Symptoms at midlife among women in Nagaland, India

Abstract

Objectives This article highlights the prevalence of symptom frequencies in Nagaland, India, with a focus on depressed mood and hot flashes. We also examine how symptoms cluster together among Naga women and identify factors associated with symptom experience. We hypothesized an elevated frequency of depressed mood because of the stresses associated with social responsibilities within a patriarchal culture, and a low frequency of hot flashes because of the thinness of the population. Methods Standardized questionnaires with close‐ended questions were used to determine the frequency of symptoms and sociodemographic and health parameters among women aged 35 to 65 years (n = 352). Factor analysis was used to examine the relations among symptoms. Bivariate analyses and linear regressions were also employed to identify sociodemographic and health factors associated with symptoms. Results Menopausal symptoms, such as feeling dizzy or faint, anxiety or panic, and excitable, were significantly higher in premenopausal women; hot flashes in perimenopausal women; and feeling tired or lack in energy, headaches, difficulty in sleeping, and muscle or joint pain in postmenopausal women. Four symptom factors were identified: symptoms related to the loss of estradiol, psychosomatic symptoms, uneasiness, and depressed mood. After adjusting for menopausal status, socioeconomic status, education, and self‐reported health status, body mass index was observed to be inversely associated with the depressed mood factor but not other factors. Conclusion In the context of Nagaland, India, having extra weight may contribute to emotional well‐being; however, further research is warranted.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative

“…Questionnaires such as Menopause Specific Quality of Life calculated domain-wise scores, whereas Menopause Rating Scale, Greene Climacteric scale and Kupperman’s index calculated total scores for all the menopausal symptoms. [ 174 175 176 177 ] The higher scores indicate severe menopausal symptoms and lower scores indicate mild menopausal symptoms.…”

“…The commonly used scales includes Menopause Rating Scale (MRS), Greene’s Climacteric Scale, and Menopause Specific Quality of Life (MENQOL). [ 172 174 175 ] According to the Practice Guideline on Menopause, MRS is the recommended self-administered tool for screening of the severity of the menopausal symptoms in midlife Indian women (refer to Annexure 6 ). [ 11 ] The MRS is also translated and validated in Hindi language for easier administration in Indian women.…”

Midlife symptoms and household stress are associated with fingernail cortisol

“…A previous analysis from this Nagaland population identified four symptom subgroups: emotional instability (heart beating quickly or strongly, difficulty in sleeping, attacks of anxiety and panic, difficulty in concentrating, feeling tired or lacking in energy, loss of interest in most things, feeling unhappy or depressed), vasosomatic symptoms (heart beating quickly or strongly, difficulty in sleeping, feeling tired or lacking in energy, headaches, hot flashes, and night sweats), mood disturbance (excitable, attacks of anxiety and panic, loss of interest in most things, crying spells, and breathing difficulties), and aches and pains (feeling dizzy or faint, pressure or tightness in head, parts of body feel numb, muscle and joint pains, and loss of feeling in hands or feet). These four factors accounted for 43.8% of the total symptom variance in the population 45 …”

Executive Summary of Evidence and Consensus-Based Clinical Practice Guidelines for Management of Obesity and Overweight in Midlife Women

“…A number of tools were identified for the assessment of menopausal symptoms and its severity. [ 51 52 53 54 55 ] According to the recommendation on clinical management of menopause in Indian women, MRS was identified as an appropriate assessment scale. [ 10 ] In addition, experts also believed that the association between the menopausal symptom severity and lifestyle-related behaviors should be assessed for customizing the weight management strategies.…”