CHAPTER ONE

INTRODUCTION

This chapter consists of the background of the study, statement of problem, objective of the
study, research questions, significance of the study, scope of the study, and operational definition
of terms on menopausal changes and coping strategies among women in medical outpatient
department in Usmanu Danfodiyo University Teaching Hospital Sokoto state.

BACKGROUND OF THE STUDY

The word menopause derived from a Greek word pause which means cessation and the root men
means the month. Word menopause simply refers to the permanent end of menstruation.
Menopause has been considered a major transition point in women’s reproductive and emotional
life. Menopause is not a disease but a natural transition in a women’s life that results from a
decrease in the ovarian production of sex hormones such as estrogen, progesterone and
testosterone. By loss of reproductive potential and transition into later life she may become a
victim of both physical and psychological problems. (Madhu et al, 2021). The world health
organization (WHO) define post- menopausal women as those who have stopped menstrual
bleeding one year ago or stopped having periods as a result of medical or surgical intervention
( Hysterectomy /Oophorectomy) or both. It usually begins between the age of 45 and 55, but can
develop before or after this age range. (Sharaddha Thorat, 2022).

There are five reproductive stages in a woman’s reproductive life cycle .These include
premenarche (before the first menstrual period) stage, the reproductive, premenopausal stage,
the early menopausal transition stage, the late menopausal /transition stage, and finally,
menopause. There is no single test to determine reproductive potential, but the menstrual cycle
pattern and hormone level can give rough estimate. (Madhu, Sathish and Vinay, 2021).

Historically, menopause has been recognized as a watershed event in the reproductive and
emotional lives of women. The decline in the general biochemistry and specifically in the
ovarian production of the steroidal sex hormones, mainly estrogen and progesterone, causes
menopause which is not an illness but a natural phase in a woman’s life. She may experience

1
physical and mental distress as a result of the decline in her ability to reproduce and the onset of
old age. Hot flashes, night sweats or chills, disturbed sleep, vaginal dryness, loss of libido, loss
of energy, mood swings , increased irritability, thinning skin, and urine incontinence are the most
commonly reported physical problems. Loss of self assurance, sadness, impatience, and
forgetfulness, inability to focus, panic attacks, and anxiety are psychological problems (Zaineh,
Deena, tareeq and Noor, 2023).

Globally, the world population of women aged over 60 was below 250 million, but it is estimated
in the year 2030, 1.2 billion will be peri or postmenopausal and that this total will increase by 4.7
million a year. The average woman in the developed world can now expect to spend
approximately 1/3 of her life in postmenopausal state. Because of these predicted changes in
population structure, physicians are beginning to see that menopause is not a negligible
phenomenon but a major public health problem. (Timothy, Gabriel, Oyenka, Chidindu,
Theophilus and Uchenna, 2023).

There are more women encroaching the menopausal age in Sub-Saharan Africa. The menopause
and its related problems are major public health and clinical concern; this is not surprising as the
average life expectancy is increasing. By the late 2020s, an estimated 76% of postmenopausal
women will be living in developing countries. Symptoms in perimenopausal women vary among
women in different countries. This is due to a strong influence by social, cultural and economic
settings. The data on the age of menopause in Sub-Saharan Africa is scanty, in Nigerian women,
the age at menopause was found to be 48.4 years. The mean age at menopause of Nigeria have
also been reported to be 49.36+- 5.0 years and 52.8 years, respectively. This similar comparison
with age at menopause globally which put the age range of menopause onset at 42-51 years with
a mea average of 46.7 years. (Min Han, Yuan, Grace and Olufola, 2022).

Menopause is a universal experience for women, occurring at a mean age of approximately 52

year. There are record numbers of women entering menopause daily, and extrapolating from
population data using age (>50years) as a proxy for menopause, an estimated 984 million women
worldwide in 2020 had reached menopause. Menopause related symptoms, including hot flashes,
night sweats, mood changes, sleep disturbances, and cognitive difficulties can significantly
impaired women’s quality of life. (Faubion, Enders, and Hedges, 2023). Physical, sexual,
vasomotor and psychological symptoms, such as hot flashes, insomnia, weight gain, bloating,

2
mood swings, irregular menstruation, breast pain, anxiety, depression, irritability, fatigue,
headache, Poor memory and concentration and high level of distress, are due to hormonal
changes that occur with the onset of menopause. These symptoms may make it difficult for
menopausal women to cope and lower their quality of life. (Nazarpour, Simbar, Ramezani,
Tehrani and Alavi, 2020.

In Nigeria, culture of silence shrouds anything that is related to reproduction. It spans from
puberty, negotiating sex and condom usage, uptake of contraceptive methods and eventually to
menopause. Menopause poses a lot of challenges to women in various ways; the transition from
reproductive age to menopausal age is not without its problem. As women get older and advance
to menopause, they may experience some of the symptoms mentioned earlier. These symptoms
may be very disturbing and sometimes unpredictable especially when the affected person does
not know that they are related to menopause and what to do. (Timothy et al, 2023).

Hence, this study aimed at letting women know about menopause, menopausal changes and
coping strategies among women attending medical outpatient department in Usmanu Danfodiyo
University Teaching Hospital Sokoto state and also to investigate the knowledge of women
toward the menopause phenomenon.

1.2 STATEMENT OF THE PROBLEM

More than 500 million women between the age of 42 and 55 experience menopause each year;
the average age at which it begins is 51.(Allahverdipour, Jafarabadi, Burri and Javadivala, 2020).

Based on the age of menopausal onset, general women health, and the particular form of
menopause a women experiences menopausal symptoms and experiences differ greatly from one
woman to another. (Aninye, Laitner, Chinnappan& Society for Women’s Health Research
Menopause Working Group, 2021).

The way that women perceived menopause is influenced by their social, economic, cultural and
lifestyle aspects. Therefore, lack of information and a negative attitude about menopause make it
difficult for women to cope with its symptoms and lower their quality of life overall, which has
an adverse effect on the entire family and society. (Rathnayake, Alwis, Lenora, Mampitiya and
Lekamwasam, 2020).

3
Women’s perception toward menopause can be improved by increasing their knowledge of the
physical, psychosocial and lifestyle changes that follow menopause through health education
programs. (Smail, Jassim and Shakil, 2020).

It was observed by the researcher during home visit that some women experience symptoms such
as hot flashes, inability to sleep, decrease sexual desire, insomnia, depression and anxiety that
range from mildly discomforting to life disrupting and majority of them have poor knowledge
about the menopausal changes which affects their life in one way to another.

This prompt the researcher to research on menopausal changes and coping strategies among
women of age 45-55 years in medical outpatient department in Usmanu Danfodiyo University
Teaching Hospital Sokoto state. .

1.3 RESEARCH OBJECTIVES

1. To determine the level of knowledge on menopausal changes among women of 45-55 years in
medical outpatient department of Usmanu Danfodiyo University Teaching Hospital Sokoto state.

2. To identify common menopausal changes experienced by women of age 45-55 years in

medical outpatient department of Usmanu Danfodiyo University Teaching Hospital Sokoto state.

3. To determine how women cope with menopausal changes.

1.4 RESEARCH QUESTIONS

1. What is the level of the knowledge of menopause and menopausal changes among women of
45-55 years in medical outpatient department of Usmanu Danfodiyo university Teaching
Hospital Sokoto state?

