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Introduction: During menopause, women experience various psychological or physical changes which need adequate attention. Moreover, women don’t seek help for these problems due to their hesitancy, lack of awareness, socio-cultural, financial constraints or as they feel this is a natural-phenomenon. The study aims to explore the postmenopausal experiences faced by women during menopause and to elicit the constraints faced by them in seeking health-care services. Methodology: This was a qualitative study with phenomenological approach conducted among post-menopausal women (≥45 years) from Oct 2022-Jan 2023 with the help of In-Depth-Interview guide in four villages of Bhatar Block, Purba-Bardhaman District. Considering the availability of the study participants, they were selected purposively from the list prepared by ASHA of each village and recruitment done till the point of data-saturation. Inductive thematic-analysis was used to identify codes and themes. Results: During menopause, women experienced physical and psychological changes in the body, changes in social life and for these changes they had to adjust to cope-up. They felt various needs like empathy from hus-bands, children, peers. On the other hand, they did not seek help from health-care services due to their knowledge gap, dissatisfaction from previous-visit, cost-issue and unavailability of resources in health-care delivery system. Conclusion: Majority of the post-menopausal women faced various problems associated with menopause, but very few had sought help. So, health care providers have an important role to generate awareness among post-menopausal women regarding physical and mental changes during this phase.
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Background: Menopause has become a popular topic of study as life expectancy rises around the world. The average age at menopause in both developed and developing countries ranges from 45 to 53 years. Factors influencing the extent of ovarian follicle reserve dwindling, such as sociodemographic, menstrual, reproductive, and dietary factors. Aim and Objective: The present study aimed to determine the mean age of menopause and to find out the various factors affecting menopause onset. Methods: A community based cross-sectional study conducted in rural and urban areas of District Dehradun for a period of 1 year starting 1st August 2020 to 31st July 2021. Data were collected using multistage stratified random sampling from 211 cases of natural menopause. Chisquare was applied as statistical test of significance and p < 0.05 was considered statistically significant. Results: According to current study, average age menopausal age is 46 years. Variables like sociodemographic characteristics, lifestyle habits, reproductive and menstrual factors were found to have a significant relationship with onset of menopause. Conclusion: Menopause, whether it occurs early or late in life, several factors are responsible for deciding its onset. As a result, it is critical to identify the factors influencing the onset of menopause.
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Introduction: Obesity is a growing problem and has signi?cant implications for a variety of diseases, including human cancers. Obesity has now become an epidemic so is the increase of gynecological malignancies in this era. So we review the association of obesity and gynecological malignancies like breast, endometrial, cervical, ovarian, tubal and Vulvo-vaginal carcinoma as an independent etiological risk factor. To Aims and objectives: estimate the prevalence of overweight and obese female in western Indian population. To ?nd the association of different gynecological malignancies and obesity. To evaluate the effect of obesity on different gynecological malignancies in accordance with age, reproductive life and socioeconomic status A cross sectional study in western . Materials and methods: Indian states Gujarat, Maharashtra and Rajasthan from January 2019 to December 2021, 10245 sample size and with overweight and obese post menarchal women up to 70 years of age with BMI >25 kg/m2 were compared to matched controls. All the consented subjects were initially screened by questionnaire by ?eld worker and examined for routine and advanced screening and examinations like Manual Palpation of breast, per abdomen, per speculum per vaginal examination and Pap smear by certi?ed professionals according to standard protocols. Investigation was performed when required like mammography, Ultrasonography and laboratory investigations. Positive association of breast and endometrial Results: carcinoma especially in postmenopausal women and cervical carcinoma. Weak positive association for ovarian carcinoma only in premenopausal woman (not statistically signi?cant). We do not ?nd enough cases to conclude anything for vulvo vaginal and tubal carcinoma. Growing epidemic of obesity can be statistically correlated with increasing Conclusion: incidence of gynecological malignancies like breast, endometrial, ovarian and cervical. Large scale studies further needed for evaluation of correlation of vulvo vaginal and tubal carcinomas
