Experiences and perceptions of menopause among women in Ibadan South East Local Government Area, Nigeria

Menopausal experiences and perceptions of menopausal women in Ibadan South East Local Government Area were determined. A three-stage sampling technique was used to select the LGA, wards, and participants for the study. Eight Focus Group Discussions (FGDs) were conducted and a validated questionnaire was used to interview 240 participants aged between 46 to 69 years. Five questions were used to assess participants' knowledge with each question attracting 1 point thus culminating to a maximum of 5 points. Data from the FGD were recorded on audio-tapes, transcribed and subjected to content analysis. Descriptive and Chi-square test statistics were used to analyze the quantitative data. The mean age of participants was 56.9 ± 6.2 years. The mean age at menopause was 46.1 ± 2.5 years. Eighty-five percent of participants had ever heard about menopause and the participants' major source of information included close relatives (75.5%). The mean knowledge score for menopause using a 5-point scale was 2.8 ±1.0. Only 28.0% of the participants could state at least one symptom of menopause and 4.1% could list the risks associated with it. Fifty-four percent who scored above the mean knowledge score had positive attitude towards menopause regarding it as a natural occurrence. Seventy percent had the belief that sexual intercourse causes sickness for menopausal women. The belief of 60.8% of the participants was that women should not tell anyone about their menopausal experiences. Eighty-three percent had experienced at least one out of the 19 common symptoms of menopause. Discomforting experiences attributed to menopause included dryness of the vagina (81.3%), pain during intercourse (76.7%) and joint pains (74.2%). Only 32.9% took action to alleviate the discomforts. Actions taken included self-medication (47.4%), adoption of sexual abstinence (13.0%) among others. Illnesses perceived to be associated with menopause included: fibroid (34.4%), weakness of the body (30.0%) and protruding stomach (18.0%). FGD revealed that many of the participants were of the opinion that sex should be avoided by menopausal women in order to prevent adverse effects associated with menopause. There are gaps in knowledge, wrong perceptions and use of inappropriate palliative measures regarding menopause among the participants. Public enlightenment and community-based patient education interventions are needed to address these challenges

Sex Hormones and Their Relationship with Leptin and Cardiovascular Risk Factors in Pre and Post- Menopausal Nigerian Women with Metabolic Syndrome.

Metabolic Syndrome (MS), which affects 33.1% of Nigerians, predisposing them to cardiovascular disease (CVD) risk, has been associated with the female gender. The cardioprotective effect of oestradiol against CVD is now controversial and was investigated in premenopausal with MS (PRMMS) and postmenopausal women with MS (POMMS). A total of 191 women (44 PRMMS, 126 POMMS and 21 premenopausal women without MS (PRM) (controls) with mean (s.d) age of 40.0 (6.9), 57.0 (8.8), 29.0 (6.8) years were participants of this study. Demography, blood pressure (BP), anthropometry, hormones, fasting plasma glucose (FPG) and lipids were obtained by standard methods. Data were significant at (P<.05). Age, parity, all anthropometric measures, FPG, leptin, ET ratio and FSH were significantly higher while HDLC, testosterone and prolactin were significantly lower in PRMMS compared with controls (P<.03). In comparison of POMMS with PRMMS, age, parity, WHR, systolic BP, TG, FSH and LH were significantly higher while body weight, HC, and leptin were lower in POMMS compared with PRMMS (P<.05). DBP positively predicted oestradiol in PRM only (P=.044) while oestradiol positively predicted testosterone in PRMMS only (P<.001). In POMMS only, DBP positively predicted testosterone; testosterone, ET ratio and FSH positively predicted oestradiol while LDLC and oestradiol positively predicted the ET ratio (P<.03). Metabolic syndrome may predispose both pre and postmenopausal women to the risk cardiovascular disease and type 2 diabetes mellitus. Oestradiol may protect against cardiovascular diseases in women without metabolic syndrome only.

Prevalent Components of Metabolic Syndrome and Their Correlates in Apparently Healthy Individuals in Sub-saharan Africa.

Aim: To assess the prevalent components of metabolic syndrome (MSC) and their related determinants of lipid metabolism in the Nigerian for early diagnosis, prevention and management of the metabolic syndrome (MS) and its associated diseases. Study Design: Cohort study. Place and Duration of Study: Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan between March and August 2010. Methodology: 534 apparently healthy Nigerian traders aged 18–105 years were participants of a cohort study. The IDF (2005) criteria was used for MS diagnosis. Anthropometric indices and blood pressure (BP) were obtained by standard methods. Fasting plasma glucose, total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDLC) were determined by enzymatic methods while low density lipoprotein cholesterol (LDLC) was calculated. Data analysed were statistically significant at P<0.05. Results: 60.1% of traders had 2 and 3MSC. 0.6%, 1.1% and 9.6% of traders had all 5MSC, ≥3MSC without elevated waist circumference (WC) and zero MSC respectively. Elevated WC, reduced HDLC and high BP were more frequent MSC representing 70.2%, 63.1% and 47.9% while FPG and TG were less frequent representing 11.2% and 2.2% of traders respectively. This pattern was similar in MS and non-MS groups. 25.3% of males and only 2.2% of females had no MSC. Reduced HDLC and elevated WC were the most frequent MSC in males and females respectively. All metabolic risk factors (MRF) except TC were significantly different in comparison between MS and non-MS groups as well as among traders with 0-5 MSC. WHR was the only parameter that correlated significantly with all MRF. Conclusion: Elevated waist circumference, reduced high density lipoprotein cholesterol, and high blood pressure may be prevalent metabolic syndrome components and important in managing metabolic syndrome in Nigeria. Regional specific cut-offs for these components for the African population is needed.