2. What are the common menopausal changes experiences by these women?

3. What are the coping pattern uses by these women with menopausal changes?

1.5 SIGNIFICANCE OF THE STUDY

The finding of this study will benefit to the midwifery profession and the entire health workers
by adding to the bulk of their knowledge as they educate and encourage menopausal women on

4
how to cope with menopausal symptoms, thus menopausal women will be fully aware of the
knowledge of menopause, and menopausal change as such to be aware of some treatment
opinion for the physiological changes during menopause, to prevent complication that may arise.

1.6 SCOPE OF THE STUDY

The study focuses on menopausal changes and coping strategies among women in medical
outpatient department of Usmanu Danfodiyo University Teaching Hospital Sokoto.

1.7 OPERATIONAL DEFINITION OF TERMS

Assessment: -is the process of collecting and analyzing data in order to have proper
understanding of the subject matter.

Menopause: - are women of 45-55 years that have stop menstruation.

Symptoms: - means feeling or experiencing menopausal changes, e.g.; hot flashes, night
sweating, and irregular menstruation.

Coping strategies: - are various techniques and ways using in managing menopausal symptoms.

Perimenopausal: -Is the time before menstruation stopped.

Post menopause: - is the time after menopause.

WHO: - World Health Organization.

MOPD: - Medical Out Patient Department.

HYSTRECTOMY: - removal of the uterus.

OOPHORECTOMY: -removal of the ovary.

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 CHAPTER TWO: LITERATURE REVIEW

2.0 INTRODUCTION

This chapter is basically concerned with the content reviews of relevant literature obtained from
journals as well as online search and the review was present such a way that it tackles every
objective of the study discussed. The theoretical perspectives and research finding relevant to the
study topics are reviewed and summarized into four sections as follows:

2.1 CONCEPTUAL REVIEW ON MENOPAUSE

The term menopause refers to the final menstrual period .the average age is 45-55 years.
According to world health organization (WHO) defines menopause as the permanent cessation of
menstruation resulting from the loss of ovarian follicular activity.

Menopause is a natural phenomenon in women which characterized by the cessation of

menstruation for complete 1 year and usually occurring between the ages of 45 and 55 years of

6
age. In some individuals it starts earlier –as early as 35 and 40 years (Premature menopause).
Others occur at the age of 45years (early menopause). Late menopause occurs at 55years of age.
Menopause occurs gradually with irregular menstrual flow which can be scanty or excessive
before it stops completely. When it occur between the age of 45 and 55 is considered normal, but
when there is no medical or surgical cause of premature menopause it is called primary ovarian
insufficiency. (Mairo Ibrahim TangazaP, 2023).

Causes of menopause are, Menopause occurs when the ovaries are totally depleted of eggs and
no amount of stimulation from the regulating hormones can force them to work. Natural decline
of reproductive hormone.

Physiology of menopause, at the age of 45-55years, there is cessation of ovulation as a result of

diminished graffian follicle maturity due to degenerative process that results from decline of
follicle stimulating hormone (FSH) and luteinizing hormone (LH).

Estrogen production is reduced which cause release of estrogen from extragonadal sites (adipose
tissue, liver, muscle, bone marrow, fibroblast, and hair roots) unopposed by progesterone
production by corpus luteum.

When it occurs between the ages of 45-55years is considered “natural” and is a normal part of
aging.

When there is no medical or surgical cause of premature menopause it is called primary ovarian
insufficiency.

There are three phases of menopause, pre-menopause, Perimenopause, menopause, and post
menopause. The Perimenopause: - pre-menopause is broadly defined as the entire woman’s life
before menopause. During this phase, a woman will have regular periods, can bear children and
the sex hormones like estrogen and progesterone retain a steady balance. The peri menopause: -
Perimenopause can begin 10 years prior to menopause with the ovaries gradually producing less
estrogen. Menopausal phase: it is the end of menstruation the age of menopause ranges between
45-55 years. Menopause refers to a specific period, and that is the last period. Once a woman has
gone through a period of 12 month without experiencing a menstrual cycle is called menopause.

7
The ovaries stop releasing eggs. Post menopause: - these are years after woman has experienced
12 consecutive month of amenorrhea.

The symptom of menopause are, irregular vaginal bleeding, hot flashes, night sweats, dryness of
the vagina, urinary incontinence, emotional and cognitive symptoms (memory problems,
irritability, mood swings), other symptoms are arthritis, insomnia, tiredness, flabby breast, loss of
libido, itching of the vulva, increased weight gain, scanty pubic hair, brittle hair and nails, dry
skin (leathery) and loss of skin texture, wrinkle skin. Psychological symptoms; (nervousness,
depression, anxiety and dementia). (John p, cunha, 2023).

Management of menopausal symptoms is, Hormone therapy can be used to control the symptoms
of menopause, which is the combination of estrogen and progesterone. Diet to maintain an
optimal body weight, unprocessed foods consisting of primarily fruit and vegetables and low fat
protein. Encourage foods high in calcium, with the goal of 1,000-1,200mg daily as recommended
by the institute of medicine. Engagement in exercise to maintain body weight. Lifestyle change;
encourage use of light, loose –fitting clothing in layers to adjust to changing body temperature.
Use of anti depressant drugs to relieve symptoms of hot flushes. Vitamin therapy especially
vitamin B6 helps to prevent symptoms of low serotonin level; e.g. loss of energy and depression.
Contraceptive pills for hormone correction. Hormone replacement therapy (H12T) is way of
replacing the ovarian hormones (due to their non production as result of menopause).
Applications of genital lubricant during sexual intercourse if vagina is dry e.g. KY jelly and
other sexual arousal activities. Stop smoking. (John p, cunha, 2023).

Complication of menopause is osteoporosis, cardiovascular disease, hypertension e.t.c.

2.2 THEOROTICAL FRAMEWORK

2.2.1 SYMPTOMS MANAGEMENT THEORY

Symptoms management theory is a conceptual framework used in nursing and healthcare to

guide the care of patient experiencing symptoms. The theory aim to alleviate symptoms,
enhances patient comfort, and improves quality of care. It was developed by nursing faculty at
the University of California by San Francisco (UCSF School of nursing symptom management
group) in 1994 and was later refined by researcher such as Dodd et al, in 2001 and Humphreys et

8
al, in 2008, the theory aim to provide a conceptual framework for understanding and managing
symptoms effectively.

The theory defines symptoms as “the subjective experience of a sensation or change in normal
functioning that is perceived as abnormal or uncomfortable” (Humphreys et al, 2019).

The theory is based on six key components which include;

Symptom experience, symptom management strategies, symptom outcome, Individual

factors, healthcare provider factors, symptom management process.

The theory explained how individual manage their symptoms and illnesses and is ongoing
process that involve three main component; 1 symptom experience: which refers to the
individual perception and interpretation of their symptoms which include physical ,emotional,
and social aspects, including their severity, frequency, and impact on daily life. 2 symptom
management strategies: these are action taken by the individual to manage symptoms, such as
self care activities (e.g. exercise, relaxation techniques), lifestyle modification (e.g. diet change,

Stress management), and professional intervention (medication, therapy). 3 symptom outcome:

these are consequences of symptom management such as reduce symptoms severity, improved
functional status (e.g. ability to perform daily activities) and enhanced quality of life (e.g. overall
well-being, lifestyle satisfaction).