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Age at menopause influences the severity of post-menopausal symptoms to determine the symptoms and clinicodemographic links in post menopauseal women in a representative population from eastern Uttar Pradesh. All postmenopausal women presenting with symptoms in the Gynaecological Emergency Department for a period of one year were enrolled. Age and clinicodemographic details, symptoms severity, and reasons for delay in seeking treatment were noted. The data was analysed using Chi-square test. Overall 990/17,927 (5.52%) women visiting the gynaecological OPD presented with post-menopausal complaints. Among menopausal women, the mean age ranged from 40 to 60 years old with a mean age of 46.6012.48 years. Majority were para 3-4 (52.5%), age at menarche were >13 years (58.3%), uneducated (58.8 %) , lower/upper lower SES (57.5%), married (77.3%) and had BMI<18.5kg/m2 (62.1%). Tobacco/smoking addiction was reported in 55 (5.6%) women. A total of 145 (14.6%) were working women. Severity of symptoms was mild, moderate and severe in 57.2%, 28.3% and 14.5% cases. Majority had onset of symptoms for 4- 5 years (56.4%) after menopause. Joint pains and Backache/body ache were the most common presenting complaints (81.8%). A significant association of age at presentation was seen with parity, age at menarche, BMI category and occupational status. Severity of symptoms showed a significant association with age at presentation, parity, age at menarche, BMI category, occupational status and tobacco/smoking use. Most common reasons for delayed treatment were financial problems (22.2%), family problems (18.2%) and commonness of problem (12.6%). Only 2.1% women were aware about HRT. Among the relatively less informed members of our study population, low socioeconomic status, underweight, and menopause age were all influenced by clinicodemographic factors.
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Background: Menopause is defined according to WHO as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is defined as uterine bleeding occurring after at least 1 year of amenorrhoea. Considering the high accuracy of hysteroscopy in evaluation of postmenopausal bleeding, the present study was carried out with an aim to evaluate hysteroscopic findings in women with postmenopausal bleeding in order to assess the causes of PMB and to determine their prevalence in our population.Methods: This was a prospective observation study, comprising of total number of 50 postmenopausal women attending gynae OPD at department of obstetrics and gynecology, Command Hospital (CH), Lucknow, Uttar Pradesh. The data obtained for the purpose of study was fed into computer using Microsoft excel 2013 software.Results: A total of 50 women with complaints of postmenopausal bleeding were enrolled in the study. Maximum number of women had achieved menopause between age 46 and 50 years. Hysteroscopy had an accuracy of 94% for detection of polyps. Hysteroscopy had an accuracy of 90% for detection of atrophy. For fibroid, hysteroscopy had an absolute sensitivity, specificity, positive predictive, negative predictive and accuracy value (100%).Conclusions: The findings of present study suggested that hysteroscopy has a useful role in evaluation of postmenopausal bleeding especially in the diagnosis of polyps and fibroids. Given fewer number of cases, the usefulness of hysteroscopy in evaluation of endometrial cancer and hyperplasia could not be established adequately. Further studies on larger number of sample size will help in providing more useful and confirmatory information.
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Background: Geriatric gynaecology deals with gynaecological pathologies essential in post-menopausal women aged 65 years and above. The spectrum of geriatric gynaecological disorders in India differs from those in developed countries as there are no effective screening program for early detection of cancer and the burden of ignorance and taboos. In this study we aim to find the spectrum of gynaecological disorders in geriatric women and establish the need of dedicated geriatric unit.Methods: A cross-sectional comparative study was conducted on menopausal women of age 45 years or above who attended gynecology OPD for general counselling about menopause or treatment of menopausal problems over the period of 6 months duration. All these menopausal women attending OPD during this interval were evaluated on the basis of pretested questionnaire.Results: Out of 234 post-menopausal women who entered the study, 29% women belong to geriatric group. Post-menopausal bleeding due to both malignant and benign causes and pelvic organ prolapse are the major problems in geriatric women whereas somatic complaints like flushing, night sweats are more common in younger menopausal women.Conclusions: Where the medical science has successfully increased the life expectancy, focused approach to geriatric gynecology around us is our responsibility, where female still hesitate to come out. The need for dedicated geriatric gynecology unit in India on urgent basis is emphasized by this study wherein cancers can be screened in early stage and severe lifestyle hampering conditions like pelvic organ prolapse can be treated timely.
