique socio-cultural characteristics, which could shape the experiences and perceptions of menopausal women in the region. 

District Sirmaur, in particular, represents a diverse population with varying degrees of exposure to modern healthcare and information. Despite the potential impact of menopause on women's health and well-being, there is a paucity of studies examining the awareness and understanding of menopause among menopausal women in this region.

While some studies have explored menopausal awareness and experiences in various parts of India, there remains a dearth of comprehensive research focusing on the District of Sirmaur, Himachal Pradesh. This study aims to bridge this research gap by investigating the awareness levels and attitudes regarding the menopausal phenomenon among menopausal women in this region. By uncovering the factors that influence awareness and attitudes, this study can inform targeted interventions and policies that cater to the unique needs of women in this area.

Objectives Of The Study

To evaluate the knowledge regarding Menopausal Phenomenon among menopausal women in District of Sirmaur, 

Himachal Pradesh

• Research Approach -Descriptive
• Research Design- Cross-sectional survey design
• Study area: District of Sirmaur, Himachal Pradesh
• Study duration- between April 2023 to July 2023
• Study population- Menopausal women as specified by the definition that has had amenorrhoea of 12 months or more.
• Sample size- 400 Menopausal women assuming 50%            have adequate knowledge regarding Menopausal phenomenon, 5% absolute error, 95% confidence level, and 5% non-response rate.
• Sampling Technique- convenience & snowball Sampling technique

• Study tool: A google form questionnaire consisting of questions regarding socio-demography and Menopausal phenomenon was created. The questionnaire was initially pre-tested on a small number of menopausal women to identify any difficulty in understanding by the respondents.

  • Description of Tool-

    1. Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.

    2. Questionnaire: The questionnaire contains 20 structured Menopausal phenomenon’s knowledge related questions. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20)=very good,60- 79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

• Validity of tool - by the experts in this field
• Inclusive Criteria- who were willing to participate in the study.
  • Exclusion Criteria: who were not willing to participate in the study

  • Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin in both rural and urban area of District of Sirmaur, Himachal Pradesh till the 400 responses were collected. Responses were then recorded in a Google Excel spreadsheet.

  • Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage.

  • Ethical Considerations- Participants confidentiality and anonymity was maintained.

Present study was done to evaluate the knowledge regarding Menopausal Phenomenon among menopausal women in District of Sirmaur, Himachal Pradesh. A total of 400 respondents including 135 (33.75%) were from urban area and 265(66.25%) were from rural area were participated in the study. Table: 1

Table-1: Responses of the Participants to Various Statements on Menopausal Phenomenon

In the present study 124(31%) Menopausal women had very good knowledge (16-20 marks) towards Menopausal phenomenon, 165(41.25%) had good knowledge (12-15 marks), 66 (16.5%) having fair knowledge (8-11 marks) and 45(11.25%) having poor knowledge (<8 marks). Figure 1

Figure-1: Knowledge towards Menopausal Phenomenon among study participants

The current study aimed to assess the knowledge of menopausal phenomena among menopausal women in District Sirmaur, Himachal Pradesh. The results revealed a diverse range of awareness levels among the participants, providing insights into various aspects related to menopause and its effects. In this discussion, we will contextualize the findings in relation to existing literature, drawing comparisons and highlighting implications.

The evaluation of knowledge indicated that 69.5% of participants correctly understood the sudden cessation of enstruation at the onset of menopause. This finding is consistent with studies conducted by Smith et al. (2018) [7] and Gupta et al. (2020)⁸, where similar proportions of women demonstrated accurate knowledge about this aspect of menopause. 

However, it's noteworthy that 30.75% of respondents held the misconception that thin women experience menopause sooner, in contrast to findings by Patel et al. (2019) [9], who reported a higher prevalence of this misconception. This underscores the importance of targeted educational interventions to address prevalent myths.

Regarding menopausal symptoms, 71.75% of participants acknowledged experiencing hot flashes during menopause. This result aligns with research by Lee et al. (2017) [10] and Kumar et al. (2021) [11], suggesting a widespread recognition of hot flashes as a common symptom. Interestingly, 78% of participants believed that menopause symptoms are preventable and curable. This perception diverges from findings by Khan et al. (2019)¹² and emphasizes the need to enhance awareness about symptom management rather than complete prevention.

Furthermore, the study revealed that 47.25% of participants perceived hormone therapy as highly useful during menopause. This aligns with reports from Sharma et al. (2018) [13], indicating a relatively substantial belief in the efficacy of hormone therapy. However, it's important to note that medical recommendations surrounding hormone therapy have evolved, necessitating education about its potential risks and benefits.

The study demonstrated that 44% of participants believed menopause leads to weight gain and obesity. This proportion is lower than the findings of Khan et al. (2019) [12], suggesting that fewer women in this study held this misconception. This could reflect variations in socio-cultural contexts or increased health literacy within the study population.

Curiously, the belief that menopause causes various types of cancer was held by 44% of participants, a figure akin to the findings of Sharma et al. (2018) [13]. This underscores the persistent prevalence of misinformation regarding menopause and its association with cancer risk. Efforts to debunk such myths and provide accurate information are imperative.

In terms of osteoporosis awareness, 66.75% of participants recognized that menopause increases the risk of osteoporosis. This result corresponds with studies by Verma et al. (2017) [14] and Madhivanan et al. (2022) [15], suggesting a relatively high awareness level concerning bone health during menopause.

Notably, 79.25% of participants endorsed the benefits of recreational activities and yoga during menopause. This highlights the growing acknowledgment of holistic approaches to managing menopausal symptoms, in line with the findings of Kumar S et al. (2021). It signals a positive trend toward embracing lifestyle modifications for improved health outcomes.

The findings underscore the varying levels of knowledge and misconceptions regarding menopausal phenomena among menopausal women in District Sirmaur, Himachal Pradesh. 

While certain facets of menopause are well- understood, the study highlights prevailing misconceptions that necessitate focused educational interventions. 

This study emphasizes the necessity of community-based awareness programs that dispel myths and convey accurate information about menopause, its symptoms, and strategies for management.

Funding: No funding sources 

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee of MM Medical College, Kumarhatti

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