This study explores the strategies used by postmenopausal women in Egbu Community, Owerri North, Imo State, Nigeria, to cope with health problems associated with menopause. Menopause, a significant life stage, is often accompanied by various physical, emotional, and mental health challenges, such as hot flashes, painful sexual intercourse, depression, and memory loss. These challenges are exacerbated by socio-cultural factors, limited healthcare infrastructure, and a lack of awareness and education about menopause, particularly in rural communities like Egbu. The study adopts a descriptive cross-sectional design and utilizes a self-structured questionnaire to collect data from 150 postmenopausal women. The findings reveal that the most common physical problem is painful sexual intercourse, while mental depression is the predominant emotional and mental issue. Coping strategies employed by these women include engaging in moderate exercise, seeking medical advice, and maintaining adequate rest and sleep. However, poor education, lifestyle factors, and religious beliefs significantly influence the effectiveness of these coping strategies.The study concludes that while some coping strategies are effective, there is a need for targeted interventions to improve awareness, education, and access to healthcare services. These interventions should be culturally sensitive and designed to empower women, enhance their quality of life, and reduce the stigma surrounding menopause. The study's findings are crucial for informing community health planning and policy development to better support postmenopausal women in rural areas.

Keywords: postmenopausal, health problems, strategies coping, Egbu community

Background to the Study

Menopause is a significant stage in a woman's life, marking the end of her reproductive years. It is characterized by the cessation of menstrual cycles for twelve consecutive months, typically occurring between the ages of 45 and 55. This transition can bring various physical and emotional changes due to fluctuations in hormone levels.¹ At puberty, every normal female is faced with the beginning of menstrual flow and the need to develop coping mechanisms. The age of menarche can vary significantly, with some girls experiencing it as early as eight or nine years for early developers and others as late as eighteen to nineteen years. These variations can be influenced by genetic, environmental, and nutritional factors.²

Then at menopause, post-menopausal women experience various health problems, including but not limited to hot flashes, night sweats, osteoporosis, cardiovascular diseases, and psychological issues such as depression and anxiety. These changes have a direct impact on their health and require effective coping strategies.³ The prevalence and severity of these symptoms can vary significantly among women, influenced by genetic, environmental, and lifestyle factors.⁴ In many parts of the world, including developed countries, women have access to various resources and support systems to help manage these symptoms. This includes hormone replacement therapy (HRT), lifestyle interventions such as diet and exercise, and psychological support. However, the availability and accessibility of these resources can vary greatly, especially in low- and middle-income countries.⁵

Menopause is a natural physiological occurrence and a necessary phase in a woman’s life, attracting a lot of meanings, reactions, beliefs, and attitudes.⁶ According to Laplace, to many people, especially in rural uninformed communities, the negative perception of menopause exposes women to suffering instead of allowing them to enjoy their menopausal period. As a result, they become mentally and physically unhealthy due to the associated problems (Laplace et al., 2023). In Africa, the experience of menopause is often compounded by socio-cultural factors and limited healthcare infrastructure. Many women may have restricted access to healthcare services, and there can be a lack of awareness and education about menopause and its management. Traditional beliefs and stigma associated with aging and menopause can further complicate the situation, making it challenging for women to seek help and cope effectively with their symptoms.⁷

In Nigeria, the situation reflects a mix of modern and traditional approaches to health. While urban areas may offer better access to healthcare services, rural areas often face significant challenges. In the rural community, menopause is surrounded by a lot of traditional myths, and most women do not understand what it is and why it occurs. Due to ignorance, women guess that it marks the end of usefulness, womanhood, meaningful living, degeneration of sex organs, and stoppage of sexual intercourse or lessened libido.⁸ Cultural beliefs and practices play a crucial role in how women perceive and manage menopause, especially in rural communities.⁹

Focusing on Imo State, and specifically Egbu Community in Owerri North Local Government Area, the challenges are pronounced. Women in this region may experience a lack of adequate information and resources to manage post-menopausal health problems. Socio-economic factors, limited access to healthcare facilities, and cultural perceptions can all influence how women cope with menopause.¹⁰ Understanding the specific health problems and coping strategies of post-menopausal women in this community is essential for developing targeted interventions to support their well-being. There is therefore, a need for increased awareness and education about menopause to help women navigate this stage of life more effectively.

In Egbu Community, Owerri North Local Government Area, Imo State, the coping strategies employed by post-menopausal women to manage their health problems are not well-documented. Understanding and managing the changes that occur during menopause is crucial for maintaining quality of life during this period.¹¹ furthermore, understanding the coping strategies during menopause is crucial for developing targeted interventions that can enhance the quality of life for these women.

Purpose of the Study

The aim of this study is to explore the strategies used by post-menopausal women in Egbu Community to cope with health problems associated with menopause.