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Background: Evaluation was done in 100 women presenting with postmenopausal bleeding, (PMB), to discuss the utility of hysteroscopy combined guided endometrial curettage in the diagnosis of uterine cancer and endometrial hyperplasia, and, treat benign lesions, like polyps, synechiae at the same sitting. At MGMH during the years, 2002 to 2006, there were 57 women, and at care, 40 women with PMB during 2011 to 2013, and three in a nursing home, Hyderabad, were investigated.Methods: Evaluation was done in 100 women presenting with PMB by hysteroscopy and curettage to diagnose the cause of PMB and benign lesions like polyps, synechiae were managed by operative hysteroscopy. Bettocchi 5 mm hysteroscope, monopolar instruments and glycine was used for excision of polyps.Results: In one hundred women with PMB, 19% had cancer. Endometrial adenocarcinoma in 14, endocervical carcinoma in 2, uterine carcinosarcoma in 3 cases. All 3 cases of uterine carcinosarcoma on hysteroscopy were large polyps measuring 5×5-6 cm size. Atypical hyperplasia endometrium in 7% and simple hyperplasia in 17%, was reported on histopathology, in cases with hyperplastic endometrium on hysteroscopy. Benign polyps in 41% were managed at the same sitting by operative hysteroscopy.Conclusions: Women with postmenopausal bleeding must have USG, trans vaginal sonography (TVS), endometrial thickness (ET) measurement, preferably endometrial echo complex (EEC). In women with PMB, the risk of uterine cancer would be 19%, i.e., 1 out of 5 women. Atypical hyperplasia in 7%. Hysteroscopy guided curettage, with histopathology, is the gold standard protocol in cases of PMB.
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Background: The physiological changes associated with menopause are responsible for increase in cardiovascular disease after menopause. BMI, physical inactivity, metabolic syndrome, hypertension and diabetes mellitus increase in post-menopausal women which are all powerful predictors of cardiovascular events. The risk factor profile between pre-menopausal and post-menopausal women presenting with acute coronary syndrome was thus studied.Methods: This study was a prospective cross-sectional hospital based study and was conducted in the Department of Medicine and Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana wherein 50 pre-menopausal women and 50 post- menopausal women who presented with acute coronary syndrome were enrolled. The risk factor profile and angiography findings amongst the 2 groups were compared.Results: There was no difference in the incidence of Diabetes Mellitus and Hypertension among the pre & post-menopausal groups. The prevalence of family history of cardiovascular disease was higher in the pre-menopausal group. The post-menopausal women showed a significant decrease in physical activity due to sedentary lifestyle. Both the groups had high BMI and increased waist circumference. Lipid parameters did not show any significant difference between the two groups. However, pre-menopausal women had higher LDL-C and triglyceride levels and lower HDL-C levels. On analysis of the angiographic findings in diabetics and non-diabetics, of both the groups diabetes mellitus was much higher in subjects presenting with triple vessel disease suggesting extensive atherosclerosis.Conclusions: study showed physical inactivity as an important cardiovascular risk factor in post-menopausal women. Obesity is an important risk factor for coronary artery disease in both pre- and post-menopausal women.
