Love And Respect Woman

Published Date: 02 Nov 2017

During the menstrual cycle the superficial layer of the endometrium undergoes changes. These cyclical changes in the endometrium can be divided into three phases; i. menstrual phase ii. proliferative phase iii. secretory phase.During the menstrual phase the superficial layer of the endometrium is discharged as the menstrual flow, (menstruation). In the proliferative phase the endometrial cells proliferate stimulated by

Griffin JE, Ojeda R(1996)

The reproductive age group of women is 15 – 44 years. In developing countries the burden of reproductive problems is particularly severe for women since they are almost always illiterate, disproportionately poor and politically powerless.

WHO (2009)

Menopause refers to the complete cessation of menses and is a single physiologic event said to occur when women have not had menstrual flow or spotting for one year and can be identified only in restrospect. Menopause occurs at the age of 45.

Lowdermilk and Perry (2004)

First stage of Premenopausal has sometimes been used to explain the point just before menopause; however, this is actually the stage in which a woman is fertile. It is Called reproductive stage where the body is producing eggs and the proper levels of hormones. In this stage a woman's reproductive system is very active and healthy manner.

Santra Yien, N A M S (2011)

When woman has officially reached menopause, most of the symptoms are over or are declining however a woman may still experience some changes and symptoms physically and mentally. The other health issues women may experience due to her age, a woman in postmenopausal is also a higher risk for osteoporosis in the case of decreased hormone levels also decreased estrogen levels means less absorption of calcium.

Santra Yien, N A M S (2011)

Skin, breast atrophy, breast tenderness increase or decrease swelling. Formication , Skin thinning and becoming drier. A psychological problem includes depression and anxiety, Fatigue, Irritability, Memory loss and problems with concentration, problem in sleeping. Interest in sexual includes dyspareunia, libido decreasing, orgasm problem, dryness in vaginal and atrophy of vaginal.

John Nose worthy MD(2008)

Psychological effects in which mood will be in range that tearfulness and irritability to depression. Depression may be increase in the years before the menopause, especially if experienced premenstrual syndrome in the previous years. Hormones can make life miserable. But estrogen deficiency alone may not be causing one to feel emotionally. It is not always clear that the depression is linked to low estrogen levels. The fact that many women face changes during their forty’s and fifty’s. They will face the emotional symptoms such as panic attacks, decrease in sexual desire and poor memory

Dr. JeniWorden (2010)

In social life of menopausal women, relationships are a major source of stress. As much as one love and need them, the parents, partner, children, boss, and even friends can be the cause of a lot of aggravation. The resultant stress can have a tremendous impact on health. Relationships changes evolve. Sometimes changes trying to make cause the people around one to feel uncomfortable. This is especially true when one is working on profound dietary and lifestyle changes.

Paula M. Lantz (2012)

Perimenopause is a natural stage in our life. Therefore it does not automatically require medical treatment. The management of menopausal symptoms are classified Hormonal, Medical, Diet, Surgical and Other alternative therapies.

Georg Moori (2003)

Non-pharmacological drugs includes homeopathy is safe and effective which relieves the menopausal symptoms which includes sepia (hot flushes), pulsatilla (mood changes, heat and chills), staphysagria (vaginal dryness, dysparunia), sanguinaria (body pain), lachesis mutus (hot flushes and mood swings), natrum muriaticum (vaginal dryness and urinary symptoms). And acupuncture, acupressure and exercises also comes under non-pharmacological therapy.

Dr. Shah (2008)

Menopause cannot be stopped; but steps can take to shrink the risk factors for any other problems related with menopause. It is suggested that postmenopausal women can consume 1,200 to 1,500 milligram of elemental calcium of 300 milligram, One cup of calcium - fortified orange essence of 300 milligram, One cup of yogurt about 400 milligram on average, One particle of cheddar cheese - around 200 milligram, Three particles of salmon with bone of 205 milligram.

Melisa Connrad Stopler, M D (2009)

Soy is a species of legume grown for its edible bean. soy protein contains the chemical constituents known as glucosides, the major constituents in soy are called isoflavones. Specifically, soy contains the isoflavones called "genistein, glycitein and daidzein". Soy isoflavones are phytoestrogens that influence the effects of estrogen in the body by affecting hormone receptors.

Livestrong (2011)

Soybean contains three types of isoflavone aglycone viz., daidzein, genistein and glycitein. Daidzein, genistein and their glycosides contribute to >90% of total isoflavone; whereas glycetein and its glycoside are present as minor component (<10%) only. Isoflavones are structurally similar to mammalian estradiol and can bind to both α and β isoforms of estrogen receptor (ER), thus called phytoestrogens.

Livestrong (2011)

Soy has been watchfully studied and found helpful for an extensive range of peri menopause/menopause symptoms and concerns. Improved insulin regulation, weight loss, bone health, improved nail, skin and hair health, heart health; and decreased frequency and severity of menopausal discomforts, particularly hot flushes and night sweats. In fact, soy is the best step when it arises to hot flushes in menopause. The principal reasons for hot flushes and night sweats can vary in menopause, and about 20 percent of the population report they do not bear the protein from soy well. .