2.2.2 THEOROTICAL FRAMEWORK

9
Figure 2.1 conceptual frameworks showing menopausal changes and coping strategies among
women in medical outpatient department of Usmanu Danfodiyo University Teaching Hospital
Sokoto.

2.2.3 APPLICATION OF THE STUDY

An individual perception on the important of health, benefit of health and susceptibility to

disease will stimulate the person toward promoting health. A menopausal woman that is fully
saware on the important of coping strategies used to cope with the symptoms during menopausal
period.

10
Modifying factors like demographic variable of menopausal women like age, group, culture,
religion, socio-economic status, knowledge of menopausal women will help in reducing
complication related to menopause.

2.3 EMPIRICAL REVIEW

2.3.1 KNOWLEDGE OF WOMEN ABOUT MENOPAUSE

A cross sectional study was conducted by Thorat shradha, (2022) on knowledge regarding
menopause and coping strategies for menopausal symptoms in the field practice area of a
medical college, the participant had good knowledge about menopause. Using sample size of 116
post-menopausal women aged 40-65years. Their overall level of knowledge on menopause was
average. About 80%of women knew that irregular menses is the early indicator of menopause,
and 42.4% didn’t use any coping method to overcome symptoms. Women knew that menopause
is attained by the age of 55years (96.55).

Similarly, A cross sectional study was conducted by Eman, Mohammed, Samah, ElAziz, and
Amina, (2024) on knowledge and perception of premenopausal women about menopause in
Mansoura University Hospital, the participant had poor knowledge about menopause. Using 382
premenopausal women aged 42 to 55years. Study showed that more than two-thirds of the
studied women had poor knowledge regarding causes of menopause (lack of hormonal
production which regulate menstruation and no response of ovaries of follicle stimulating
hormone). Most of them had poor knowledge regarding menopausal symptoms as frequency of
urination, depression and mood swings. Most women had poor knowledge regarding to physical
coping mechanisms during menopause in addition to more than three-quarters of them were
unaware of hormonal replacement therapy. More than two-thirds of women expressed hatred and
worrying about menopause. Majority of the women verbalized that menopausal women are
losing their physical strength and youthfulness.

A descriptive study was conducted by Marie E Pinto (2020) on knowledge attitude regarding
menopause among rural an urban married women in Mangalore using 100 married women age
40 to 50. The participant has average knowledge regarding menopause. The study revealed that
majority of women in rural area (60%) belonging to age group of 40-50 had average knowledge
regarding menopause and a majority of women in urban area (62%) had satisfactory knowledge

11
regarding menopause. So menopausal health is important since this stage of life is not avoided.
Nurses as health personnel can assess knowledge and symptoms toward menopause and help
them to select coping strategies to overcome the menopausal problems.

2.3.2 COMMON MENOPAUSAL CHANGES EXPERIENCE BY WOMEN

A cross sectional online study was conducted by David, Abigail, Iman, Aos, Eva, Benedict and
Austen, (2023), on experience and severity of menopause symptom and effect of health seeing
behaviors’ of community dwelling in the United Kingdom. Using sample of 200 both post
menopausal and perimenopausal women age 35-70years. The most common menopausal
symptom (81.8%) was sleep disturbances (including difficulty falling sleep, staying asleep or
early waking). This was closely followed by hot flashes or night sweats (80.7%) and
forgetfulness or memory problems (75.6%). 73% of respondent experienced symptoms of
incontinence, psychological symptoms were prevalent (72.4%) with low or depressed mood
(66.6%) being most common. Followed by anxiety or panic attacks (59.7%). 68.3% reported a
lower sex drive, whereas 42% of all respondents experienced dry vagina or painful sex. Dry skin,
broken hair and nails affected 54.7% of the respondents. Migraines, dizziness, and dry mouth or
eye were the most common other symptoms, experienced by 7% of respondents.

A cross sectional study conducted by Meenakshi, Komal, Choudhary, Seema, Pankaj, and Tarun,
(2020) on prevalence of menopausal symptoms and its effect on quality of life among rural
middle aged women 40-60years in Haryana, India. Using sample of 400 respondents both
perimenopausal and post menopausal symptoms. The common menopausal symptoms were
anxiety (80%) followed by physical and mental exhaustion (71.5%), sleep problem (61.2%), and
heart problems (54%). The most classical symptom of menopause i.e., hot flashes was reported
in 36.7%.

A cross sectional study conducted by Zaineh, Deena, Tareq, and Noor, (2023) on assessment of
menopausal symptoms and coping strategies among Jordanian women of 40-60 years age group
in Qatar. Using sample of 309 through online questionnaire. The common menopausal symptoms
were sleep problems which affected the majority of the participants (>90%), hot flashes were
reported by a considerable portion of women (85% of the study sample), depressive mood
(30%), night sweat (31.1%), body ache (44.3%), and insomnia (51.8%).

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2.3.3 COPING STRATEGIES WITH MENOPAUSE

A descriptive study conducted by Mary, Josephine, Soorya, Violet and Rena, (2022) on
menopausal symptoms and coping strategies among menopausal women in selected Hospital at
Mangaluru. Using 100 menopausal women aged 45-60 years. The coping strategies show that
54%of women use a cooler environment to face the hot flash and sweating, 55% of women sit in
a comfortable place to relieve their heart discomfort. 47%of women have milk at the night to
manage their sleeping problems, 60% women use hot water to relieve joint and muscle pain. The
majority of women 82% do not have any problem related to dryness if the vagina. 50% of
women talk to friends when they are depressed, 56% cry to relax to relieve anxiety and 52% use
physical and mental fatigue to facilitate eating energizing food. Sharing with friends when
anxious 37% and praying when irritable 27%, were also shared as coping strategies.

Similarly, A descriptive study conducted by Eman, Aziza, Randa, and Amira, (2022) on coping
strategies with menopausal symptoms. Using sample of 75 menopausal women working at
governmental secondary schools in Kolkata aged 45-55 years. The coping strategies show that
21.3% of the studied women usually occupy themselves to forget menopause, 29.3% of then
usually control the emotion, 22.7% of them usually learned from the mistakes as positive coping
strategy related to menopausal symptoms on the other hand 25.3% of the studied women usually
take too many painkiller, 29.3% of them usually stop chasing dreams.

A descriptive study conducted by Jayashri, and Deelip (2020) on coping strategies in menopausal
women in Balgakot. Using 100 menopausal women age 45-60 years. The coping strategies
shows that 26% of women used exercises to relief the back and joint pain, control weight and
increase emotional wellbeing. 50%ate healthy diet to remain problem free. Candyce H hroche et
al concluded that weight loss as a part of healthy dietary modification may help to eliminate
vasomotor symptoms among postmenopausal women. 24% of women used yoga exercises
meditation and lifestyle modifications have relieved stress and enhanced the quality of life.

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 CHAPTER THREE

3.0 RESEARCH METHOD

Research method is a systematic plan for conducting research. Hence, this chapter was discussed
under the following: research design, setting of the study, target population, sample and sampling
technique, instrument for data collect, validity and reliability of instrument, method of data
collection, method of data analysis and ethical consideration.