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Background: Abnormal uterine bleeding is defined as any type of bleeding in which the duration, frequency or amount is excessive for an individual patient. Hysteroscopy has ushered a new era in the evaluation of abnormal uterine bleeding. With this background, we conducted a study to find the role of hysteroscopy with dilation and curettage in post-menopausal bleeding.Methods: It was an observational study conducted in the department of obstetrics and gynecology of a tertiary care hospital in Maharashtra. Post-menopausal patients with abnormal uterine bleeding, admitted in the period of March 2018 to September 2019 were included in the study. A pretested and predesigned questionnaire was used to collect the data. Hysteroscopy with dilation and curettage was done and samples were sent for histopathology.Results: Bleeding was present in all the 30 cases. About 33.33% had pain abdomen, 56.67% had hot flushes, 10.00% had mass and 10% had other symptoms in the present study. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of hysteroscopy in diagnosing malignancy was 75%, 96.15%, 75%, 96.15% and 93.33% respectively.Conclusions: To conclude the most common cause of abnormal uterine bleeding in post-menopausal women in our study was polyp. The sensitivity and specificity of the hysteroscopy in diagnosing the malignant lesions is 75% and 96.15% respectively which corroborated with other study findings. Hysteroscopy with dilation and curettage is better alternative to hysterectomy and biopsy in most of the cases.
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Background: Menopause is recognised to have occurred after 12 months of amenorrhoea for which there are no obvious pathological and physiological causes, it is retrospective diagnosis. Objective of this study was to compare the efficacy, safety and compliance of oral estradiol and vaginal estriol for urogenital problems in post-menopausal women.Methods: A total of 100 postmenopausal women having urogenital symptoms were selected for the prospective study. The selected patients were randomly allocated in 2 groups. Group A received 2 mg of estradiol OD for 4 weeks and then evaluated after 4 weeks. Group B received 0.5 mg of vaginal estriol cream continuously for 4 weeks at night and then evaluated after 4 weeks. Patients were followed after 1,3 and 6 months. Inclusion criteria were postmenopausal women, vaginal symptoms, urogenital symptoms. exclusion criteria were all patients having estrogen dependent neoplasia and comorbidities.Results: For urinary complaints, symptomatic relief was assessed by AUA Score in which after 6 months; in Group A the difference in mean from baseline was 19.64±1.63 and in Group B it was 21±2.52 and was statistically insignificant from each other. For genital complaints, symptomatic relief was graded as 1, 2, 3, 4 in which grade 4 means complete relief. After 6 months of therapy 88.2% got complete relief in Group A and 91.1% in Group B. In vaginal cytological smears; in both groups, parabasal cells were reduced and superficial cells were increased after 6 months of therapy and both groups were statistically insignificant from each other. After 6 months of therapy, increase in mean value of KPI from the baseline is 24.54±10.1 in Group A and 28.6±10.11 in Group B and both groups were statistically insignificant. Endometrial thickness remained unchanged in both the groups after 6 months of therapy.Conclusions: Both drugs were equally effective in alleviating the urogenital symptoms with no significant side effects.
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Background: Women who lay the foundation of the whole society are most neglected in our society, especially in their mid-life. Physical and psychosocial symptoms among post -menopausal women had a positive relation with the quality of life.Methods: A total of 110 women of an urban area of North Bengal region of West Bengal, India were interviewed with help of schedule to obtain information regarding the personal characteristics and MENQOL tool to assess four domains means on the basis of 29 symptoms.Results: The mean menopausal age was 44.58±3.11 years. The means and standard deviation found in different domains are, vasomotor domain (5.35±2.94), physical domain (27.95±10.25), psychosocial domain (13.81±4.70) and sexual domain (1.99±2.91). In the vasomotor domain, muscles ache, joint ache and low back ache were the common symptoms. In psycho-social domain, 99% of the women suffered from poor memory and 97.2% of them felt depressed or down/blue. In sexual domain, 33.6% were bothered by changes in their sexual desires and avoided intimacy. In physical domain, age category, financial and decision autonomy had significant association. In the sexual domain, age category, literacy status, money and sexuality had a significant difference.Conclusions: Post-menopausal women are vulnerable group for whom appropriate and practical measures should be provided in their post-menopausal age in order to have a contented and pleasant life till they die.
