Context: Menopause is a crucial phase of the women fraternity which marks the end of reproductive age. Mostly it is physiological; however, certain conditions may lead to premature menopause. Menopause has an extensive spectrum of symptoms which are extremely bothersome. An effective, empathetic, and rational treatment strategy is necessary. Aim: The present study was carried out to appraise the treatment strategies to tackle menopausal problems in Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha – a tertiary care hospital in rural Vidarbha. Materials and Methods: This monocentric hospital-based qualitative study was carried out on 330 menopausal women. Data were collected from in-depth interview of the health-care professionals of obstetrics and gynecology department and patients. Results: Of 330 participants, the incidence of natural menopause was 90.96% (2016) and 85.36% (2017); surgical menopause was 09.03% (2016) and 14.63% (2017). There was no incidence of chemotherapy-induced and pelvic radiation-induced menopause during the study. Pharmacotherapy (85.45%) and surgery (19.09%) were the mainstay treatments. The most common route of drug administration was oral (92.20%), followed by intravaginal (15.60%), topical (09.57%), and injectables (0.35%). Pharmacotherapy was categorized into core therapy (84.75%), supportive therapy (47.52%), and alternative therapy (03.19%). Conclusion: The present study concludes that there is a decline in the use of hormone replacement therapy for the management of menopausal complaints. There is lack of awareness of the complexity of menopausal symptoms and available treatment strategies in this rural population, and therefore, it is recommended to organize various awareness camps, so that a prompt and most suitable treatment can be provided.

Menopause transition is experienced by 1.5 million women each year and often involves troublesome symptoms including vasomotor symptoms, vaginal dryness, fatigue, and joint pain. Menopausal hormone therapy has been available for over half a century to provide relief from vasomotor symptoms, osteoporosis and symptoms of urogenital atrophy. Recently there has been an interest in a class of compounds known as the selective estrogen receptor modulators (SERMs)  that have been found to be effective in treating postmenopausal symptoms. Hence, the present study was aimed to find out the role of SERMs in menopause. This hospital based analytical study was carried out between 1st  January 2016  to 31st  March 2018  in OBGY Department of A.V.B. Rural Hospital on 332 women of menopausal age group belonging to rural vidarbha region. The data were collected from in-depth interview of unit heads,professors,associate professors,assistant professors, Junior residents as well as patients in A.V.B. Rural Hospital, Wardha. Menopausal women were categorised in Group I (6th Decade :50 - 59 Years), Group II (7th Decade :60 - 69  Years) and Group III (8th Decade: 70 - 79 Years).The presenting complaints were bone and joint pain(56.01%,26.08%, 19.07% in grade I,II, III), burning micturition( 24.17%,23.60%,16.66% in grade I,II, III, hot flashes( 67.06%,31.00%,26.37 in grade I,II, III), vaginal dryness (21.02%,38.16%,39.11% in grade I,II, III) and uterine prolapse(11.54%,14.16%,16.66% in grade I,II, III). Drug therapy in the form of symptomatic treatment (OCPs) and surgical treatment was given to the patients. SERMs were not given to any patient due to difficulty in keeping follow up and SERMs associated severe adverse effects. Also these patients belong to rural area and for them it is not possible to bear high cost of this drugs. Further investigations and studies are required  to help  clarify the  relative benefits/risks of novel SERMs in development within specific indications and in patient‐specific management in the field of postmenopausal health.