Objectives of the study

The specific objectives are:

1. To identify the common health problems experienced by post-menopausal women in Egbu Community.
2. To examine the commonest coping strategies for coping with menopausal health problems among women with post-menopausal women in Egbu community.
3. Determine factors influencing the coping strategies with menopausal health problems among women in Egbu community.

Significance of the study

This study is significant as it aims to improve health outcomes for post-menopausal women in Egbu Community by identifying effective coping strategies that can lead to targeted interventions. By highlighting the knowledge gaps surrounding menopause, the study can promote enhanced awareness and education, dispelling myths and misconceptions among women. It also emphasizes the importance of cultural sensitivity in healthcare, guiding providers to design interventions that respect and align with the community's cultural beliefs.

The findings can support policy development to improve access to healthcare services for post-menopausal women, particularly in rural areas, by advocating for better infrastructure, funding, and training. Empowering women through this research can validate their experiences and equip them with proactive health management tools, fostering a supportive environment where the stigma surrounding menopause is reduced. The study’s insights will inform community health planning, ensuring that programs are tailored to the unique needs of these women. Additionally, it will contribute to academic literature on menopause, offering valuable data for future research. By promoting a holistic approach to health, the study addresses both physical and emotional aspects of menopause, laying a foundation for further research and interventions that can positively impact similar communities.

Main dody

Conceptual review

The conceptual review will explore the health problems associated with menopause, the biological and psychological changes women undergo, and the various coping strategies employed globally, while also defining key concepts such as menopause and post-menopausal health problems. Menopause, typically occurring between ages 45 and 55, marks the end of a woman's reproductive years due to declining ovarian function and estrogen levels.^12,13

Factors such as lifestyle and nutrition can influence the onset and severity of menopausal symptoms, with artificial menopause associated with smoking, high altitudes, and poor nutrition, which can exacerbate symptoms.¹⁴ Contrary to misconceptions, menopause can lead to an increase in sexual activity due to decreased concerns about pregnancy.¹⁵ The menopausal transition can vary in duration, with some women experiencing sudden cessation of menstruation, while others may have irregular periods before reaching menopause.¹³

Health problems associated with menopause

Menopause is associated with a range of health problems including physical symptoms such as vaginal dryness, hot flashes, weight changes, and painful intercourse, as well as emotional issues like fatigue, depression, anxiety, and insomnia.¹ Mentally, women may face memory difficulties and heightened anxiety, with additional concerns including increased risks of cardiovascular diseases, osteoporosis, and certain cancers.^11,16

Coping methods of menopause

Coping with menopause involves a range of strategies such as hormone replacement therapy (HRT), lifestyle changes like regular exercise and a balanced diet, and alternative therapies such as acupuncture and herbal supplements to manage symptoms and enhance well-being.^17–19 Additionally, education, support from healthcare professionals, and maintaining positive interpersonal relationships play crucial roles in effectively managing this transitional phase.^20,21

Factors influencing coping strategies for menopausal health problems among women

Menopause marks a significant transition in a woman’s life, presenting physical, emotional, and psychological challenges that are influenced by factors such as socio-economic status, cultural beliefs, access to healthcare, education, and social support. Women with higher socio-economic status generally have better access to healthcare, nutrition, and information, which helps in managing menopausal symptoms effectively, while those from lower socio-economic backgrounds may face exacerbated health issues due to limited resources.²² Cultural beliefs also affect menopausal management, with negative perceptions in many societies leading to stigma and reduced likelihood of seeking medical help, particularly in rural or traditional settings.²³ Access to healthcare is crucial, as it provides opportunities for interventions like hormone replacement therapy (HRT) and nutritional guidance, but limited infrastructure in rural areas can hinder effective symptom management.²⁴ Education and awareness about menopause enable women to adopt better coping strategies, with community outreach and educational programs playing a key role in increasing knowledge and support.²⁵ Additionally, strong social support from family, friends, and community groups helps women share experiences and reduce anxiety, while individual psychological factors such as resilience and mental health status contribute to coping effectiveness.^26,27

The various methods and materials employed by the researcher for this research are explained under the following headings:

Research design

For the achievement of the objectives of this research, the study adopted a descriptive cross-sectional design. Specifically, this is found most appropriate because it provides an opportunity for collecting data from respondents. It was used to study the strategies for coping with postmenopausal health problems among women in Egbu Commuity in Owerri Local Government Area.