3.1 RESEARCH DESIGN

`Basavanthappa (2019) highlighted that research design portrays an explicit guideline/framework

of how the research activities was conducted. A descriptive design will be adopted for the
study .descriptive study usually deals with concise assessment and presentation of situation the
way they are and it determines the extent or direction of the attitude or behavior.

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3.2 RESEARCH SETTING

Research setting can be defined as a place where study is being carried out by annex (2015). This
study was conducted in Usmanu Danfodiyo University Teaching Hospital (UDUTH) sokoto state
Nigeria. The hospital was established in 1975 by the federal government of Nigeria in September
-1975, it is among the teaching hospitals that were later established by decree in may 1980 as
second generation teaching hospitals along with calabar, port-Harcourt, Ilorin, Maiduguri, and
jos. Seventeen years after, precisely in 1989, the hospital was completed and commissioned by
then military president General Ibrahim Babangida. The hospital has different department among
which is medicine department. The study will be conducted in medical outpatient department
(MOPD).

3.3 TARGET POPULATION

Jacob (2012) defined target population as the group of people to whom research is to carry on.
The target population for the study will be menopausal women attending medical outpatient
department at Usmanu Danfodiyo University Teaching Hospital Sokoto state. The total number
of menopausal women seen weekly is 186 and average inflow of 744 menopausal women
monthly.

3.4 SAMPLING SIZE DETERMINATION

Is the process of selection a number of individual or object from a population such that the
selected group contains element representation of the characteristics found in the entire
population Orodo and Kombo, (2019). The research was able to determine the sample size using
Taro Yamane formula.

n=N/ 1+N(e)^2

When n=sample size; N= population size; d= level of precision (assumed to be 0.05 at 95%
confidence interval); N is 744. Thus:

n= 744/1+744(0.05)2

n= 744/ 1+744(0.0025)

15
 n= 744/ 1+3.8688

n=744/ 4.8688

n=152.80

Approximately 153.

3.5 SAMPLING TECHNIQUE

A convenience sampling is a type of non probability sampling method where the sample is taken
from a group of people easy to contact or reach. There are no other criteria to the sampling
method except that people are available and willing to participate. In addition, this type of
sampling method does not require that a simple random samples is generated, since the only
criteria is whether the participants agree to participate sunders et al. (2019). The research was
able to attain the sample size in the period of one month by visiting the department 2 times in a
week Monday; Wednesday there by making a total of 2 visits 19 menopausal women were
selected until the sample size of 153 was reached.

3.6 INSTRUMENT FOR DATA COLLECTION

A self- structured questionnaire was used for data collection. It was developed by the researcher
to elicit the research questions under study. The questionnaire was divided into 4 sections A, B,
C and D. Section A deals with socio demographic data, section B deals with the level of
knowledge of menopause among women, section C deals with menopausal symptom experience
by menopausal women, section D deals with coping strategy with menopausal symptoms.

3.7 VALIDITY OF INSTRUMENT

Validity of instrument refers to, whether a measurement instrument accurately measure what is
supposed to measure Basavanthappa. (2020). the questionnaire was developed to reflect the
objectives of the study. The validity of the instrument was based to ensure face and content
validity. Content validity was assessed by the project supervisor of relevance, representativeness,
specificity and clarity.

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3.8 RELIABILITY OF INSTRUMENT

Reliability is described as when the instrument gives a consistent result with high accuracy
Basavanthappa (2019). A pilot study was conducted among 55 menopausal women in specialist
hospital sokoto. They was given time to answer the question at the end the questionnaire was
collected check and corrections were made to ensure reliability.

3.9 METHOD OF DATA COLLECTION

Data was collected using self-administered questionnaire. The questionnaire was distributed by
the researcher with the assistance of the midwife in the department to participate after
explanation on the researcher had been given to them. About 19 questionnaires were distributed
on each visit and 153 were retrieved within 6 clinic days from 12pm to 1pm.

3.10 METHOD OF DATA ANALYSIS

Denscombe (2019). State that analysis portrays particulars, culture or experiences in depth and
details, allowing the texture and subtlety of the situation to become visible to the reader, the data
collected manually and analyzed by descriptive statistical method using percentage and
presented on frequency distribution table. Data was also analyzed using frequencies and
percentages. Significant association was tested for at 0.05level of significance.

3.11 ETHICAL CONSIDERATION

An introduction letter was given to the researcher from the school in order to obtain permission
for data collection from medical outpatient department (MOPD) in UDUTH, sokoto state. In
which approval was given to carry out the study and consent from all those involved was
obtained. They were assured that all information was treated with outmost confidentiality and a
copy of this work was found in the library for reference and further research only.

17
 CHAPTER FOUR

RESULT

4.0 INTRODUCTION

The chapter deals with the presentation and analysis of data from one hundred and fifty three
questionnaires administered to menopausal women attending medical outpatient department of
Usmanu Danfodiyo University Teaching Hospital Sokoto state.

4.1 DATA ANALYSIS AND PRESENTATIONS

TABLE 4.1 socio-demographic data

1. AGE FREQUENCY PERCENTAGES%

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40-45 33 21.6%
46-50 45 29.4%
51-55 35 22.9%
56 and above 40 26.1%
TOTAL 153 100%
2.RELIGION

Islam 120 78.4%

Christianity 30 19.6%
Others specify 3 2%
TOTAL 153 100
3. MARITAL STATUS

Married 80 52.3%
Widowed 40 26.1%
Divorced 28 18.3%
Single 5 3.2%
TOTAL 153 100%
4. OCCUPATION

Full house wife 70 45.8%

Business women 23 15%
Civil servant 60 39.2%
TOTAL 153 100
5. TRIBE

Hausa/Fulani 90 58.8%
Yoruba 30 19.6%
Igbo 20 13.1%
Others 13 8.5%
TOTAL 153 100%
6. LEVEL OF EDUCATION

.Nomadic education 70 45.8%

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 Tertiary 43 28.1%
Secondary 25 16.3%
Primary 15 9.8%
TOTAL 153 100%

Table 4.1 in the above table shows the Socio-demographic data. The above figures show that
45(29.4%) respondents age 46-50 years were the majority, 40 (26.1%) respondents are within the
age of 56 and above years, 35(22.9%) respondents are within the age of 51-55, 33(21.6%)
respondents are within the age of 40-45 years. More than half of the respondents are married 80
(52.3%), 5(3.2%) were single, 28(18.3%) each were divorced and separated respectively and
40(26.1%) are widowed. Majority of the respondents were from the 3 major ethnic groups in
Nigeria: Hausa 90(58.8%), Yoruba 30(19.6%), and Igbo20 (13.1%). Only 13 (8.5%) were from
the minority tribes such as Edo, Tiv, Egala etc. 120(78.4%) were Muslim, 30 (19.6%) were
Christians, 3(2%) were traditionalist. 70 (45.8%) respondents were full house wife and were the
majority, 60(39.2%) respondents were civil servants, 23 (15%) were business women.
70(45.8%) of the participants had Nomadic education out of which 43 (28.1%) had tertiary
education, 25(16.3%) had secondary education only 15(9.8%) had primary education.

