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Psychological Problems and Coping Strategies Adopted By Post Menopausal

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Article  in  International Journal of Science and Research (IJSR) · February 2014

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 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064

Psychological Problems and Coping Strategies

Adopted By Post Menopausal Women
Nutan Potdar1, Mahadeo Shinde2
1
Associate Professor, Krishna Institute of Medical Sciences Deemed University
Krishna Institute of Nursing Sciences Karad Dist-Satara (India) 415539
2
Professor, Krishna Institute of Medical Sciences Deemed University
Krishna Institute of Nursing Sciences Karad Dist-Satara (India) 415539

Abstract: Background: Hormones are important in menstruation and in post menopausal period, blood level of some of the hormones is
decreased. There are physical, physiological, psychological and social effects due to changed hormonal level. In some women psychological
changes are more prominent and may affect the mental health and social life of the women. Modifications in life style and adopting coping
strategies during menopausal period are important. Methods: A survey of 100 postmenopausal women, selected by convenient sampling
method was done using structured questionnaire Pune city. The questions were directed towards assessment of psychological problems faced
by the samples and coping strategies adopted by them to overcome the psychological problems.Findings: 57% women have mild
psychological problems and 78% women are adopting coping strategies to overcome these problems. Association between the psychological
problems and coping strategies shows that there is a strong significant association between the psychological problems and coping strategies.
Score of both psychological problems and coping strategies are observed to be lying between 21-60.It shows that the postmenopausal
women’s are having mild to moderate psychological problems and they are using coping strategies often.Conclusion: Post menopausal
women face psychological problems; they also adopt coping strategies to overcome these problems. Nurse educators.

Keywords: Harmonal levels in postmenopausal women, psychological problems & coping strategies

1. Introduction strategies: either appraisal focussed, problem focussed, or

emotion focussed coping. Various coping strategies are
Human being goes through various stages of life. Each stage adopted by post menopausal womens. Yoga is, instead, an
of life is influenced by specific aspect as infancy, childhood, adaptive discipline that can support the body through the
adolescent, adult, middle age, old age. Womens of myriad of biological changes it is making. Importantly, it
postmenopausal period is very important since it influences can also support our minds and emotions, and allow us to
psychological, social, and emotional aspects due to come to a perspective on the inner processes that are
physiological changes. Psychological problems affects your happening. Many perimenopausal women have found both
physical well-being, resulting in chronic fatigue, sleep the physical and less tangible benefits of yoga helpful at this
problems, and changes in appetite. It affects your mood, time. There are some general points about asanas (poses),
with feelings of sadness, emptiness, hopelessness and however. Back bends can be great for improving one's mood
dysphoria. It affects the way you think, interfering with and lifting energy levels, and forward bends are good for
concentration and decision making. And, it affects your anxiety and stress.
behavior, with increased irritability and loss of temper,
social withdrawal, and a reduction in your desire to engage Given that quite active physical exercise had been found to
in pleasurable activities. Postmenopausal woman is mainly help with menopause, this observation is no real surprise.
affected by the hormonal factors. It is believed that a cause Ultimately, it depends on what is going on for each woman,
of depression is a change in estrogen levels, which occur and this can vary over time anyway. If you're feeling really
during menopause. Menopause has been considered a major tired all the time, restorative poses may be best for that
transition point in women's reproductive and emotional life. period. However, if you've got more energy, there are a
While its reproductive significance is clear, its emotional number of other asanas that can really help [2].
implications have been confused. Menopause refers to the
end stage of a natural transition in a woman's reproductive 2. Literature Survey
life when ovaries stop producing eggs and a woman is no
longer able to get pregnant naturally. Post-menopause refers Related research & non- research literature was reviewed to
to a woman's time of life after menopause has occurred. broaden the understanding & to gain insight into the
When women approach physiological changes that lead to selected problem under study. The review of literature is
mood swings, forgetfulness, hot flashes and all the other organized under the following headings.
symptoms associated with menopause. The symptoms of
depression and menopause are similar. [1] In coping with a) Literature related to the psychological problems of
stress, people tend to use one of the three main coping postmenopausal women.

