Prime Undergraduate Medical Research Department Research Proposal 1. Title: “AN ACCOUNT OF WOMEN’S EXPERIENCE OF POSTMENOPAUSAL SYMPTOMS IN DAILY LIFE” 2. Introduction: Background Menopause is a physiological phenomenon that is caused by the pause of the acti ity of the ovaries followed by complete menstrual cessation, as defined by the world health organization [ 1 ]. Women experience vasomotor, urogenital, psychosomatic and physiological changes with this transition to menopause [ 2] With the increasing population of menopausal women, spending one third of their life time during postmenopausal period, the menopausal health and related fence suggests that as many as 85% of menopausal women experience at least one hot flush , although large differences were found with respect to the frequency, severity and duration of hot flashes [ 4 ] . The age of menopause in women around the world of between 40 and 60 years varies from year to year , linked to a variety of factors [ 5,6] . The period of change in ovarian function from being fertile to becoming infertile, called menopausal transition, is a natural and inevitable change that affects all women [12]. Measuring the severity of symptoms presented by middle-aged women, and, in addition, determining their knowledge about menopause and related topics, will help develop future programs intended to educate them on the identification of relevant clinical signs of deterioration of quality of life linked to the menopause [13]. Identifying factors that negatively impact women during the menopausal transition is key to improving their health. issues are major responsibilities of any nation [ 3] . Existing Review of Literature A research conducted in Turkey had an objective to investigate the effect of menopausal symptoms on women's daily life activities .The results of this study showed that menopausal symptoms in a menopausal period negatively affected the daily activities of women [7]. ‘A research conducted in Abbottabad, Khyber Pakhtunkhwa, Pakistan had an objective to assess the level of adherence to health promoting behaviors among postmenopausal women .This study concluded that there is a need to work on health promoting behavior of the postmenopausal women with particularly targeting illiterate menopausal women with low socioeconomic status [8]. A research conducted in England had an objective to investigate whether physical activity affects well - being through menopausal symptoms and psychosomatic factors. This study focuses on how PA influences working womenwith menopause. The results of this study showed that PA was positively associated with well-being but negatively associated with menopausal symptoms. Menopausal symptoms may lower well-being through anxiety, depression and stress, but PA can be associated with better well-being through depression, anxiety and stress (9). Rationale ‘As women spend a significant portion of their lives in the post ~ menopausal stage, understanding the impact of menopausal symptoms on daily life activities is crucial for promoting healthy aging and improving overall quality of life. By exploring the complex interplay between menopausal symptoms, daily life activities and women's experiences. This research aims to provide a comprehensive understanding of the challenges faced by women during this transition. The knowledge will be raised among general public, women, healthcare providers and policy makers. Research Question 1, How do menopausal symptoms affect women’s daily life activities? 2. Which menopausal symptoms have the most significant impact on daily life activities, and how do women prioritize their management? 3. How do menopausal symptoms affect women’s physical, emotional and social well being and what are the implications for their overall quality of life? Research Objectives: 1. To develop a symptom profile of menopausal women, identifying clusters of symptoms and their effect on quality of life. 2. To explore the nuanced impact of menopausal symptoms on women’s daily life activities. 3. To determine the level of awareness and knowledge among postmenopausal women experiencing postmenopausal symptoms. Methodology: ‘* Sample and Data Collection: 1. Study population will be limited to menopausal women between the ages of 40-60. 2. This research will be conducted in Peshawar and Mardan. 3. This research will be based on cross sectional study. 