TABLE 4.2 KNOWLEDGE OF MENOPAUSE AND MENOPAUSAL CHANGES

AMONG WOMEN OF 45-55 YEARS

S/N STATEMENT Frequency Percentage %

7 Are you still menstruating?
Yes 18 11.8%
No 135 88.2%
Total 153 100%
8 If no is it due to menopause?
Yes 130 85%
No 23 15%
Total 153 100%

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9 What do you understand by the
term menopause?
(a) It marked the end of 40 26.1%
reproductive stage
(b) It characterized by the 59 38.6%
cessation of menstruating for
complete 1 year
(c) It refer to a disease 30 19.6%
(d) It characterized by stop of 24 15.7%
monthly period occur at age of 50
and above
Total 153 100%
10 What causes menopause
(a) Natural aging process 100 65.4%
(b) Hysterectomy 40 26.1
(c) Hormonal changes 13 8.5%
Total 153 100%
11 Where do you get your
information about menopause
from?
(a) Media 40 26.1%
(b) Magazine 13 8.5%
(c) Family/friends 60 39.2%
(d) In hospital 40 26.1%
Total 153 100%
12 How do you view menopause
(a) Positive for example means no 100 65.4%
more period and no more use of
contraceptive
(b) Negative for example 53 34.6%
menopause means loss of fertility

21
 and youth
Total 153 100%

Table 4.2 above cumulatively show that majority of the respondent have good knowledge of
menopause and menopausal changes, majority 130(85%) of the respondent heard about
menopause,60(39.2%) of respondent heard about it from friends and family. 135(88.2%) of the
respondent are not menstruating, while 18(11.8%) are still menstruating. 100(65.4%) were able
to identify the cause of menopause as natural aging process 40(26.1%) said it occur due to
hysterectomy and 13(8.5%) said it occur due to hormonal changes. 100(65.4) of the respondent
view menopause as positive change meaning no more period and no more use of contraceptive,
while 53(34.5%) view it as negative change meaning loss of fertility and youth.

TABLE 4.3 COMMON MENOPOUSAL CHANGES EXPERIENCE BY WOMEN

S/ STATEMENT Not at all Rarely Sometime Often Frequentl Total

N s y
13 Night sweat 40 24 39 16 34 153
(26.1%) (15.7%) (25.5%) (10.5%) (22.2%) 100%
14 Hot flashes 8 13 16 48 68 153
(5.2%) (8.5%) (10.5%) (31.4%) (44.4%) 100%
15 Irregular period 80 15 25 20 13 153
(52.3%) (9.8%) (16.3%) (13.1%) (8.5%) 100%
16 Dry skin 10 13 20 45 65 153
(6.5%) (8.5%) (13.1%) (29.4%) (42.5%) 100%
17 Depression 23 30 35 24 41 153
(15%) (19.6%) (22.9%) (15.7%) (26.8%) 100%
18 Anxiety 40 18 15 20 60 153
(26.1%) (11.8%) (9.8%) (13.1%) (39.2%) 100%
19 Mood swings 15 13 25 30 70 153
(9.8%) (8.5%) (16.3%) (19.6%) (45.8%) 100%
20 Forgetfulness 9 10 25 50 59 153

22
 (5.9%) (6.5%) (16.3%) (32.7%) (38.6%) 100%
21 Loss of weight 59 40 30 11 13 153
(38.6%) (26.1%) (19.6%) (7.2%) (8.5%) 100%
22 Weight gain 15 9 48 15 66 153
(9.8%) (5.9%) (31.4%) (9.8%) (43.1%) 100%
23 Difficulty in 10 13 22 33 75 153
sleeping (6.5%) (8.5%) (14.4%) (21.6%) (49%) 100%
24 Poor 20 23 20 32 58 153
concentration (13.1%) (15%) (13.1%) (20.9%) (37.9%) 100%
25 Back ache 12 8 24 16 93 153
(7.8%) (5.2%) (15.7%) (10.5%) (60.8%) 100%
26 Joint pain 19 20 34 30 50 153
(12.4%) (13.1%) (22.2%) (19.6%) (32.7%) 100%

Table 4.3 above cumulatively shows that 64(41.8%) of respondent rarely experienced night
sweat, 50(32.7%) experienced it frequently, while 39(25.5%) experienced it sometimes.
116(75.8%) of the respondent frequently experienced hot flashes, 21(13.7%) rarely, while
16(10.5%) experienced it sometimes. 95(61.8%) of the respondent rarely experienced irregular
period, 33(21.6%) of the respondent experienced it frequently while 25(16.3%) of them
experienced it sometimes. 110(71.9%) of the respondent frequently experienced dry skin,
23(15%) of the respondent rarely experienced it, while 20(13.1%) of them experienced it
sometimes. 65(42.4%) of respondent frequently experienced depression, 53(34.6%) of the
respondent rarely experienced depression, while 35(22.9%) of them experienced it sometimes.
80(52.3%) of respondent are frequently anxious, 58(37.9%) of the respondent rarely experienced
it, while 15(9.8%) of them experienced it sometimes. 100(65.4%) of the respondent frequently
experienced mood swings, 28(18.3%) of the respondent rarely experienced it, while 25(16.3%)
of them experienced it sometimes. 109(71.3%) frequently experienced forgetfulness,
19(12.4%)of the respondent rarely experienced it, while 25(16.3%)of them experienced it
sometimes. 99(64.7%) of the respondent rarely experienced loss of weight, 24(15.7%) often
frequently experienced it, while 30(19.6%) of the respondent experienced it sometimes.
108(70.6%) of the respondent are frequently experienced difficulty in sleeping, 22(14.4%) rarely

23
experienced sleep difficulties, while 23(15%) of them experienced it sometimes. 90(58.8%) of
the respondent frequently experienced poor concentration, 43(28.1%) of the respondent rarely
experienced it, while 20(13.1%) of them experienced it sometimes. 81(71.9%) of the respondent
frequently experienced weight gain, 24(15.7%) of the respondent rarely experienced it, while
48(31.4%) of them experience it sometimes. 109(71.3%) of the respondent frequently
experienced back ache, 20(13%) of the respondent rarely experienced it, while 24(15.7%)of
them experienced it sometimes. 80(52.3%) of the respondent frequently experienced joint pain,
39(25.5%f the respondent rarely experienced it, while 34(22.2%) of them experienced it
sometimes.

TABLE 4.4 COPING STRATEGIES WITH MENOPAUSE

S/N STATEMENT Not at all Sometime Effective Very Highly Total

s effective effective
effective
27 Adequate diet 10 13 50 60 20 153
and weight (6.5%) (8.5%) (32.7%) (39.2%) (13.1%) 100%
control
28 Lifestyle change 10 18 60 40 25 153
(6.5%) (11.8%) (39.2%) (26.1%) (16.3%) 100%
29 Social 3 10 25 35 80 153
interaction with (2%) (6.5%) (16.3%) (22.9%) (52.3%) 100%
friends/ family
30 Creative 8 15 60 30 40 153
activities (5.2%) (9.8%) (39.2%) (19.6%) (26.1%) 100%
31 Genital lubricant 10 25 61 37 20 153
(6.5%) (16.3%) (39.9%) (24.2%) (13.1%) 100%
32 Recitation of the 0 10 48 65 30 153
holy Quran and (6.5%) (31.4%) (42.5%) (19.6%) 100%
bible/ prayer
33 Vitamin therapy 28 45 65 10 5 153
(18.3%) (29.4%) (42.5%) (6.5%) (3.3%) 100%

