Menopause is a natural biological event characterized by the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. According to the World Health Organization (WHO), natural menopause is diagnosed after 12 consecutive months of amenorrhea in the absence of any pathological or physiological cause. With increasing life expectancy, women now spend nearly one-third of their lives in the postmenopausal period, making menopause an important public health concern, particularly among geriatric women.[1]

The decline in estrogen levels during menopause is associated with a wide spectrum of vasomotor, psychological, somatic, and urogenital symptoms that may adversely affect physical health, emotional well-being, sexual function, and overall quality of life. Common manifestations include hot flushes, night sweats, sleep disturbances, mood changes, anxiety, depression, joint and muscle pain, vaginal dryness, and urinary complaints. The prevalence and severity of these symptoms vary according to age, ethnicity, socioeconomic status, lifestyle, and cultural background.[2,3]

Large epidemiological studies have shown that vasomotor symptoms are among the most frequently reported menopausal complaints and may persist for several years after menopause. These symptoms are often associated with impaired sleep, reduced work productivity, and decreased quality of life, emphasizing the need for early identification and appropriate management.[4]

Assessment of menopausal symptoms has been standardized using validated instruments such as the Menopause Rating Scale (MRS), which evaluates somatic, psychological, and urogenital symptoms and allows objective comparison across different populations. The MRS has been widely adopted in clinical practice and research because of its reliability and validity.[5,6]

The Stages of Reproductive Aging Workshop (STRAW) has further provided standardized criteria for defining reproductive aging and menopausal transition, facilitating uniformity in clinical and epidemiological studies.[7] Despite increasing awareness, many elderly women continue to perceive menopausal symptoms as a normal part of aging and therefore do not seek medical attention. Understanding the prevalence and pattern of postmenopausal symptoms among geriatric females attending tertiary care hospitals is essential for planning appropriate counseling, screening, and management strategies.

Therefore, the present study was undertaken to determine the prevalence and pattern of postmenopausal symptoms among geriatric females attending a tertiary care hospital.

Study Design This was a hospital-based cross-sectional observational study conducted to determine the prevalence and pattern of postmenopausal symptoms among geriatric females attending a tertiary care hospital. Study Setting The study was carried out in the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital. Study Duration The study was conducted over a period of 12 months after obtaining approval from the Institutional Ethics Committee. Study Population The study included postmenopausal geriatric women attending the outpatient and inpatient departments of the hospital during the study period. Sample Size A total of 220 postmenopausal women were enrolled in the study. The sample size was calculated using the formula for estimating a single population proportion: [n=\frac{Z^2pq}{d^2}] Assuming an expected prevalence of 50%, 95% confidence level, and 7% absolute precision, the calculated sample size was approximately 196. After accounting for possible non-response, the final sample size was increased to 220 participants. Inclusion Criteria • Women aged 60 years and above. • Natural menopause (amenorrhea for at least 12 consecutive months). • Willingness to participate and provide written informed consent. Exclusion Criteria • Surgical menopause (bilateral oophorectomy or hysterectomy with ovarian removal). • Women receiving hormone replacement therapy. • Known psychiatric illness affecting interview responses. • Severe systemic illness or cognitive impairment preventing participation. • Women unwilling to provide informed consent. Data Collection Eligible participants were recruited consecutively after obtaining informed written consent. Sociodemographic characteristics including age, education, occupation, socioeconomic status, parity, body mass index, marital status, age at menopause, duration since menopause, lifestyle factors, and associated comorbidities were recorded using a structured questionnaire. Assessment of Postmenopausal Symptoms Postmenopausal symptoms were assessed using the Menopause Rating Scale (MRS), which evaluates symptoms under three domains: • Somatic symptoms • Psychological symptoms • Urogenital symptoms Each symptom was graded on a scale from 0 (no symptoms) to 4 (very severe symptoms). Total and domain-specific scores were calculated to determine the severity and pattern of menopausal symptoms. Outcome Measures • Prevalence of postmenopausal symptoms. • Pattern and severity of somatic, psychological, and urogenital symptoms. • Association of menopausal symptoms with age, duration since menopause, parity, BMI, and associated comorbidities. Statistical Analysis Data were entered into Microsoft Excel and analyzed using IBM SPSS Statistics version 25.0. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequency and percentage. Associations between categorical variables were analyzed using the Chi-square test or Fisher's exact test where appropriate. Continuous variables were compared using the Student's t-test or one-way ANOVA. A p-value <0.05 was considered statistically significant.