Area of the study

The study area was at Egbu Community, located in Owerri North Local Government Area, Imo State, Nigeria. The study area comprised of the five existing clans in Egbu community and these include: Umuofor, Mpama. Umuayalu, Ofeuzo and Ishiuzo. Egbu commuity shares boundary with Owerri at the north and has neighbouring communities with Awaka, Emekuku, Emi and Mbaise.Egbu as a united people has one leader known as the EZE who comes for a particular family known as EGBUKOLE. The community does not have a primary health care but has two private hospital, these are the Christiana Specialist Hospital and the Mount Sanai Hospital which are patronized by the community as well as people from far and near. Egbu is a middle class community,the predominant occupation of the inhabitant is hunting, trading, farming as well as civil servants. The highly educated ones are professional health workers mainly and government workers.

Population of the study

"Egbu community has an area of 138 square Km ad an estimated population of 3000 people (National Population Census, 2006). It consists of 1,450 men in the community and 1,550 women in the five drawn clans. The population consisted of all post-menopausal women residing in Egbu Community.

Inclusion criteria:

1. Women who have not menstruated for twelve consecutive months.
2. Women who are residents of Egbu Community.

Sample size and sampling technique: The sample size for the study consist of 150 post-menopausal women drawn from the five different clans in Egbu. The sampling technique employed is the non-probability sampling technique (Convenience sample) was used in picking 30 post menopausal women from each of the five randomly drawn clans. On the whole 150 post menopausal women were chosen.

Instrument for data collection: The instrument used for data collection was a self-structured questionnaire. The questionnaire consisted of four sections (Sections A, B, C, D): Section A contained items on demographic information of the respondents. Section B consist of questions on health problems of menopausal women, section C contained all questions on the commonest strategies for coping with menopausal health problems and section D consist of items influencing coping strategies. The entire instrument consists of 13 items in all.

Procedure for data collection: permission was obtained from local authorities including the village head and the Eze of Egbu.The self-constructed and validated questionnaire was administered to women that met the inclusion criteria after verbal and written consents were obtained.

Method of data analysis: Data will be analyzed using descriptive statistics (frequencies, percentages, mean) and inferential statistics (chi-square tests) to determine the effectiveness of coping strategies.

(Tables 1–4)

Commonest problems associated with menopause

Objective 1 revealed that majority of post-menopausal women has painful sexual intercourse with 52 (34.7) respondents. This confirms the critical review w out in Smith²⁸ which pointed that 70% of post-menopausal women experience painful sexual intercourse.

Commonly used coping strategies

Objective 1 revealed that majority of the post-menopausal women with 90 (61.3% responses engage in exercise. This agrees with Brown²¹ who opined that exercise is beneficial for coping with health problems of menopause and regular exercise is advantageous in managing the health challenges associated with menopause. The study reveals that 58.7% of post-menopausal women which is the highest frequency go to the doctor for medical advice. This agrees with Lee²⁹ who opined that health counselling is beneficial during menopause for effective coping. The study revealed that majority of the post-menopausal women do have adequate rest and sleep with 141 (94%) responses. This agrees with Johnson,¹⁵ who opined that adequate rest and sleep help to conserve energy.

Majority of post-menopausal women cope effectively by cordial relationship with couples with a frequency of 62 (41.3%). This agrees with Davis (2021) who pointed out that maintaining a supportive relationship with one's partner is crucial for coping with post-menopausal health challenges. Furthermore, 135 (90%) affirmed that the coping strategies employed by them are effective. This is in agreement with Thompson, (2020) that evidence supports that coping strategies are effective in managing challenges during menopause.

Factors influencing the coping strategies with menopausal health problems among women in Egbu community

The findings from the study in Egbu align with existing literature on the factors influencing coping strategies for menopausal health problems. The high percentage of respondents identifying "poor education" as a key factor is consistent with research indicating that lack of knowledge about menopause can impede effective coping.^7,25 Similarly, the significance of "lifestyle" supports the empirical evidence that healthy lifestyle practices are crucial for managing menopausal symptoms.¹⁹ Although "religion" was identified by a smaller percentage of respondents, this factor remains relevant as cultural and religious beliefs do impact menopause management.^9,23 Overall, the study's findings corroborate the empirical evidence, highlighting the need for improved education and lifestyle interventions, as well as sensitivity to cultural and religious contexts in developing support systems for menopausal women.

The findings indicate that menopausal coping strategies vary by age, with women aged 55-60 showing the highest effectiveness, while those 60 and above show the lowest. Marital status, parity, education level, and religion also significantly influence coping strategies, with married women, those with higher education, and Christians demonstrating better coping. Sources of menopause knowledge primarily come from healthcare personnel, and while most women consider their coping strategies effective, poor education and lifestyle issues are significant hindrances.

To God Almighty, we give our profound gratitude for keeping us alive, healthy and for the grace to carry out this work to completion. We wish to express our sincere and profound gratitude to Village head of Egbu and the women that participated in the study.

To our lovely families, thank you for the support and understanding and for allowing us with the time to carry out this study. Our warm appreciation also goes to all the authors for the psychological and financial support in order to get this article published.

None.

There is no conflict of interest.

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