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Background: There are large number of post menopausal patients in India deserving more care and attention than is given at present.MRS questionnaire in Hindi (MRS-H), a translated and validated version of original MRS Scale (MRS-E), self assessed by patients in their own native language. This tool can be used to assess and document current quality of life as well as improvement with treatment of severe post menopausal symptoms, in Indian population.Methods: 30 bilingual English and Hindi speaking postmenopausal patients were recruited for this study.MRS Questionnaire has 11 questions covering somatic, pschycological and genitourinary symptoms of menopause. The scoring system is simple. Hindi translation of MRS Questionare was done from English (MRS-E) to Hindi (MRS-H) by 4 independent translations using standard protocol. The MRS-H was tested for internal validity and also compared with MRS - E.Results: Quality of life is a subjective perception modified by the cultural habitat in which one lives. MRS-H showed high validity and good co-relation with MRS-E. The MRS-H possessed good convergent and discriminant validity. MRS-H showed anICC (Intraclass coefficient) was more than 0.5 and cronbach alpha more than0.5. There was found to be strong correlation between MRS-E and MRS-H questionnaire with all correlation value above 0.7.Conclusions: The authors recommend the use of the self assessed MRS-H in Hindi should be used to assess menopausal complaints and relief with treatment in India.
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Background: The objective of the present study was to observe the post void residual volume (PVRV) in women with pelvic organ prolapse (POP) pre and postoperatively and to correlate stage of prolapse with lower urinary tract symptoms and quality of life in women with pelvic organ prolapse.Methods: This is a prospective observational cohort study of 100 women with symptomatic pelvic organ prolapse of stage II or greater. Patients were admitted for Vaginal hysterectomy with pelvic floor repair for pelvic organ prolapse in Gynaecology Department at Christian Medical College Hospital, Vellore, India over one year were recruited. This study was approved by the institutional review board and ethical committee of the hospital. Pre- and post-operative PVR were measured. The statistical analysis was done by using SPSS version 21 and P value < 0.05 was considered as statistically significant.Results: In this study 100 patients were recruited and 11% of women had pre-operative high post void residual volume of more than 100 ml. Stages of POP did not correlate with severity of LUTS and QOL. Pre-operative elevated PVR resolved post operatively in 91%, the P value <0.000 which was highly significant.Conclusions: 11% of women had preoperative high PVR. Stages of POP did not correlate with severity of lower urinary tract symptoms (LUTS) and quality of life(QOL). Pre-operative elevated PVR resolved post operatively in 91%, the P value < 0.000 which was highly significant. Majority of the patient with severe pelvic organ prolapse had elevated pre-op PVR which resolved post- operatively after surgical correction.
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Background: The phase of menopause is a physiological event which occurs as a result of progression of reproductive ageing. Women from developing countries view variations due to menopause as natural process and there is no need for medical care. The objective of the study was to assess the health seeking behaviour among the post menopausal women.Methods: A cross-sectional study was conducted in the rural and urban field practice areas of department of Community Medicine of Gandhi Medical College, Hyderabad. About 300 urban and 300 rural women were interviewed using a semi-structured and pretested questionnaire from August 2015 to September 2017.Results: Among the rural women, 100 (25.4%) women did not seek health care and among those who sought health care, majority (34.3%) preferred government healthcare services followed by 23% who consulted private facility. Of the urban women, 14.7% did not seek health care, 42% of the women approached private practitioner followed by 23% who sought health care in government hospital. Majority of the women (42.2%) did not seek health care as they thought they will be normal with time.Conclusions: More than one third of the women are not aware of menopause and related problems. Among those who did not seek health care, higher proportion felt they will be Ok with time followed by financial constraints, fear/shy, family problems and lack of transport.
