Documentation of self-care actions taken for somatic complaints by postmenopausal Malay women living in Kelantan Malaysia.

OBJECTIVE: The aim of this study was to document some of the self-care actions taken by women in Kelantan to manage their somatic symptoms associated with menopause. METHOD: A verified semi-structured questionnaire in the Malay language was administered to 326 naturally menopaused healthy women (mean age of 57.01+/-6.58 (S.D.) years) residing in Kelantan to determine the prevalence and types of self-care actions taken for their somatic complaints. RESULTS: Mean age at menopause was 49.4+/-3.4 (S.D.) years and 75% of these women were within the first 10 years of menopause. Of the four somatic symptoms, tiredness was the most prevalent followed by reduced level of mental concentration, musculoskeletal aches and pains, and backache. The prevalence of self-care actions was highest for backache (91%) and the lowest for reduced level of concentration (47.7%), and both prevalence and type of self-care action appear to depend upon the area of residence, and the educational level of the subject. Of those who took self-care actions, majority were from urban areas and with a higher educational level. Although HRT was used for all the four complaints, the use of pain relief tablets and traditional body massage was more commonly used for musculoskeletal aches and pains and backache than HRT. There was also a small fraction of women who had used the traditional herbs like 'akar kayu' and 'jamu' for these two complaints. CONCLUSION: It appears that the self-care actions used by postmenopausal women in Kelantan for their somatic complaints ranged from HRT to a combination of conventional, traditional, and alternative remedies. The fraction of women taking self-care action varied from symptom to symptom and the choice of self-care action also depended upon the education level, socio-economic status and place where the respondents were domiciled. There was a tendency for the more affluent and educated women to use more of the modern practices and slightly less of the traditional remedies whereas the rural women did the opposite. This is the first study of its kind in Kelantan documenting the self-care practices of menopausal women for their somatic complaints. Clearly more studies are needed to document these practices and the effectiveness of these self-care remedies.

Prevalence of menopausal symptoms in women in Kelantan, Malaysia.

OBJECTIVES: The aim of the study was to document the prevalence of 16 symptoms commonly associated with menopause, in women living in Kelantan. METHOD: After verification, a semi-structured questionnaire in the Malay language was administered to 326 naturally menopaused healthy women in Kelantan (mean age of 57.1+/-6.58 (S.D.) years) to assess the prevalence of 16 common symptoms, which had been identified through focus group discussions and those that have been repeatedly reported in the literature. RESULTS: Mean age at menopause was 49.4+/-3.4 (S.D.) years while both the mode and median were 50 years. Of these, 75% were within the first 10 years of menopause and the rest were within the range of 11 to more than 20 years postmenopause. The mode for the number of symptoms complained by each woman was 8 (range 0-16). The prevalence of atypical symptoms was as follows: tiredness (79.1%), reduced level of concentration (77.5%), musculo-skeletal aches (70.6%) and backache (67.7%). Night sweats (53%), headache (49.4%) and hot flushes (44.8%) were the typical vasomotor symptoms, whereas mood swings (51%), sleep problems (45.1%), loneliness (41.1%), anxiety (39.8%) and crying spells (33.4%) were the main psychological symptoms. Uro-genital symptoms such as vaginal discomfort (45.7%), occasional stress incontinence (40%), weak bladder control (24%) and urinary tract infection (19.3%) were also reported. CONCLUSION: The symptoms are somewhat similar to those experienced by postmenopausal women elsewhere, albeit at different frequencies. There was a tendency for the women to admit to having more of the atypical symptoms, the prevalence of some which increased with increasing menopausal status, and lesser of the vasomotor and psychological symptoms.

Sexual function in menopausal women in Kelantan, Malaysia.

OBJECTIVES: The aim of the study was to document sexual function in Kelantanese postmenopausal women. METHOD: A semi-structured questionnaire in Malay language was administered to 326 women (mean age of 57.1+/-6.58 (S.D.) years) residing in Kelantan. The subjects comprised of naturally menopaused, healthy women. RESULTS: Of the total respondents, 70% (n=227) were with a spouse at the time of the study. Of these, more than two-thirds reported a decrease in sexual activity following menopause. Varying degree of dyspareunia was reported by 44% of the women. A small fraction (8.8%) reported inability of the vagina to stretch sufficiently to enable the complete penetration of an erect penis. Of the total married respondents, vaginal secretion during sexual intercourse was decreased in 52.4%, did not change in 31% but increased in 1.3% of the women following menopause. Sexual desire was reportedly decreased or absent in two-thirds of the total respondents (n=326). CONCLUSION: It appears that sexual function significantly decreases during menopause. This may be due to dyspareunia, poor lubrication, loss of sexual desire, and the spouse's health status and ageing itself. Although declining sexual function was recognised by nearly two-thirds of the women, more than half did not take any action to improve their sexual function. Of those who did, they used hormonal therapy, traditional, alternative medicine or practiced healthy lifestyle or a varied combination of above self-help actions.