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 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064

b) Literature related to the coping strategies adopted by Similarly Discigil G, et all (2006) conducted a study on,’
postmenopausal women. Profile of menopausal women in west Anatolian rural region
sample,’ proved that urogenital, and psychological problems
a) Literature Related to the Psychological Problems of in post-menopausal women are the most prevalent
Postmenopausal Women symptoms.[5]

It has been reported that most women in developed This is found that similarly many such studies have been
countries will live a third of their lives after the menopause conducted considering many aspects of demographic profile
(Rozenberg et al., 2000) and vasomotor as well as such as, A study conducted by Lagos X, et all (1998) on,’
psychosomatic symptoms occur frequently during this Prevalence of biological and psychological symptoms in
period of life although their severity and duration may vary postmenopausal women from different socioeconomic
widely between individuals. levels in the city of Temuco,’ proved that Bone and muscle
aches were the most frequent referred symptoms in 36% of
The menopausal symptomatic reaction can be taken to be women. Thirty one percent complained of vaginal dryness
the sum of the impact of the three components of (a) the and 28% of headache. No differences in symptom frequency
amount of estrogen depletion and the rate at which estrogen per age or between post or pre menopausal women, were
is withdrawn (b) the inherited and acquired propensities to observed. Depressive disorders were found in 39% of
succumb or withstand the imposition of the overall aging women, mostly in women not working outside their houses.
process and (c) the psychologic impact of aging and the 67% of women had a PAP smear and 58% had a
individual`s reaction to the emotional implications of a mammography performed. Women of low income levels
change of life (Speroff et al., 1999). The psychological or had a greater prevalence of biological and psychological
psychosomatic symptoms (including insomnia, depression, symptoms and a lower frequency of self care behaviors.[6]
irritability, dizziness, nervousness) are sometimes grouped
together as the menopausal syndrome and their causal Shipra Nagar, Parul Dave, 2005, conducted a study on,’
relation with estrogen is uncertain. It is also known that Perception of women towards psychological problems faced
many postmenopausal women obtain inadequate sleep and at post menopause,’ proved that the post menopausal
that sleep problems are common during the menopausal women faced psychological problems like headache,
transition (Landis and Moe, 2004). It can be argued that backache uneasiness, fatigue, hot flushes & sleep
sleep quality is an important determinant of health status disturbances.[7]
and quality of life for women during and beyond
menopause. Similarly such study conducted by Juang KD, et all (2005)
on ‘Hot flashes experienced by post menopausal women are
Similarly many studies are conducted on post menopausal associated in the higher level of anxiety and depression &
women to assess the psychological problems and coping has low prevalence of vasomotor symptoms.[8]
strategies which highlights the post menopausal women
were experiencing severe psychological problems and they Similarly such study conducted by Osinowo HO, (2003)
are using coping strategies moderately.[3] conducted a study on,’ Psychosocial factors associated with
perceived psychological health, perception of menopause
Similarly such study is done by Hunter M, et all (1986), on and sexual satisfaction in menopausal women,’ proved that
the ‘Relationships between psychological symptoms, post-Menopausal women reported better psychological
somatic complaints and menopausal status’ concludes that health compared to the pre-menopausal women but no
the importance of distinguishing climacteric symptoms from significant differences in their attitude regarding their sex
other psychological and somatic complaints has been role. Post menopausal women had more positive attitude to
repeatedly stressed, Eight hundred and fifty pre-, peri- and sex and were more knowledgeable about menopause.
post-menopausal women, aged 45-65 yr, took part in a Women with conservative/reactionary preference for
cross-sectional survey of general health, psychosocial traditional sex roles reported negative perception of
factors and current symptomatology. menopause compared to those with liberal attitude toward
sex role. Menopausal Status, Educational level and social
They were a non-menopause clinic sample and were blind to support predicted positive attitude to sex, Age, self-image
the purpose of the study. Using a principal components and attitude to sex domain of the marital satisfaction scale
analysis, the relationships between symptoms were predicted better psychological health, and marital cordiality
examined. Certain psychological and somatic symptoms predicted better psychological health as measured by GIIQ.
occurred together in specific clusters. Some of these Marital satisfaction significantly predicted better sexuality.
symptom clusters, e.g., vasomotor symptoms and sexual Sources of information on menopause included health
difficulties, were best predicted solely by menopausal status, institutions, books, doctors, and books/health workers &
while others, such as psychological and somatic symptoms, concludes that the study highlights the need for sensitizing
were more clearly associated with psychosocial factors.[4] menopausal Nigerian women on how to improve their self-