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Background: Estrogen therapy in younger postmenopausal women is associated with a decisive reduction in morbidity and mortality, but estrogen use in this population is low because of risk of side effects. Weekly intermittent therapy is a more patient friendly approach with reduced pill burden increasing compliance and adherence as well as reducing side effects. Therefore, authors wanted to study the effect of weekly intermittent fixed dose estrogen and progesterone (ultra-low dose) supplements in hysterectomised surgically menopaused women.Methods: The present study was prospective and retrospective study. For retrospective study authors records of 100 hysterectomised women up to 45years of age with severe post-menopausal symptoms treated in authors Medicine Department of Hospital with once weekly MALA-D tablets were studied. For prospective study, all consecutive hysterectomised patients with severe post-menopausal symptoms attending medicine OPD were given once weekly MALA-D which contains ethinylestradiol 0.03mg and levonorgestrel 0.15mg tablets and followed up monthly with outcomes measured by Modified Kuppermann Index, visual analogue scale, and women’s health questionnaires.Results: Present retrospective study showed moderate degree of postmenopausal symptoms as indicated by Modified Kuppermann index of 19.57. Prospective study showed significant improvement in postmenopausal symptoms with weekly intermittent hormone replacement therapy as indicated by outcomes measured by Modified Kupperman index and Visual analogue scale. Women’s health questionnaire also showed statistically significant improvement in 6 out of 8 dimensions.Conclusions: Authors concluded that weekly estrogen progesterone hormone replacement therapy with mala-D tablet (ultra-low dose therapy) was 100% effective in relieving vasomotor symptoms and it is very effective in improving psychosomatic symptoms, urinary symptoms and quality of life with no obvious side effects and greater adherence.
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@#Introduction: Post-menopausal osteoporosis is the most common type of osteoporosis, which occurs due to a deficiency of oestrogen following menopause. Considering the adverse effects of oestrogen replacement therapy, natural products may serve to replace the current conventional treatment. Ficus carica (FC) which is commonly known as fig may have a potential in treating post-menopausal osteoporosis due to their abundance of important minerals and bioactive compounds such as phenolic, flavonoid and anthocyanins. This study aimed to evaluate the effects of FC on bone metabolism of ovariectomized rats. Materials and Methods: Fifty-six female Spraque-Dawley rats were randomly divided into seven groups; SHAM operated (SHAM), ovariectomized control (OVX), ovariectomized + 64.5 µg/kg oestrogen (ERT), ovariectomized + 50 mg/kg aqueous extract of FC (AQ50), ovariectomized + 100 mg/kg aqueous extract of FC (AQ100), ovariectomized + 50 mg/kg raw FC (RW50), and ovariectomized + 100 mg/kg raw FC (RW100). After eight weeks of treatments, rats were euthanized and femurs were dissected out to measure bone osteocalcin, Ctelopeptide of type 1 collagen and bone estrogen level. Results: RW50 and RW100 showed an increasing trend in osteocalcin levels and also oestrogen level, but no significant difference between all groups. RW50 and RW100 also showed significantly reduced C-telopeptide of type 1 collagen levels compared to OVX group. Conclusion: These findings suggested that raw FC at the doses of 50 mg/kg and 100 mg/kg have potential to improve bone in treating post-menopausal osteoporosis. However, this need to be confirmed with higher doses.
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Post-menopausal osteoporosis (PO) is one of the major health issues associated with menopause-related oestrogen withdrawal. Despite the intense research and the relevant progress achieved in the last two decades, the pathogenic mechanism underlying PO is still poorly understood. As a consequence of this gap in the knowledge, such disorder and the related complications are still difficult to be effectively prevented. A wealth of experimental and epidemiological/clinical evidence suggests that the endocrine change associated to menopausal transition might lead to a derangement of redox homeostasis, that is, the prelude to the health-threaten condition of oxidative stress (OxS). In turn, this (bio)chemical stress has been widely hypothesized to contribute, most likely in synergy with inflammation, to the development of menopause-related diseases, including PO. The main aim of this review is to discuss the current literature evidence on the association between post-menopausal oestrogen withdrawal, OxS and PO. It is also aimed to provide a critical overview of the most significant epidemiological studies on the effects of dietary antioxidants on bone health and to devise a strategy to overcome the limitations emerged and controversial results.
