• Nusrat Nisar
  • Nisar Ahmed Sohoo
  • Raheel Sikandar


Background: Age at menopause and symptoms vary among populations and societies. Scarcedata is available about menopausal age, symptoms and socio-demographic and reproductivefactors from rural women of Sindh, Pakistan. The present study was conducted to find out the selfreported age at natural menopause, prevalence of menopausal symptoms, and to identify sociodemographic and reproductive factors that may influence the onset of menopause. Methods: Asurvey was carried out on women aged 40–70. A multistage random sampling technique was usedto retrieve 1,355 women with natural menopause from 10 union councils of district Matiari. Thesewomen were further categorised into 3 groups, I, II, and III having menopause for 1–5, 6–10, >10years respectively. Pearson’s chi-square test was used to analyse the percentage of symptomsdistribution. ANOVA was used to analyse the relationship between demographic, reproductivefactors and the age at natural menopause. Results: Age at menopause in our subjects was 46.2±6.4years. The prevalence of menopausal symptoms ranges from 26 % to 83%. Frequency of somatic,psychological and urogenital symptoms was high in group II. No significant association was foundbetween parity, socioeconomic status and age at natural menopause. Conclusion: The results haveshown the early age at menopause. The prevalence of menopausal symptoms is high. Resultsregarding correlation of age at menopause with socio-demographic and reproductivecharacteristics were different from literature.Keywords: Menopause, Postmenopausal Syndrome, Age, Sindh, Reproductive, Rural, Women


Dennerstein L, Dudly EC, Hopper JL, Guthrie, Burger HG. A

prospective population-based study of menopausal symptoms.

Obstet Gynecol 2000;96:351–8.

Deeks AA, McCabe MP. Well being and menopause: an

investigation of purpose in life, self acceptance and social role in

pre-menopausal, peri menopausal and postmenopausal women.

Qual Life Res 2004;13:389–98.

Gold EB, Bromberger J, Crawford S, Samuels S, Greendale GA,

Harlow SD, Skurnick J. Factors associated with age at natural

menopause in multiethnic sample of midlife women. Am J

Epidemol 2001;153:865–74.

Randolph JF Jr, Sowers M, Gold EB, Mohr BA, Luborshy J,

Santoro N. Reproductive hormones in early menopausal

transition: relationship to ethinicity, body size and menopausal

status. J clin Endocrinol Metab 2003;88:1516–22.

Yahya S, Rehman N. Age, Pattern and symptoms of menopause

among rural women of Lahore. J Ayub Med Coll Abbottabad


Thomas F, Renaua F, Benefice E, Thierry de Meeus T de,

Guegan JF. International variability of ages at menarche and

menopause: pattern and main determinants. Hum Biol


Kritz-Silverstein D, Barrett-Connor E. Early menopause, number

of reproductive years and bone mineral density in the

postmenopausal women. Am J Public Health 1993;83:983–8.

Kelsey JL, Gammon MD, John EM. Reproductive factors and

breast cancer. Epidemiol Rev 1993;15:36–47.

Morabi A, Costanza MC. World Health Organization

Collaborative Study of Neoplasia and Steroid Contraceptives,

International variability in ages at menarche, First live birth and

menopause. Am J Epidemiol 1998;148:1195–1205.

Arroyo A, Yeh J. Understanding the menopausal transition, and

managing its clinical challenges. Sexuality Reproduction and

Menopause 2005;3:12–7.

Sharma S, Tandon VR, Mahajan A. Menopausal symptoms in

Urban women. J K Sci 2007;9:13–17.

Wasti S, Robinson SC, Akhtar Y, Khan S, Badaruddin N.

Characteristics of menopause in three socioeconomic urban

groups in Karachi, Pakistan. Maturitas 1993;16:61–9.

Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian N,

Woods N. Executive summary: Stages of Reproductive Aging

Workshop (STAW). Climacteric 2001;4:267–72.

Heinemenn LA, Pottoff P, Schneider HP. International version of

the menopausal rating scale (MRS). Health Qual Life Outcomes


Aso T. Demography of the menopause and pattern of climacteric

symptoms in the East Asian region. First consensus meeting on

manopause in the East Asian region. [on line] 2003 [cited Oct

Available from: URL:

Qazi AR. Age, Pattern of menopause, climacteric symptoms and

associated problem among urban population of Hyderabad

Pakistan. JCPSP 2006;16(11):700–3.

Bairy L, Adiga S, Bhat P, Bhat R. Prevalence of menopausal

symptoms and quality of life after menopause in women from

South India. ANZJOG 2009;49:106–9.

Foo-HoeL, Lay-Wai K, Seang-Mei S,Jeannette JML, Ken G.the

age of Menopause and the menopause transitionin a multiracial

population: A nation-wide Singapore study. Maturitas


Richardson SJ, Nelson JF. Follicular depletion during

menopausal transition. Ann NY Acad Sci 1990;592:13–20.

Gold EB, Block G, Crawford S, Lachance L, FitzGerald G,

Miracle H, et al. Life style and demographic factors in relation to

vasomotor symptoms: baseline results from the study of

women’s health across the nations. Am J Epidemol


Durgan SA, Powell LH, Kravitz HM, everson Rose SA,

Karavolos K, Lubosky J. Musculoskeletal pain and menopausal

status. Clin J Pain 2006;22:325–31.

Nisar N, Sohoo NA. Severity of menopausal symptoms and the

quality of life at different status of menopause: a community

based survey from rural Sindh Pakistan. Int J Collabor Res Inter

Med Public Health, 2010;2(5):118–30.

Oldenhav A, Jaszman LJ, Hespels AA. Impact of climacteric on

well-being: a survey based on 5213 women, 39 to 60 years old.

Am J Obstet Gynecol 1993;168:772–80.

Nisar N, Zehra N, Haider G, Munir AA, Naeem A. Knowledge,

attitude and experience of menopause. J Ayub Med Coll,

Abbottabad 2008;20(1):56–59.

Hardy R, Kuh D. Reproductive characteristics and age at

inception of perimenopause in a British National cohort. Am J

Epidemiol 1999;149:612–20.

Soberon J, Calderon JJ, Goldzieher JW. Relation of parity to age

at menopause. Am J Obstet Gynecol 1966;96:96–100.

Beard RJ, ed. ‘The Menopause’. Lancaster, UK: MTP Press Ltd,


Luoto R, Kaprio J, Uutela A. Age at natural menopause and

Sociodemographic status in Finland. Am J Epidemiol


Cramer DW, Xu H, Harlow BL. Does incessant ovulation

increase risk for early menopause? Am J Obstet Gynecol