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 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064

image, marital satisfaction, and sexual satisfaction. disease by stimulating circulation, controls weight, and
Conventional treatment options emphasizing hormone enhances emotional well being.
replacement therapy, need for nutritional supplement,
dietary changes, marital and sex therapy are emphasized.[9] Similarly such study conducted by Ahn S, (2007)on,’
Effects of walking on cardiovascular risk factors and
Yasui T, et all (2007) conducted a study on,’Association of psychosocial outcomes in postmenopausal obese women,’
serum cytokine concentrations with psychological Suggest that 3 months of moderate-intensity exercise
symptoms in post menopausal women’s,’ Suggest that training can improve psychosocial outcomes but further
Psychological stress manifested as climacteric symptoms in studies are needed to replicate walking exercise on
post menopausal women may be associated with increases physiologic variables among postmenopausal obese women.
in serum concentrations.[10] These findings are of public health relevance and add a new
facet to the growing literature on the health benefits of
Amore M, et all (2007) conducted a study on,’ Sexual and moderate,exercise.[13]
psychological symptoms in the climacteric years,’ suggest
that Depressive and sexual symptoms presented greater Asbury EA et all (2006) conducted a study on,’ The
severity in the post-menopausal group. Both clusters of importance of continued exercise participation in quality of
symptoms were strongly associated with life events. life and,psychological well-being in previously inactive
postmenopausal women,’suggest that Healthy
The parallel course of the two clusters could be related with postmenopausal women gain significant psychological
a common pathoplastic action of life events, both on sexual benefit from moderate-intensity exercise. However, exercise
symptoms and on depressive symptoms, occurring right at participation must continue to maintain improvements in
the time that a woman has to face the transition into psychological well-being and quality of life.[14]
menopause.[11] Similar such study was conducted by
Kalpakjian CZ et all (2007)on ‘Menopause as predictors of Maintaining a healthy diet is another way for post
subjective sleep disturbance in poliomyelitis survivors,’ menopausal women to remain problem free. They may want
proved that Psychological symptoms is the basic reason for to think about supplements such as vitamin D and calcium
sleep disturbance in postmenopausal women [12]. to guard against osteoporosis. Not smoking may not only
put off the menopause by a couple of years, it will also
b) Literature Related to the Coping Strategies Adopted reduce the risk of heart disease and osteoporosis. Using
by Post Menopausal Women progesterone creams may keep the vagina and bladder area
healthier, and make intercourse more comfortable and
A postmenopausal women experience many psychological therefore more appealing.
problems. When any individual experience psychological
problems he/she adopts the different ways to overcome the Lee HG et all (2002) conducted a study on,’ Sexuality and
problems. Similarly many psychological problems like quality of life after hematopoietic stem cell transplantation
Depressive disorders, anxiety, poor self-image, fatigue due in menopause,’ conclude that although sexuality is affected
to insomnia reduction in self confidence faced by by the physical changes following HSCT, we should not
postmenopausal women & to overcome such psychological overlook the psychological and social effects on the
problems different coping strategies are adopted by them. sexuality of post-transplant patients. Therefore, educational
Similarly such studies are carried out by researcher on and counseling programs are very important to restore and
coping strategies adopted by postmenopausal women. improve their sexuality.[15]
Emotionally, post menopausal women may experience
depression, fatigue due to insomnia, hot flashes and night There are many problems associated with post menopausal
sweats, and a reduction in self confidence and libido. women, but by exercising regularly and maintaining a
Although these emotional responses can be triggered by healthy lifestyle they don't have to mean a huge decrease in
hormonal changes, they may also be related to other factors. quality of life. Işil İrem Budakoğlu et all conducted a study
Reaching the menopause, and the changes happening in her on,’ Quality of life and postmenopausal symptoms among
body, may make a woman feel old, unattractive and women in a rural district of the capital city of Turkey,’
worthless and these feelings can trigger depression and lack proved that Quality of life is worse in postmenopausal
of sex drive. women than premenopausal women, and in older than
younger women in the postmenopausal period. Thus rural
Thus there are many ways to overcome these problems. The populations are primarily in need of public health care in the
coping strategies to overcome these problem is exercise postmenopausal period.[16]
This is one crucial way to control these conditions. Exercise
keeps bones, joints and cartilage healthy, guarding against Kruk J, 2007 conducted a study on,’ Association of lifestyle
osteoporosis as well as arthritis. It reduces the risk of heart and other risk factors with breast cancer according to
menopausal status: a case-control study in the Region of