24
 34 Meditation 11 24 68 34 16 153
(6.5%) (16.7%) (44.4%) (22.2%) (10.5%) 100%
35 Yoga exercise 110 24 13 6 0 153
(71.9%) (15.7%) (8.5%) (3.9%) 0% 100%
36 Use of anti- 18 80 40 10 5 153
depressant to (11.8%) (52.3%) (26.1%) (6.5%) (3.3%) 100%
relief symptoms
37 Hormonal 65 45 30 8 5 153
replacement (42.5%) (29.4%) (19.6%) (5.2%) (3.3%) 100%
therapy

Table 4.4 above cumulatively shows that 23(15%) of the respondent adopt dietary practice and
weight controlling as coping strategies as sometime effective for them, 50(32.7%) of the
respondent said its effective for them, while 80(52.3%) of the respondent said its very effective.
60(39.2%) of the respondent adopt lifestyle modification to cope with the symptoms and they
said its effective for them, 65(42.5%) of the respondent said its very effective for them to cope
with situation while 28(18.3%) said sometime its effective but not all the time. 115(75.2%) 0f the
respondent maintained good relationship with the friends/family as coping strategies and they
said its very effective for them, 25(16.3%) of the respondent said its effective, 13(8.5%) of the
respondent it’s not all the time that its effective. 60(39.2%) of the respondent practice creative
activities as method of coping strategy and its effective for them, 23(15%) of the respondent said
sometimes its effective, while, 70(45.7%) of the respondent said its very effective for them.
95(62.1%) 0f the respondent usually read their Quran/Bible/prayer as their own way to cope with
symptoms and its very effective for them, 48(31.4%) of the respondent said its effective, while
10(6.5%) said sometimes its effective. 50(32.7%) 0f the respondent adopt self-calming
skills(exercise, meditation and yoga exercise) as coping strategy and its very effective for them,
68(44.4%) said its effective, while 35(22.8%) of them said its sometimes effective. And
15(9.8%) of the respondent adapt for medical treatment (hormonal replacement, vitamin therapy
and used of anti depressant drugs) as coping strategies and they said it very effective for them,
majority of the respondent 108(64.1%) said they are not effective because they don't have
knowledge regarding them, and 45(29.4%) of the respondent said it usually effective for them.

25
4.2 ANSWERING RESEARCH QUESTIONS

Q1. What is the level of the knowledge of menopause and menopausal changes among
women of 45-55 years in medical outpatient department of Usmanu Danfodiyo University
Teaching Hospital Sokoto state?

Table 4.2 above cumulatively show that majority of the respondent have good knowledge of
menopause and menopausal changes, majority 130(85%) of the respondent heard about
menopause,60(39.2%) of respondent heard about it from friends and family. 135(88.2%) of the
respondent are not menstruating, while 18(11.8%) are still menstruating. 100(65.4%) were able
to identify the cause of menopause as natural aging process 40(26.1%) said it occur due to
hysterectomy and 13(8.5%) said it occur due to hormonal changes. 100(65.4) of the respondent
view menopause as positive change meaning no more period and no more use of contraceptive,
while 53(34.5%) view it as negative change meaning loss of fertility and youth.

Q2. What are the common menopausal changes experiences by these women?

Table 4.3 above cumulatively shows that 64(41.8%) of respondent rarely experienced night
sweat, 50(32.7%) experienced it frequently, while 39(25.5%) experienced it sometimes.
116(75.8%) of the respondent frequently experienced hot flashes, 21(13.7%) rarely, while
16(10.5%) experienced it sometimes. 95(61.8%) of the respondent rarely experienced irregular
period, 33(21.6%) of the respondent experienced it frequently while 25(16.3%) of them
experienced it sometimes. 110(71.9%) of the respondent frequently experienced dry skin,
23(15%) of the respondent rarely experienced it, while 20(13.1%) of them experienced it
sometimes. 65(42.4%) of respondent frequently experienced depression, 53(34.6%) of the
respondent rarely experienced depression, while 35(22.9%) of them experienced it sometimes.
80(52.3%) of respondent are frequently anxious, 58(37.9%) of the respondent rarely experienced
it, while 15(9.8%) of them experienced it sometimes. 100(65.4%) of the respondent frequently
experienced mood swings, 28(18.3%) of the respondent rarely experienced it, while 25(16.3%)
of them experienced it sometimes. 109(71.3%) frequently experienced forgetfulness,
19(12.4%)of the respondent rarely experienced it, while 25(16.3%)of them experienced it
sometimes. 99(64.7%) of the respondent rarely experienced loss of weight, 24(15.7%) often
frequently experienced it, while 30(19.6%) of the respondent experienced it sometimes.

26
108(70.6%) of the respondent are frequently experienced difficulty in sleeping, 22(14.4%) rarely
experienced sleep difficulties, while 23(15%) of them experienced it sometimes. 90(58.8%) of
the respondent frequently experienced poor concentration, 43(28.1%) of the respondent rarely
experienced it, while 20(13.1%) of them experienced it sometimes. 81(71.9%) of the respondent
frequently experienced weight gain, 24(15.7%) of the respondent rarely experienced it, while
48(31.4%) of them experience it sometimes. 109(71.3%) of the respondent frequently
experienced back ache, 20(13%) of the respondent rarely experienced it, while 24(15.7%)of
them experienced it sometimes. 80(52.3%) of the respondent frequently experienced joint pain,
39(25.5%f the respondent rarely experienced it, while 34(22.2%) of them experienced it
sometimes.

Q3. What are the coping pattern uses by these women with menopausal changes?

Table 4.4 above cumulatively shows that 23(15%) of the respondent adopt dietary practice and
weight controlling as coping strategies as sometime effective for them, 50(32.7%) of the
respondent said its effective for them, while 80(52.3%) of the respondent said its very effective.
60(39.2%) of the respondent adopt lifestyle modification to cope with the symptoms and they
said its effective for them, 65(42.5%) of the respondent said its very effective for them to cope
with situation while 28(18.3%) said sometime its effective but not all the time. 115(75.2%) 0f the
respondent maintained good relationship with the friends/family as coping strategies and they
said its very effective for them, 25(16.3%) of the respondent said its effective, 13(8.5%) of the
respondent its not all the time that its effective. 60(39.2%) of the respondent practice creative
activities as method of coping strategy and its effective for them, 23(15%) of the respondent said
sometimes its effective, while, 70(45.7%) of the respondent said its very effective for them.
95(62.1%) 0f the respondent usually read their Quran/Bible/prayer as their own way to cope with
symptoms and its very effective for them, 48(31.4%) of the respondent said its effective, while
10(6.5%) said sometimes its effective. 50(32.7%) 0f the respondent adopt self-calming
skills(exercise, meditation and yoga exercise) as coping strategy and its very effective for them,
68(44.4%) said its effective, while 35(22.8%) of them said its sometimes effective. And
15(9.8%) of the respondent adapt for medical treatment (hormonal replacement, vitamin therapy
and used of anti depressant drugs) as coping strategies and they said it very effective for them,

27
majority of the respondent 108(64.1%) said they are not effective because they don't have
knowledge regarding them, and 45(29.4%) of the respondent said it usually effective for them.