A total of 220 postmenopausal geriatric women were included in the study. The mean age of the participants was 66.8 ± 5.4 years (range: 60–82 years). The majority of women belonged to the 60–64 years age group (40.9%), were multiparous (85.5%), and had attained menopause between 45–50 years of age. Overall, 192 (87.3%) participants reported at least one postmenopausal symptom on the Menopause Rating Scale (MRS).

Table 1. Baseline demographic and clinical characteristics of the study participants (n = 220)

Mean age: 66.8 ± 5.4 years
Mean age at menopause: 48.3 ± 3.7 years

Among the 220 postmenopausal women, the majority (40.9%) were aged 60–64 years, followed by 30.9% aged 65–69 years. Most participants had primary education (37.3%) and were multiparous (85.5%). About 40.0% had completed more than 15 years since menopause. The mean age was 66.8 ± 5.4 years, while the mean age at menopause was 48.3 ± 3.7 years.

Table 2. Prevalence and pattern of postmenopausal symptoms according to Menopause Rating Scale (n = 220)

Overall prevalence of at least one menopausal symptom: 192 (87.3%)

Overall, 87.3% of participants reported at least one postmenopausal symptom. Joint and muscular discomfort (68.2%) was the most common symptom, followed by sleep disturbances (60.0%) and hot flushes/sweating (53.6%). Among psychological symptoms, irritability (47.3%) was the most frequent, whereas vaginal dryness (37.3%) was the most common urogenital complaint.

Table 3. Association between age group and severity of menopausal symptoms (MRS total score)

*Chi-square test; p < 0.05 considered statistically significant.

There was a statistically significant association between increasing age and the severity of menopausal symptoms (p = 0.001). Women aged ≥75 years had the highest proportion of severe symptoms (54.5%), whereas women aged 60–64 years predominantly had mild to moderate symptoms, indicating that symptom severity increases with advancing age

The present hospital-based cross-sectional study evaluated the prevalence and pattern of postmenopausal symptoms among geriatric females attending a tertiary care hospital. The findings demonstrated that 87.3% of women experienced at least one menopausal symptom, indicating that postmenopausal health concerns remain highly prevalent even in the geriatric age group. Musculoskeletal complaints, sleep disturbances, and vasomotor symptoms were the most commonly reported manifestations, while increasing age was significantly associated with greater symptom severity. The high prevalence of menopausal symptoms observed in the present study is comparable with findings reported by Palacios et al. and Nisar and Sohoo, who demonstrated that a substantial proportion of postmenopausal women experience persistent physical and psychological symptoms that negatively influence quality of life, despite considerable geographic and ethnic variation in symptom distribution. These studies emphasized that many women continue to experience symptoms long after the menopausal transition, particularly in resource-limited settings where healthcare-seeking behavior is poor.[8,9] Joint and muscular discomfort emerged as the most common symptom in our study, followed by sleep disturbances and hot flushes. Similar observations were reported by Kaulagekar and Sharma et al., who found musculoskeletal pain and vasomotor symptoms to be the predominant complaints among Indian postmenopausal women. These symptoms are largely attributed to estrogen deficiency, age-related degenerative changes, and associated chronic medical conditions.[10,11] Among urogenital complaints, vaginal dryness and bladder symptoms were relatively common, consistent with the findings of Bairy et al., who reported that urogenital symptoms significantly affect daily activities, sexual health, and overall quality of life in postmenopausal women.[12] The present study also demonstrated a significant increase in symptom severity with advancing age. Similar trends were observed by Mishra and Kuh, who reported that prolonged duration after menopause contributes to worsening somatic and psychological symptoms because of progressive hormonal deficiency and aging-related physiological changes.[13] Current recommendations from The North American Menopause Society emphasize early identification of menopausal symptoms, individualized counseling, lifestyle modification, and evidence-based non-hormonal or hormonal treatment when appropriate to improve quality of life and healthy aging. Regular screening for postmenopausal symptoms in geriatric women attending tertiary care hospitals may facilitate timely intervention and reduce long-term morbidity.[14]

Postmenopausal symptoms were highly prevalent among geriatric women attending the tertiary care hospital, with musculoskeletal discomfort, sleep disturbances, and vasomotor symptoms being the most frequent complaints. The severity of symptoms increased significantly with advancing age. Routine screening using standardized tools such as the Menopause Rating Scale (MRS), along with appropriate counseling, lifestyle interventions, and timely management, can improve the quality of life and overall well-being of postmenopausal women. Increasing awareness among healthcare providers and elderly women is essential to ensure comprehensive menopausal healthcare.

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