Menopausal symptoms and quality of life (QOL) of pre- and postmenopausal women in Sri Lanka have not been studied adequately. This study aimed to evaluate the prevalence and severity of menopausal symptoms and the QOL of pre- and postmenopausal women in Galle District, Sri Lanka. A cross-sectional study was conducted with a randomly selected sample of premenopausal (n=184) and postmenopausal (n=166) community-dwelling healthy women aged 30-60 years. The mean (SD) ages of pre- and postmenopausal women, respectively, were 46.1(3.7) and 55.8(3.8) years. Menopausal symptoms were evaluated using the menopause rating scale under three subscales: psychological symptoms, somatovegetative symptoms, and urogenital symptoms. The QOL was evaluated using the short form 36 survey under eight domains. Further, sociodemographic status, gynaecologic factors, physical activity pattern (walking, moderate, and vigorous), body mass index, and waist to hip ratio were also evaluated. The prevalence and severity of all the menopausal symptoms were higher among postmenopausal women. In premenopausal women, the most frequently reported menopausal symptoms were mental exhaustion (49.5%), joint and muscular discomforts (48.5%), and irritability (41.3%). Physical and mental exhaustion (53%), irritability (48.2%), depressive mood (43.4%), and hot flushes (42.2%) were the most frequently reported menopausal symptoms in postmenopausal women. The QOL was significantly impaired among postmenopausal women [mean (SD); 57.47(18.83)] compared to premenopausal women [mean (SD); 66.82(17.93)] (p<0.001). Psychological symptoms score and somatovegetative symptoms score were associated with the QOL of premenopausal women (adjusted R2; 0.35). Somatovegetative symptoms score, psychological symptoms score, moderate and vigorous physical activity scores, and monthly income were associated with the QOL in postmenopausal women (adjusted R2; 0.38). The current study showed that the prevalence and severity of menopausal symptoms and impaired QOL were significantly higher among postmenopausal women, compared to premenopausal women. Menopausal symptoms mostly contributed to the poorer QOL in both pre- and postmenopausal women.

Limited knowledge and negative attitudes about menopause among postmenopausal women (PMW) create a multitude of health-related issues leading to impaired quality of life (QOL) among them. This study evaluated the impact of a health-promoting lifestyle education intervention (HPLEI) on knowledge, attitude, and QOL in a group of PMW in Sri Lanka. A quasi-experimental study was conducted with 72 PMW, matched for sociodemographic status of the community from two geographically separated areas in Galle, and they were allocated to intervention (n=37) and control (n=35) groups. HPLEI is comprised of health education sessions focused on postmenopausal health management with lifestyle modifications provided only for the intervention group for 8 weeks and follow-up for 6 months. The control group was not given any planned education programme and was allowed to proceed with the usual lifestyle during this period. Knowledge, attitude, menopause-specific QOL (MENQOL), and overall QOL were evaluated in both groups with self-administered questionnaires at the baseline, after 8 weeks of education sessions and at the end of 6 months of follow-up. The mean (SD) ages of the intervention and control groups were 54.6 (4.5) and 56.5 (3.4) (p=0.06) years, respectively. All evaluated variable scores were not different between the intervention and control groups (p>0.05) at the baseline. In the intervention group, knowledge (mean±SD; 21.70±1.05) and attitude (mean±SD; 44.02±5.33) scores increased at the end (p<0.001). In the control group, a marginal increase in all dimensions of knowledge scores (mean±SD; 9.71±2.21) and unchanged attitude scores (mean±SD; 23.91±7.56) were seen. All MENQOL scores decreased during the follow-up in the intervention group (mean±SD; 138.51±18.47) (p<0.001) except the sexual domain (p=0.32). MENQOL scores were increased in the control group (mean±SD; 92.05±28.87) (p<0.001) with time. Overall QOL scores increased (mean±SD; 74.85±9.71) (p<0.001) in the intervention group during the study period and in the control group overall QOL (mean±SD; 51.03±13.61) showed a reduction (p<0.001) at the end. Health education focused on health-promoting lifestyle modifications was effective in improving knowledge, attitude, MENQOL, and overall QOL of PMW.