CHAPTER FIVE: DISCUSSION OF FINDINGS

5.0 INTRODUCTION

This research was design to assess the menopausal changes and coping strategies among women
in medical outpatient department of Usmanu Danfodiyo University Teaching Hospital Sokoto
State. The findings were discussed based on the objectives of the study.

5.1 DISCUSSION OF FINDINGS.

The findings of the study reveal that menopausal women in UDUTH have good knowledge on
menopausal changes. cumulated results shows that majority of the respondent have good
knowledge of menopause and menopausal changes, majority 130(85%) of the respondent heard
about menopause,60(39.2%) of respondent heard about it from friends and family. 135(88.2%)

28
of the respondent are not menstruating, while 18(11.8%) are still menstruating. 100(65.4%) were
able to identify the cause of menopause as natural aging process 40(26.1%) said it occur due
hysterectomy and 13(8.5%) said it occur due to hormonal changes. 100(65.4) of the respondent
view menopause as positive meaning no more period and no more use of contraceptive, while
53(34.5%) view it as negative meaning loss of fertility and youth. This corresponds to a study by
Thorat shradha, (2022) on knowledge regarding menopause and coping strategies for
menopausal symptoms in the field practice area of a medical college, the participant had good
knowledge about menopause. Using sample size of 116 post-menopausal women aged 40-
65years. Their overall level of knowledge on menopause was average. About 80%of women
knew that irregular menses is the early indicator of menopause, and 42.4% didn’t use any coping
method to overcome symptoms. Women knew that menopause is attained by the age of 55years
(96.55).

The common menopausal changes experienced by women of 45-55 years. 64(41.8%) of

respondent rarely experienced night sweat, 50(32.7%) experienced it frequently, while
39(25.5%) experienced it sometimes. 116(75.8%) of the respondent frequently experienced hot
flashes, 21(13.7%) are rarely, while 16(10.5%) experienced it sometimes. 95(61.8%) of the
respondent rarely experienced irregular period, 33(21.6%) experienced it frequently while
25(16.3%) experienced it sometimes. 110(71.9%) of the respondent frequently experienced dry
skin, 23(15%) are rarely, while 20(13.1%) experienced it sometimes. 65(42.4%) of respondent
frequently experienced depression, 53(34.6%) are rarely, while 35(22.9%) experienced it
sometimes. 80(52.3%) of respondent are frequently anxious, 58(37.9%) are rarely, while
15(9.8%) experienced it sometimes. 100(65.4%) of the respondent frequently experienced mood
swings, 28(18.3%) are rarely, while 25(16.3%) experienced it sometimes. 109(71.3%) are
frequently experienced forgetfulness, 19(12.4%) are rarely, while 25(16.3%) experienced it
sometimes. 99(64.7%) of the respondent are rarely experienced loss of weight, 24(15.7%) are
frequently experienced it, while 30(19.6%) experienced it sometimes. 108(70.6%) of the
respondent are frequently experienced difficulty in sleeping, 22(14.4%) are rarely, while
23(15%) experienced it sometimes. 90(58.8%) of the respondent are frequently experienced poor
concentration, 43(28.1%) are rarely, while 20(13.1%) experienced it sometimes. 81(71.9%) of
the respondent are frequently experienced weight gain, 24(15.7%) are rarely experienced it,
while 48(31.4%) experience it sometimes. 109(71.3%) of the respondent are frequently

29
experienced back ache, 20(13%) are rarely experienced it, while 24(15.7%) are experienced it
sometimes. 80(52.3%) of the respondent are frequently experienced joint pain, 39(25.5%) are
rarely experienced it, while 34(22.2%) experienced it sometimes. This corresponds to a study by
David, Abigail, Iman, Aos, Eva, Benedict and Austen, (2023), on experience and severity of
menopause symptom and effect of health seeing behaviors’ of community dwelling in the United
Kingdom. Using sample of 200 both post menopausal and perimenopausal women age 35-
70years. The most common menopausal symptom (81.8%) was sleep disturbances (including
difficulty falling sleep, staying asleep or early waking). This was closely followed by hot flashes
or night sweats (80.7%) and forgetfulness or memory problems (75.6%). 73% of respondent
experienced symptoms of incontinence, psychological symptoms were prevalent (72.4%) with
low or depressed mood (66.6%) being most common. Followed by anxiety or panic attacks
(59.7%). 68.3% reported a lower sex drive, whereas 42% of all respondents experienced dry
vagina or painful sex. Dry skin, broken hair and nails affected 54.7% of the respondents.
Migraines, dizziness, and dry mouth or eye were the most common other symptoms, experienced
by 7% of respondents.

The coping strategies with menopausal symptoms. The finding of the study reveal that 23(15%)
of the respondent adopt dietary practice and weight controlling as coping strategies as sometime
effective for them, 50(32.7%) of the respondent said its effective for them, while 80(52.3%) of
the respondent said its very effective. 60(39.2%) of the respondent adopt lifestyle modification to
cope with the symptoms and they said its effective for them, 65(42.5%) of the respondent said its
very effective for them to cope with situation while 28(18.3%) said sometime its effective but
not all the time. 115(75.2%) 0f the respondent maintained good relationship with the
friends/family as coping strategies and they said its very effective for them, 25(16.3%) of the
respondent said its effective, 13(8.5%) of the respondent it’s not all the time that its effective.
60(39.2%) of the respondent practice creative activities as method of coping strategy and its
effective for them, 23(15%) of the respondent said sometimes its effective, while, 70(45.7%) of
the respondent said its very effective for them. 95(62.1%) 0f the respondent usually read their
Quran/Bible/prayer as their own way to cope with symptoms and its very effective for them,
48(31.4%) of the respondent said its effective, while 10(6.5%) said sometimes its effective.
50(32.7%) 0f the respondent adopt self-calming skills(exercise, meditation and yoga exercise) as
coping strategy and its very effective for them, 68(44.4%) said its effective, while 35(22.8%) of

30
them said its sometimes effective. And 15(9.8%) of the respondent adapt for medical treatment
(hormonal replacement, vitamin therapy and used of anti depressant drugs) as coping strategies
and they said it very effective for them, majority of the respondent 108(64.1%) said they are not
effective because they don't have knowledge regarding them, and 45(29.4%) of the respondent
said it usually effective for them. This corresponds with the study by Mary, Josephine, Soorya,
Violet and Rena, (2022) on menopausal symptoms and coping strategies among menopausal
women in selected Hospital at Mangaluru. Using 100 menopausal women aged 45-60 years. The
coping strategies show that 54%of women use a cooler environment to face the hot flash and
sweating, 55% of women sit in a comfortable place to relieve their heart discomfort. 47%of
women have milk at the night to manage their sleeping problems, 60% women use hot water to
relieve joint and muscle pain. The majority of women 82% do not have any problem related to
dryness if the vagina. 50% of women talk to friends when they are depressed, 56% cry to relax to
relieve anxiety and 52% use physical and mental fatigue to facilitate eating energizing food.
Sharing with friends when anxious 37% and praying when irritable 27%, were also shared as
coping strategies.