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 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064

Western Pomerania (Poland),’ is proved that there is Similarly such study was conducted by Baksu B et all (Feb
evidence for a dose-response relationship between several 2009) on,’ Effect on hormonal therapy on postmenopausal
lifestyle factors and breast cancer risk. The results also women proved that hormonal therapy helps in reducing
suggest that some different mechanisms may operate in psychological symptoms of postmenopausal women.[23]
breast cancer etiology inpre-and post-menopausal women. A Blümel JE et all (2008) conducted a study on,’ Effect of
multifactorial process of breast cancer development, the androgens combined with hormone therapy on quality of
complex interaction between physical activity, diet, energy life in post-menopausal women with sexual dysfunction,’ is
intake and body weight, inconsistent and in conclusive data proved that quality of life was unchanged in the placebo
on breast cancer risk factors coming even from well- group whereas AHT significantly improved scores of
designed epidemiological studies are the case for continual vasomotor, psychological, physical and sexual symptoms.
update knowledge on primary prevention and identification As expected, FSFI was not modified in the placebo group
of changes in behavior that will reduce the risk.[17] while in AHT group the FSFI score improved significantly
so adding methyl-testosterone to hormone therapy improves
Schneider HP. 2002 conducted a study on,’ the quality of quality of life and sexuality in post-menopausal women with
life in the post-menopausal woman,’ The most important sexual dysfunction.[24]
factors analysed were attractiveness, self-confidence, re-
orientation in life and partner relationship shows that the France CR et all (2004) conducted a study on,’ Laboratory
severity of menopausal symptoms is what reflects best the pain perception and clinical pain in post-menopausal women
profile of quality-of-life dimensions.[18] Giusti M, et all and age-matched men with osteoarthritis: relationship to
(1999) conducted a study on,’ Assessment of quality of life pain coping and hormonal status,’ proved that women were
in recently post-menopausal women on dopaminergic more likely than men to report using emotion-focused pain
therapy for pathological hyperprolactinaemia,’ proved that strategies, and that emotion-focused coping was associated
Quality of life seems unchanged in recently post- with more arthritic pain and lower electrocutaneous pain
menopausal women with a long-term history of tolerance. Correlations between coping measures and pain
hyperprolactinaemia currently on dopaminergic therapy. reports revealed that catastrophizing was associated with
The present study does not therefore support the differences greater arthritis pain and lower pain threshold and tolerance
in psychological profile reported in literature between levels. However, catastrophizing was not related to
untreated hyperprolactinaemic and control women nociceptive flexion reflex threshold, suggesting that the
unselected for age.[19]Monterrosa et all (2009) conducted a observed relationship between catastrophizing and
study on,’ Quality of life impairment among subjective pain does not rely on elevated nociceptive input.
postmenopausal women varies according to race,’ Thus, older adults with osteoarthritis do not exhibit the
concluded that In this postmenopausal Colombian series, pattern of sex differences in response to experimental pain
menopausal symptoms in indigenous (urogenital) and black procedures observed in prior studies, possibly due to the
(somatic/psychological) women were more severe (impaired development of disease-related changes in pain coping
QoL) when compared to Hispanic ones.[20] strategies. Accordingly, individual differences in clinical
and experimental pain may be better predicted by pain
Ekström H, Hovelius B, (2000) conducted a study on,’ coping than by sex or hormonal differences.[25]
Quality of life and hormone therapy in women before and
after menopause,’ proved that the effects of menopause on Klinika Ostrych Zatruć, Instytut Medycyny Pracy w Lodzi,
QoL seemed generally to be of minor importance. QoL in conducted a study on,’The impact of personal resources on
women was lower in those with a history of HT than in coping with stress in climacteric women,’ Climacterium is a
those with no such experience.[21] Owing to menopause, physiological (so absolutely normal) occurrence in a
women as they age, face problems ranging from mood woman's life. Menopause is not a disease but some women
swings to hot flashes to sleepless nights. In order to cope have somatic and/or psychic (for example: stress related)
with the increasing life expectancy women often struggle to problems connected with this life-stage transition. The
overcome the effects of natural hormone decline using presented study examined stress-coping strategies and
synthetic hormonal replacement. Ueyama T et all (2007) personal coping resources (optimism, emotional control,
conducted a study on ,’ Chronic estrogen supplementation sense of self-efficacy, sense of self-worth and sense of life
following ovariectomy improves the emotional stress- satisfaction). Fifty post menopause women completed the
induced cardiovascular responses by indirect action on the psychological questionnaires. suggest that stress-coping
nervous system and by direct action on the heart,’ These strategies and personal coping resources are often used by
data suggest that estrogen supplementation partially post menopausal women’s.[26]
prevents emotional stress-induced cardiovascular responses
both by indirect action on the nervous system and by direct
action on the heart.[22]