BackgroundMenopause Rating Scale (MRS) evaluates eleven menopausal symptoms and health related quality of life (HRQOL) of postmenopausal women under three subscales. In this study we attempted cross cultural adaptation and evaluation of psychometric properties of a Sinhala translation of MRS.MethodsSinhala version of MRS was adapted following standard methodology; forward and backward translations, review by an expert group, focus group discussion (FGD) and pre-testing. It was self-administered among randomly selected healthy, Sinhalese, community-dwelling 166 postmenopausal women (aged; median = 56.5, IQR, 53.0–59.0 years) along with the Short Form 36 (SF-36) survey questionnaire. MRS was re-administered among a subsample (n = 80) after two weeks of first administration. Psychometric properties; reliability and validity were evaluated.ResultsIn Sinhala version of MRS, both internal consistency (Cronbach’s alpha coefficient = 0.79) and test retest reliability (intra class correlation / ICC = 0.86, 95%CI = 0.82–0.91, p < 0.001 and Pearson correlation / r = 0.93) were high. Factor analysis (FA) with Principal Component Analysis (PCA) extracted three factors explaining 59.82% cumulative variance with few exceptions from the original version. In the item-subscale correlation analysis items showed stronger correlations within their own subscale score (r range between 0.56–0.84) than with other subscales scores and subscales' scores showed strong correlations with the overall MRS score (r range between 0.70–0.86) indicating strong convergent validity. Mean (SD) symptom severities of each item were significantly different between symptomatic and asymptomatic women (p < 0.05) emphasizing good discriminant validity. The overall MRS and SF-36 scores correlated significantly (Pearson correlation: − 0.52, p < 0.01 and Kendall’s tau-b: − 0.39, p < 0.01) ensuring strong criterion validity.ConclusionsThe Sinhala version of MRS we adapted is an informative tool with high reliability and validity and this tool can be used to evaluate the menopausal symptoms and HRQOL in postmenopausal women conversant in Sinhala.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0977-9) contains supplementary material, which is available to authorized users.

The knowledge and perception of falls facilitate a better pathway to improve the health status among the elderly. Knowledge and perception of falls among community dwelling elderly were assessed in 300 participants (175 females) aged 65 years and above using an interviewer-administered questionnaire. Mean (SD) age of the participants was 73.0 (6.7) years. Majority (72%) knew some biological factors, and 60% knew environmental and behavioral factors which increase the risk of falls. Among 300 participants, 18% had poor, 61% had average, and 21% had good knowledge on falls. The mean (SD) knowledge was 48.14 (19.13). The most frequent (49%) information source was television. Significant associations were found between age (p = 0.002) and educational status (p < 0.001) with level of knowledge regarding falls. Individuals, 25.4% with good knowledge, 32.2% with average knowledge, and 51.9% with poor knowledge, had experienced falls during the previous 12 months (p = 0.007). Regarding perception of falls, 20.3% (n = 61) had negative perception and 79.7% (n = 239) had positive perception. Significant associations were found between gender (p = 0.01), age (p = 0.04), and level of education (p < 0.001) with perception of falls. This study revealed that the community dwelling elders had average knowledge and positive perception regarding falls and preventive measures, emphasizing the importance of falls prevention awareness programs.

Health promotion through lifestyle education is an important measure to enhance health status of postmenopausal women (PMW). This study evaluated the effectiveness of health-promoting lifestyle education intervention (HPLEI) on adhering to health-promoting behaviors (HPB) and enhancing the health status in a group of Sri Lankan PMW. A quasi-experimental study was conducted with randomly selected, sociodemographic status matched, 72 PMW from two geographically separated areas in Galle District, Sri Lanka, allocated as experimental (n = 37, 54.6 ± 4.5 years) and control (n = 35, 56.5 ± 3.4 years) groups. Education intervention focused on postmenopausal health management including lifestyle modifications was performed only for the experimental group during 8 weeks, and a health education package was provided. The control group was not given any planned education programme. Both groups were followed up for a 6-month period. HPB and menopausal symptoms severity were evaluated by validated Health Promoting Lifestyle Profile-II and Menopause Rating Scale, respectively. Anthropometric adiposity indices (AAIs) including weight, body mass index (BMI), waist (WC) and hip (HC) circumferences, and waist to hip ratio (WHR); cardiovascular disease risk indicators (CVDRI) including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), total cholesterol and triglycerides, muscle strength; hand grip strength (HGS) and physical performance (PP); gait speed (GS) were measured. All parameters were evaluated before the intervention (baseline) and after follow-up of 6 months. All evaluated parameters were not different between experimental and control groups (p>0.05) at the baseline. In the follow-up evaluation, HPB (p<0.001), menopausal symptom scores (p<0.001), AAI (p<0.001), CVDRI (SBP, DBP, and FBS) (p<0.05) and HGS and GS (p<0.001) were significantly improved in the experimental group but not in the control group. Health education intervention focused on health-promoting lifestyle modifications is effective in improving the adherence to HPB and enhances the health status in PMW. This provides positive impact in lifestyle medicine.