PROMOTION OF DIET AND PROMOTION OF DIET AND EXERCISE TO MENOPAUSAL EXERCISE TO MENOPAUSAL

WOMEN IN RESTORATION OF WOMEN IN RESTORATION OF HEALTH IN URBAN SLUM HEALTH IN URBAN SLUM

COIMBATORE, TAMILNADU, COIMBATORE, TAMILNADU, INDIA.INDIA.

BYBYMRS.CHRISTY MEKALA.VMRS.CHRISTY MEKALA.VASSOCIATE PROFESSORASSOCIATE PROFESSOR

P S G COLLEGE OF NURSINGP S G COLLEGE OF NURSINGCOIMBATORECOIMBATORETAMILNADUTAMILNADU

MENOPAUSEMENOPAUSE

Ceasing of menstrual period is called menopause.

• Change of life

• Climacteric

• Third age

LIFE SPAN OF INDIAN WOMENLIFE SPAN OF INDIAN WOMEN

• During 20th century - 40 years

• At third millennium - 70-74 years

• Indian women life expectancy - 63.5years (Census 2001)• 375 million women are at menopause age between 40-59 years ( NWHIC Dec2004)

Every woman’s period will stop at menopause. Every woman’s period will stop at menopause. Some women may not have any other symptoms. Some women may not have any other symptoms.

But, But,

• Changes in period – the time between periods and the flow from month to month may be different.

• Abnormal bleeding or “spotting"

• Hot flashes (“hot flushes”) – getting warm in the face, neck and chest.

• Night sweats and sleeping problems

• Vaginal infections. • Tense. • Thinning of your bones – this may lead to loss of

height and bone breaks (osteoporosis). • Mood changes – such as mood swings, depression,

and irritability. • Urinary problems – such as leaking, burning or pain

when urinating, or leaking when sneezing, coughing, or laughing.

• Problems with concentration or memory. • Less interest in sex and changes in sexual response. • Weight gain or increase in body fat around your waist. • Hair thinning or loss.

CENTRAL OBJECTIVECENTRAL OBJECTIVE

An attempt is made to determine the knowledge of women regarding menopause, and educate them on role of diet and exercise in management of menopausal symptoms

METHODOLOGY METHODOLOGY

A semi structured questionnaires of two type, one open ended and other closed ended with opinion / attitude was prepared. Each sample was interviewed to assess the knowledge regarding menopause. The response of the women during the interview was recorded in a questionnaire form.

PROGRAM OUTLINE:PROGRAM OUTLINE:Gathered preliminary information’s related to :

• Women’s knowledge on menopause

• Investigated women’s attitude towards communication about the menopause

• Examined the relationship between a women’s knowledge about the menopause and their background characteristics, such as educational level, income, marital status and religion.

• Assessment was done to find out the menopausal symptoms like hot flush, sweating, palpitation, osteoporosis, back ache, and burning micturition.

• Identified the dietary practices and exercise habits among the women.

Post Assessment was done to ;Post Assessment was done to ;

•  Identify the coping ability of women with menopausal symptoms ,which were taught to them.

DATA FINDINGSDATA FINDINGS

• 80% of the women felt that menopause is a subject that should not be discussed.

• 65% of women felt that Menopause relieves her feminity.• 95% felt there is no relationship between diet, exercise

and their menopause symptoms.• 92% women felt that menopause is the sign of old age.• 94% strongly believed that there is no relationship

between the menopausal symptoms and life style.• Menopause does not depend upon the age of

Menarche.

•   A lean highly stressed women is more likely to experience profound symptoms than a more well endowed, easily going women

•      This study found that “Menopause comes late in women who had three or more children and earlier in nulliparous women.