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 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064

3. Aim and Objectives 5. Results / Discussion

“A study to assess the psychological problems & coping 5.1 Organization of Study Findings
strategies adopted by postmenopausal women in selected
areas of pune city.” 5.1.1 Section I - Description of Sample Characteristics

3.1 Objectives It deals with the analysis of demographic data. This part
deals with the analysis of demographic characteristics. Age,
1) To assess the psychological problems of Education, Occupation, Marital status when did you
postmenopausal women. achieved your menopause, any disease condition before
2) To identify the coping strategies adopted by menopause, any disease condition after menopause,
postmenopausal women. Monthly family income.
3) To correlate identified psychological problems with
coping strategies adopted by postmenopausal women Table 1: Demographic description of personal variables by
4) To correlate identified psychological problems with frequency and percentage
selected demographic variables. Sr.No Variables Frequency Percentage
5) To correlate identified coping strategies adopted by the Age in years
postmenopausal women with selected demographic 40-44 11 11.0
variables. 1 45-49 22 22.0
50-54 26 26.0
55-59 41 41.0
4. Methods / Approach Education
Illiterate 67 67.0
4.1 Research Approach 2 Primary 25 25.0
Secondary/Higher secondary 6 6.0
Survey approach. non experimental descriptive design. Graduate/Post graduate 2 2.0
padmavati area, Taljai area, Shankar maharaj math, Chavan Occupation
nagar,and Sahakar nagar. reliability of the tool & pilot study Unemployed/Housewife 82 82.0
was proposed to be conducted in sahakar nagar and date Laborer/Daily wages 15 15.0
3
vasti. 100 postmenopausal women Non probability Business 0 0
convenience sampling technique Government service 3 3.0
Professionals 0 0
4.1.1 Inclusion Criteria Marital status
Married 64 64.0
1) The women whose age group between 40yrs-59yrs & 4 Unmarried 0 0
those who attained menopause. Widow 36 36.0
Divorce 0 0
2) The women’s who are residents of the padmavati area,
When did you achieved your menopause
Taljai area, Shankar maharaj math, Chavan nagar
1-3 yrs back 30 30.0
&Sahakar nagar. 4-6 yrs back 22 22.0
3) The women’s who understand Marathi & English. 5
7-9 yrs back 11 11.0
10-12 yrs back 36 36.0
4.1.2 Exclusion Criteria Any other specify 0 0
Any disease condition before menopause
1) The women who has attained menopause surgically. Hypertension 3 3.0
2) The likert scale for collection of data in relation to the Diabetes 1 1.0
6
psychological problems faced by the post menopausal Cancer 0 0
womens. Any other specify 4 4.0
3) The likert scale for collection of data in relation to the None 92 92.0
coping strategies adopted by the post menopausal Any disease condition after menopause
womens. Hypertension 8 8.0
4) In this study psychological problems was assessed by Diabetes 3 3.0
7
five point likert type of rating scale. This scale Cancer 0 0
Any other specify 4 4.0
consisting of 25 structured items. Alternative responses
None 85 85.0
were None, Mild, Moderate, Severe & Very severe. The
Monthly family income
psychological problems scale range as,0-4. Rs. 1000-5000 93 93.0
8 Rs. 5001-10000 3 3.0
Rs. 10001-15000 3 3.0
Rs. 15001-20000 1 1.0