5.2 IMPLICATION TO MIDWIFERY PRACTICE

It is valuable to midwifery practice because it sheds more light on the important aspects that can
impact on the effectiveness of coping strategies among menopausal women. It guides the
development of evidenced based guidelines and protocol for midwives, equipping them with the
most-up to date and effective methods to promote good coping strategies among menopausal
women. It is important to midwifery practices as it help ensure women adopt positive coping
strategies for outcomes of their lives, thus reduces the negative impact of menopausal symptoms
on their daily life style, there by empowering women and their families to adopt to these
transitional stage.

5.3 LIMITATION OF THE STUDY

This study was restricted to menopausal women attending medical outpatient department in
UDUTH Sokoto, on menopausal changes and coping strategies among women in medical
outpatient department of Usmanu Danfodiyo University Teaching Hospital Sokoto. The study
may not capture the full range of on menopausal changes and coping strategies, as the sample

31
size and location may not provide enough diversity or representation across different
demographic, cultural, or socio-economic backgrounds. This could limit the understanding of
symptoms that may be specific to certain subgroups or population.

5.4 SUMMARY

This study was carried out on menopausal changes and coping strategies among women in
medical outpatient department of Usmanu Danfodiyo University Teaching Hospital Sokoto. The
objectives of the study are, To determine the level of knowledge on menopausal changes among
women of 45-55 years in medical outpatient department of Usmanu Danfodiyo University
Teaching Hospital Sokoto state, To identify common menopausal changes experienced by
women of age 45-55 years in medical outpatient department of Usmanu Danfodiyo University
Teaching Hospital Sokoto state, To determine how women cope with menopausal changes. The
findings of the study will benefit to the midwifery profession, and the entire health workers by
adding to the bulk of their knowledge as they educate and encourage menopausal women to
adopt coping strategies, thus women will be fully aware of the important of medical management
of menopause as such prevent complication that might arise. It will also be of great benefit to the
society hence, reducing the risk of depression and hypertension among these menopausal
women, through adopting to some of these coping strategies, Adequate diet and weight control,
Lifestyle change, Social interaction with friends/ family, Creative activities, Genital lubricant,
Recitation of the holy Quran and bible/ prayer, Vitamin therapy and meditation. A descriptive
research design and convenience sampling technique was adopted to select the sample size of
153 menopausal women. The data were analyzed statistically using percentage and presented
using frequency tables. The findings show that majority of the respondents have good knowledge
about menopause. The symptoms that usually experienced by these menopausal women include:
Night sweat, Hot flashes, Irregular period, Dry skin, Depression, Anxiety, Mood swings,
Forgetfulness. Based on the findings of the study the following recommendations will help the
midwives and other health professions to ensure consistency in encouraging women that come
to medical outpatient department to comply with health education. Public awareness and
community mobilizations and participation on important and benefits of adopting positive coping
strategies.

5.5CONCLUSION

32
The study helps the researcher to assess menopausal changes and coping strategies among
women in medical outpatient department of Usmanu Danfodiyo University Teaching Hospital
Sokoto. This research work was able to find ways to cope with menopausal changes the among
women of 45-55 years.

5.6 RECOMMENDATIONS

In view of the above findings, the following recommendations were made with view of
improving the important of adapting to positive coping strategies to overcome the menopausal
changes:

It is therefore recommended that more public awareness should be done on the benefits of
adequate diet, weight control, Lifestyle change, Social interaction with friends/ family and
Creative activities, to overcome the menopausal symptoms.

It is recommended to integrate menopause education into routine health care check-up, develop
personalized treatment plans for addressing physical and emotional symptoms, and provide
counseling on coping strategies and mental health support.

It is recommended for government to develop national guidelines for menopause management,

increase funding for menopause research and education, implement workplace policies
supporting menopausal women(flexible working hours, wellness program), and ensure access to
affordable healthcare services for menopausal women.

5.7 SUGGESTIONS FOR FURTHER STUDY

The researcher suggests that further studies should be carried out on investigation into cultural
and socioeconomic factors influencing menopausal experiences.

33
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menopouse. Mansoura Nursing Journal, 12(4).

15. Tayyen, I.A., Labib, T.A., Ebrahim, M.R., & Yousif, M.A.(2022). coping strategies with
menopousal symptoms among Palestine women. Egyptian journal of health care ,13 (4).

16. Thorat, S. (2022). A community base study on knowledge regarding menopouse and coping
strategies for menopausal symptom in the field of practice area of a medical college. Bharati
Vidyapeeth Medical Journal ,1(4).

QUESTIONNAIRE

COLLEGE OF NURSING SCIENCES, DEPARTMENT OF MIDWIFERY UDUTH

SOKOTO.

Dear respondent,

I am a student of the above mentioned institution carrying out a study on menopausal changes
and coping strategies among women in medical outpatient department of Usmanu
Danfodiyo University Teaching Hospitals. You are cordially requested to participate in the
study by completing the questionnaire which is designed to elicit information, all information
provided will be strictly confidential and all responses will be used for academic purpose only.

Please answer the questions in all sections correctly, thank you.

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SECTION A: socio demographic data

1. Age

(a) 40----45. (b) 46----50. (c) 51-----55. (d) 56 and above

2. Religion

(a) Islam. (b) Christianity

3. Marital status

(a) Single. (b) Married. (c) Divorced. (d) Widowed

4. Occupation

(a) Full House wife. (b) Business. (c) Civil servant.

5. Tribe

(a) Hausa/ Fulani (b) Yoruba. (c) Igbo. (d) Others

6. Level of education

(a) primary. (b) Secondary. (c) Tertiary (d) Religion studies (Nomadic
Education)

SECTION B: knowledge of menopause among menopausal women

1. Are still menstruating

(a) Yes.

(b) No

2. If no is it due to menopause

(a) Yes.

(a) No

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3. What do you understand by the term menopause?

(a) It marked the end of reproductive stage

(b) It characterized by the cessation of menstruating for complete 1 year

(c) It refer to a disease

(d) It characterized by stop of monthly period occur at age of 50 and above

4. If yes where do you get your information about menopause from

(a) Media. (b) Magazine. (c) Health care provider. (d) Family/friends (e) in hospital

5. How do you view menopause?

(a) Positive for example means no more periods and no more contraceptive

(b) Negative for example menopause means a loss of fertility and youth

(c) Others

6. What causes menopause?

(a) Natural aging process

(b) Hysterectomy

(c) Hormonal changes

SECTION C: menopausal symptom among women

Please rate each statement below based on how frequently you experience these psychological
effects during your menstrual period. Use a scale from 1 (Not at all) to 5 (Frequently).

STATEMENT Not at all Rarely Sometimes Often Frequently

Night sweat
Hot flashes
Irregular period

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 Dry skin
Depression

Anxiety
Mood swings
Forgetfulness
Loss of weight
Weight gain
Difficulty in sleeping
Poor concentration
Back pain
Joint pain
Sexual problem

Section D: Coping strategies with menopausal symptoms

Please rate the effectiveness of the following coping strategies you use to manage the
menopausal symptom. Use a scale from 1 (Not Effective) to 5 (Highly effective)

STATEMENT Not at all Sometimes Effective Very Highly

effective effective effective
Adequate diet and
weight control
Lifestyle change
Social interaction with
friends/ family
Creative activities
Genital lubricant
Recitation of the holy
Quran and bible/ prayer
Vitamin therapy

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Meditation
Yoga exercise
Use of anti-depressant
to relief symptoms
Hormonal replacement
therapy

40