Somatic, mood, and vasomotor symptoms at midlife in relation to family structure and household workloads in Sylhet, Bangladesh

Abstract

The purpose of this study was to test whether the frequencies of vasomotor, somatic, and emotional symptoms at midlife were associated with household composition or workloads. Patrilocal family arrangements are common in Bangladesh and, since mothers-in-law hold a position of power vis-à-vis their daughters-in-law, we hypothesized that living with a mother-in-law would increase the likelihood of symptoms at midlife, while living with a daughter-in-law would decrease likelihood of symptoms. We also hypothesised that women with high levels of household workloads would be more likely to report symptoms associated with midlife. Women aged 35-59 living in Sylhet, Bangladesh, (n=157) participated in interviews and anthro po metric measures. Symptom frequencies during the past two weeks were collected. Household workloads were computed as minutes spent in housework, caring for dependents, and cooking. Daily values were multiplied by times per week the activity was carried out. Logistic regression was used to evaluate the association between family composition, workloads, and symptoms. Dizzy spells, nervous tension, lack of energy, aches/stiffness in joints, and trouble sleeping were most frequent. Hot flashes were reported by 46% of participants. Women spent more hours caring for dependents than cooking or doing housework. The likelihood of hot flashes increased with time spent in housework and cooking, with daughters in the household, and with chewing betel nut. Daughters-in-law in the household decreased the likelihood of hot flashes. The likelihood of nervous tension increased with peri-menopausal status, stress, and sons in the household, and decreased with more hours spent caring for dependents. The frequency of somatic symptoms and depressed mood exceeded the frequency of hot flashes. Household composition and workloads were more important than menopausal status in explaining variation in symptom frequencies. After controlling for other variables, the presence of mothers-in-law did not increase the likelihood of reporting symptoms at midlife; however, the presence of a daughter-in-law reduced the likelihood of hot flashes, perhaps because of fewer hours spent on housework and cooking.

Hot flash report and measurement among Bangladeshi migrants, their London neighbors, and their community of origin

“…For the entire sample, time spent on housework was a significant determinant of subjective hot flashes during the study period after controlling for group membership, menopausal status, parity, and BMI. This is consistent with findings limited to just Sylhet, Bangladesh, where both housework and cooking were significant determinants of hot flashes (Sharmeen et al, ).…”

“…Household workloads were computed as minutes per day spent in an activity multiplied by the number of times per week the activity was performed. Workloads were categorized as “housework” (mopping, dusting, cleaning the bathroom, and washing clothes by hand) and “cooking” (Sharmeen et al, ). Height, weight, waist, and hip circumferences were also measured.…”

“…Active women may experience fewer hot flashes than inactive women (Guthrie et al, ; Ivarsson, Spetz, & Hammar, ); however, exercise has also been associated with increased hot flash frequencies (Aiello et al, ; Elavsky and McAuley, ; Freedman and Krell, ; Whitcomb, Whiteman, Langenberg, Flaws, & Romani, ). In a study of symptoms among women in Sylhet, Bangladesh, the likelihood of reporting hot flashes increased with time spent doing housework and cooking (Sharmeen et al, ). Among Muslims in Sylhet, the timing of hot flashes appeared to be influenced by the physical activity associated with Islamic prayer, as well as culture‐specific clothing (Sievert et al, ).…”

“…High adiposity may also play an endocrine role in hot flashes through the aromatization of androgens to estrogens (Bulun, Zeitoun, Sasano, & Simpson, ). Differences in hot flash frequencies may also reflect variation in household and sociocultural environments (Gupta, Sturdee, & Hunter, ; Lock, ; Melby et al, ; Sharmeen et al, ).…”

Hot flushes and reproductive hormone levels during the menopausal transition

“…Participants (n=108) who volunteered to give blood were drawn from a larger sample of women (n=485) recruited into a study of the menopausal transition in Bangladesh and London [23,31,32]. These included: Bangladeshi women living in Sylhet, northeast Bangladesh (sedentees), Bangladeshi women living in London (mostly in Camden and East London) who migrated to London as adults (adult migrants), and women of European origin living in London (Europeans).…”