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 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064

The sample distribution in table 1 shows that 41% (N=100) Table 2: Description of association between the
samples were between age group of 55-59, 67% were psychological problems and coping strategies adopted by
illiterate 82% were Unemployed/Housewife, 64% were postmenopausal women.
married, 36% had achieved menopause 10-12years back, Coping strategies (Category)
92% were having no any disease condition before
menopause, 85% were having no any disease condition after Psychological
21- 41- 60- P
menopause, 93% were from Rs.1000-5000 income group. problems Total
40 60 80 value
(Category)
0-20 0 0 1 1
21-40 8 46 3 57
41-60 11 22 1 34
61-80 0 5 0 5
81-100 0 3 0 3 .001
Total 19 76 5 100

The table 2 shows that there is a strong significant

association between the psychological problems and coping
strategies. Score of both psychological problems and coping
strategies are observed to be lying between 21-60.It shows
that the postmenopausal women’s are having mild to
moderate psychological problems and they are using coping
strategies often.

There is no significant association between the age,

education, occupation, marital status, when did you
Figure 1: Diagram showing percentage of psychological
achieved your menopause, any disease condition before
problems of post menopausal womens
menopause , any disease condition after menopause,
monthly family income and psychological problems because
Figure 1 shows that 56% post menopausal women’s are
P-value is less than 0.05. There is a strong significant
having mild psychological problems.
association between any disease condition before
menopause because P-value is < 0.001 and any disease
condition after menopause with coping strategies because P-
value is smaller than 0.05 & no significant association
between age, education, occupation, marital status, when did
you achieved your menopause, monthly family income with
psychological problems because P-value is more than 0.05.

6. Conclusion
Post menopausal women face psychological problems; they
also adopt coping strategies to overcome these problems.

Figure 2: Diagram showing percentage of coping strategies 7. Future Scope

of post menopausal woman’s
Nurse Educators should give stress on educating students
Figure No 2 shows that 76% post menopausal women’s are about post menopausal problems and coping strategies.
using coping strategy often.
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ISSN (Online): 2319-7064

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Authors Profile
Nutan Potdar, Asoociate Professor,Krishna Institute
Of Medical Sciences Deemed University, Krishna
Institute Of Nursing Sciences Karad Dist-Satara
(India) 415539.

Mahadeo Shinde, Professor, Krishna Institute of

Nursing Sciences, Krishna Institute of Medical
Sciences Deemed University, Karad, Dist-Satara
(India)415539

Volume 3 Issue 2, February 2014

Paper ID: 02013961 300
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