•      Women who have habit of betal and tobacco chewing undergone earlier menopause than others

SINGS AND SYMPTOMS SINGS AND SYMPTOMS MENOPAUSEMENOPAUSE

Physiological symtoms

• 70% of women had loss of skin elasticity

• 84% women had severe back ache

• 16% of women complained about urinary incontinence

• 61%of women had palpitation

• 87% of women had head ache

• 26% of women had hot flush and sweating

• 17% women had burning micturation

• 46% of women had vulval skin pale ness

• 31.5% of women had vulval skin thinning

• 30% of women had osteoarthritis

• 2% of women had abnormal libido

Womens Personal Expereince in Menopause

0%

20%

40%

60%

80%

100%

Symptoms

Per

cen

tag

e

Loss of Skin elasticity

Backpain

Urniary incontinence

Palpitation

Head ache

Hot flush and Sweating

Burning Micturation

Valval Skin Paleness

Vulval Skin thinning

Osteoporosis

PSYCHOLOGICAL SYMPTOMSPSYCHOLOGICAL SYMPTOMS

•     32% women had irritation

•     13% women had depression

•     48% women had insomnia

• 66% women had mood swing

• 9% unable to cope with normal stress

• 24% short tempered

WOMEN' PERSONAL EXPERINCE ON EMOTIONAL DISTURBANCE

0

10

20

30

40

50

60

70

Irritation Depression Insomnia Mood Swing Distress Temper Loss

SYPTOMS

WO

ME

N-P

.C.

PRESCRIBED DIETARY PRESCRIBED DIETARY MODIFICATION MODIFICATION

• vitamin E rich foods like wheat gram, nuts, eggs and olive oil

• Vitamin A, D, calcium, phosphorous and magnesium

• excellent source of calcium like Fish, drumstick leaves, ragi and dairy products

• Phytoestrogens, which mimic human oestrogen, are found mainly in soyabeans and sprouts.

• Omega-3 fatty acid products like fish, Omega-3 enriched eggs

• eat foods rich in protective antioxidants (fresh fruit and vegetables)

• eat foods rich in dietary fibre (fresh, raw fruits and vegetables and unprocessed grains

• take a B complex supplement especially folate, B6 and B12 which protect against heart disease

Food items to be restricted during Food items to be restricted during menopausemenopause

• Spicy foods like pickles

• Coffee, tea

• Chocolate

• Alcoholic drinks

• Refined products. avoid foods containing trans-fatty acids (hard or block margarine, commercial cakes, biscuits and pies)

Alternative measuresAlternative measures• dress in layers. Remove pieces of clothing at

the first sign of a hot flush to feel cooler.  • keep the office or home cool by using a fan

or air conditioner. Sleep in a cool room.  • exercise regularly to reduce stress and

promote better sleep.• reduce stress with a leisurely bath,

meditation, massage or yoga.  • slow and deep, abdominal breathing at the

start of a hot flush may be helpful. 

Knowledge of Women on Menopause and Health Measures

0

5

10

15

20

25

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53

No.of respondents

No.o

f Cor

rect

Ans

wer

s

Pretest Posttest

ResultsResults• 70% women reduced the intake of tea from 4-

5 times to 1-2 times thus minimized the symptom of hot flush.

• 25% of women practiced walking as their relaxation technique.

• 30% of taken initiative to consume Vit E rich foods.

• 75% women identified the importance of taking calcium rich foods like ragi to manage the osteoporosis.

• 2% women expressed the drastic change in hot flush episodes while consumes less tea and baked foods

• 14% women relieved from back pain after the exercises and relaxation

• 56% women expressed that they are relieved from head ache after meditation

• 11% women practiced to consume more water and maintained personal hygiene to manage their burning micturition

HEALTH IMPLICATION:HEALTH IMPLICATION:

• Mass media can be used for disseminating the knowledge regarding menopause ,so that the message will reach the large group of women.

• The basic health workers like health visitors , community nurse are need to be educated regarding menopause ,through imparting the knowledge to the local people.

Self help group women to be empowered in these aspects of health measures so that it can reach the women .

Using a large sample and wider geographical distribution could help to analyze the dietary modification and exercise for this age group.

DiscussionDiscussion

The participants in the group reported a significant reduction in the perceived severity of the physiological symptoms, hot flushes, nocturnal perspiration ,fatigue, and insomnia.