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Background: Menopausal women may experience vasomotor, urogenital and psychological symptoms as well as sexual dysfunction. These problems are often attributed to hormonal changes during midlife and are projected as health risk. The present study was conducted to assess the quality of life (QOL) and determinants in postmenopausal women. Materials & Methods: The present study was conducted on 140 postmenopausal women age ranged 45- 60 years of age. All women were provided with a pre-designed questionnaire containing 24 questions about quality-of-life in menopause. Scores for vasomotor aspect ranged from 0 to 6, for psychosocial aspect from 0 to 18, for physical aspect from 0 to 42 and for sexual aspects from 0 to 6. Results: 60 women were <50 years and 80 were >50 years. Psychosocial score of 5-15 was observed in 42 women, vasomotor score of 2-5 was seen in, physical score of 24-33 was seen in 12 and sexual score of 2-4 was seen in 32 women. 65 women had more than 5 years of menopause while 75 had less than 5 years. 110 women exercise in the form of brisk walking while 30 do not. In 90 women, relation with husband deteriorated after menopause and 50 women never complained of this. 80 were living with their children while 60 not. 50 women had support from their children while 90 had not. 75 women had good perception of her heath while 65 had average perception. All domain showed significant difference in QOL. Conclusion: Post-menopausal women who fall in a transitional population between the reproductive age group and geriatric population need special attention. Their quality of life is highly determined by physical domain and psychosocial domain
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Background: Drug prescription in menopause is complex as estrogen deficiency, hypertension (HT) and other risk factors, rapidly increase the risk of cardiovascular diseases (CVD) in post-menopausal women (PMW). Objectives: To evaluate the prescription trends of anti-hypertensive drugs in PMW. Methods: This was an observational, cross sectional study conducted over a period of 1 year, on hypertensive PMW. The prescriptions were evaluated for antihypertensive drug use patterns and also as per WHO core drug indicators. Results: 21.82% of prescriptions had monotherapy, amongst which angiotensin receptor blockers (ARB) (10%) and individually, telmisartan (5.45%) were most commonly prescribed. Majority of prescriptions had two drug therapy (44.09%), among which ARB + beta-blockers (BB) (20.91%) and individually, Telmisartan + Metoprolol (13.64%) were most frequently prescribed. ARB + Diuretic (DI) (9.55%) was the most common fixed drug combination (FDC) prescribed. ARB + BB + DI (10.45%), ARB + 2DI + BB (4.09%) and ARB + 2DI + BB + Calcium channel blocker (1.82%) were most commonly prescribed three, four and ≥five drug combinations, respectively. Hypolipidemic drugs (60.45%) were maximally co-prescribed. Percentage of drugs prescribed by generic name was 4.63% and from essential drug list was 32.62%. Conclusions: A high trend of polypharmacy was observed in hypertensive PMW. HT, being a multifactorial disease, deserves a multidisciplinary and a comprehensive approach in the care of this population subgroup. Knowledge of prescription pattern and thus the rational utilisation of drugs will help achieve better control rates of HT and hence curb down the burden of CVDs in PMW.
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OBJECTIVES: Menopause is a transitional time in a woman's life leading to both physical and emotional challenges which affects the quality of life (QOL). Average age of menopause is around 48 years but it strikes Indian women at the age of 40 to 45 years. So, menopausal health demands higher priority in Indian as well as global scenario. The present study was conducted to compare the QOL of postmenopausal women residing in urban and rural communities. METHODS: The study adopted quantitative research approach with comparative survey design. The samples were 100 postmenopausal women from rural urban communities selected using non probability purposive sampling technique. Data was collected by interview using demographic performa and menopause specific QOL. RESULTS: The mean QOL score (X2 = 27.24) of rural women was higher than the mean QOL score (X1 = 26.34) of urban women. The calculated independent ‘t’ value (t = 0.86; P < 0.05) is lesser than the table value (t 98 = 1.980). There was association between QOL of urban postmenopausal women and monthly income of the family (χ2 = 4.023) was statistically significant at 0.05 levels. CONCLUSIONS: There was no significant difference in the QOL of postmenopausal women in rural and urban areas. Indian women are ignorant about the changes taking place in their reproductive system. Religion and culture of our society also inhibits to express these changes. Health care professionals have a great role in addressing these issues to prepare women to face the challenges of reproductive health.