4. The sample size was calculated through an online sample calculator and came ‘out to be 120 on the basis of 8% margin of error, 92% confidence interval, 80% response distribution keeping the population 20,000.5. The menopausal women in OPD, waiting area, those seeing a doctor, those admitted in ward, in my college staff and neighbourhood will be taken into the study through purposive sampling technique. 6. This research will include menopausal women of Peshawar and Mardan. 7. It will exclude women with psychological problems and those who refuse to give consent. © Research Tool: Research questionnaire was a validated tool taken from [10] Variables: Independent variables : Socio-demographic variables ; It includes age , residency , marital status, educational status, occupation , economic status , family structure and postmenopausal age. Dependent variables : This will include the quality of life of menopausal women . Statistical Analysis: Descriptive statistics will be calculated through frequency, percentage, mean value and standard deviation. ‘+ Ethical Consideratior 1. Verbal consent will be taken from participant 2. Approval from ERC. 3. This information will be kept confidential and will not be shared with anyone else. 4, The data will be kept safe in password protected laptop. Gantt Chart: 'S.No.| ACTIVITIES Month 1 Month 2 ‘W1 | W2 | w3 | W4 | Wi | w2 | W3 | W4 1. | Proposal development 2. | Submission of proposal for ethical approval 3. | Data collection4, | Data entry & analysis 5. | Report writing 2 Budget: ITEM UNIT COST QUANTITY TOTAL Cost Photocopies 1Page=20Rs. | 120x60=7200 | 7200 1 Questionnaire = 3 pages. 1 Questionnaire costs = 60 Rs. Stationary pen costs=30 | 2boxofpens | 1520 Rs. costs 30 x 24 = 720 Rs. 1 pencil costs 20 Rs, 20 pencils costs Eraser and “ sharpener each | 10 Erasers and costs 20 Rs. 10 sharpeners costs 400 Rs. Refreshments | 1shake=150 | Shakes=3600 | 4800 Rs. Rs, Rs, cake =5S0Rs. | Cakes = 1200 Rs. Taxi charges Approximately | 500 x 20 visits= | 10,000 500 Rs. 10,000 Rs. GRAND TOTAL 23,520 Rs. 3.References : 1. Ceylan B, Ozerdogan N. Menopausal symptoms and quality of life in Turkish women in the climacteric period. Climacteric. 2014;17(6):705-12 https:/doi.or, 109/13697137.2014.9291052. Khatoon F, Sinhal P, Shahid S, et al, Assessment of menopausal symptoms using modified menopause rating scale (MRS) in women of Northern India. Int J Reprod Contracept Obstet Gynecol. 2018:7:947-51 3. Satpathy M, A study on age at menopause, menopausal symptoms and problems among urban women from western Odisha, India. Int J Sci Res Publ. 2016;6(3):422— 7. 4. American College of Obstetricians and Gynecologists, ACOG Practice Bulletin No. 141: Management of menopausal symptoms. Obstet Gynecol. 2014;123:202-16 Schoenaker DA, Jackson CA, Rowlands JV, Mishra GD. Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents. Int J Epidemiol, 2014;43:1542-62 6. Bjelland EK, Gran JM, Hofvind S, Eskild A. The association of birthweight with age at natural menopause: a population study of women in Norway, Int J Epidemiol. 2020:49:528-36. 7. Arar MA, Erbil N. The effect of menopausal symptoms on women’s daily life activities [Internet]. PubMed. Available from: https://pubmed.nebi.nlm nih gov/?term=%22Arar%620MA%22%5BAuthor%SD 8. Lifestyle behaviours among postmenopausal women in Khyber Pakhtunkhwa, Pakistan. J Dow Univ Health Sci. 2021;15(3), https://doi org/10,36570/iduhs.2021 3.1208 9. Newson Health Menopause Society [Internet]. Stratford-upon-Avon: Newson Health, {cited 2024 Oct 25], Available from: https://www newsonhealth co.uk 10, Awareness regarding menopausal symptoms and effect on daily life of postmenopausal women. J Patan Acad Health Sci, 2020:7(1). https://doi org/10.3126/ipahs.v7il, 28890 11, World Health Organization, Menopause [Internet]. Geneva: WHO; 2024 Oct 16 [eited 2024 Oct 25]. Available from: https://www who int/news-roomvfact- sheets/detail/menopause 12, Stanzel KA, Hammarberg K, Nguyen T, Fisher J. “They should come forward with the information’: menopause-related health literacy and health care experiences among Vietnamese-born women in Melbourne, Australia. Ethn Health, 2020. https://doi, org/10,1080/13557858,2020.1740176 13. Barriga J, Castelo-Branco C, Chedraui P, et al. Educational and organizational interventions used to improve the knowledge of metabolic syndrome among postmenopausal women. Fertil Steril. 2008,90(2):444-6. doi: 10, 1016/j.fertnstert.2007.06.039 Name and Signature of the PI: Wareesha Rani Name and Signature of the Supervisor: Dr. Farhat R .Malik