Tiwari (2012)

Hormonal changes and disease due to hormonal imbalance results when sex hormone levels vary too widely and too quickly, external range that body can succeed. There are also changes in the cycling and the ratios between estrogen, progesterone, testosterone, Dehydroepiandrosterone, follicle-stimulating hormone, and luteinizing hormone. The increasing effects of poor diet, chronic stress, absence of sleep, little workout and ecological toxins offen undetermined the women and the sex hormone get pressed out.

Mercy Holmes (2012)

Side effects of drugs and therapies may cause increased risk in menopausal women. While HRT may help many women get through menopause, the treatment is not risk free. Known health risks includes, increased risk of endometrial cancer (if a women still has her uterus and is not taking progesterone along with estrogen), blood clots, stroke, gallbladder disease, blood pressure risks are larger, more invasive breast cancers (combination HRT only).

Mikio A. Nihira (2012_

It can be concluded that, though the available drugs and therapies relatively reduce the menopausal symptoms and risks in women on one side, the consequences are accompanied by risks with an outcome of new inconveniences and diseases.

NEED FOR THE STUDY

India has a large population - which has already crossed the 1 billion with 71 million people over 60 years of age and the number of menopausal women about 43 billion. Projected figures in 2026 have estimated the population in India will be 1.4 billion, people over 60 years 173 million and the menopausal population 103 million. Average age of menopause is 47.5 years in Indian women with an average life expectancy of 71 years. Therefore, Indian women are, likely to spend almost 23.5 years, that is one third of their total lives, in menopause.

Jyothi Unni (2000)

The elderly population is increasing every year in India and it is projected that it could increase to about 12 percentage of the total population by the year 2025. Roughly half of the population will be the women. According to Indian menopausal society there are about 65 Million Indian women over the age of 45 years, average age of menopause is around 48 years but it strikes Indian women as young as 30 – 35 years.

Sudeepa et. al. (2012)

Takeshi Aso (2010) conducted a research on the incidence of vasomotor menopausal symptoms, like hot flashes and night sweats in Japanese menopausal women is comparatively a lesser amount of women form western countries. High consumption of soy isoflavones the possible explanation of the variance. Epidemiological studies have reported that the content of soy wills biologically active metabolite of the isoflavone, daidzein, is lesser in the women who complain of severe vasomotor symptoms. To explore the involvement of soy in the manifestation of menopausal symptoms, particularly vasomotor symptoms and the possible therapeutic role of a supplement containing of soy on the menopausal symptoms of Japanese women, three randomized clinical trials were performed. The studies indicated that a daily intake of 10 milligram of natural soy improved menopausal symptoms. In the final study, menopausal women who were soy non-manufacturers who used up 10 milligram per day of natural soy for the period of 12 weeks had significantly reduced severity. Also frequency of hot flashes as well as a significant decrease in the harshness of neck or shoulder toughness. The soy ingesting group also showed trends of improvement in sweating and a significant improvement in the somatic category signs. Finally it is concluded that the supplement containing natural soy, a novel soybean derived functional module, has a likely role as an another remedy in the management of menopausal symptoms. An effect of natural soy on the menopausal symptom was rated by using Greene climacteric scale. The total isoflavonoids, genistein, daidzein and soy of all applicants were 38.9 +/- 29.2, 19.6 +/- 15.1, 10.0 +/- 8.9, and 9.3 +/- 14.1 μmol/24 hours (Arithmetic mean +/- Standard Deviation), respectively.

Menopausal is not a disease but the risk symptoms of menopause are more or less as same as any other diseases. As no women can neglect the middle age or old age when menopause affects, it is advisable to have awareness regarding the stages of menopause and management of reducing symptoms as India is predominantly suffering with under nutrition at all ages. It is found from various sources that the drugs and therapies reduce the menopausal symptoms, but the side ill effects of are also inevitable as well. So the researcher chose this experimental study and has proved the natural available source - Soy and its positive effects in reducing menopausal symptoms.

STATEMENT OF THE PROBLEM

Effectiveness of Soy on Menopausal Symptoms among Perimenopausal Women in Selected Area in Dharapuram.

OBJECTIVES

To assess the pre and post test level of menopausal symptoms among perimenopausal women in experimental and control group.

To compare the pre and post test level of menopausal symptoms among perimenopausal women in experimental group.

To compare the post test level of menopausal symptoms among perimenopausal women between experimental and control group

To find the association between the post test level of menopausal symptoms among perimenopausal women and their selected demographic variables.

OPERATIONAL DEFINITION

Effectiveness:

It refers to the production of desired or intended results.

Kindersly (2007)

In this study, effectiveness refers to determining the extent to which there is a significant difference level in the menopausal symptoms which is measured by statistical measurements.

Soy

Soy bean is a species of legume classified as oil seed widely grown for edible purpose. Major constituents of soy protein are isoflavones. Soy isoflavones are phytoestrogen that influence the effect of oestrogen in the body.

Audioenglishdictionary (2011)

In this study, roasted soy flour is mixed with jaggery syrup. Soy balls (25gms) prepared from the dough is given to each sample once in a day for a period of 30 days.

Menopause

Menopause will be in woman's life when her menstruation periods ultimately stop and the body goes through modifications that no longer permit her to get pregnant. It is a natural event that normally arises in women age 45-55.

David Zieve, MD, (2011)

Menopausal Symptoms

Approximately 20 percent of the women never experience symptoms, the symptoms include vasomotor instability, hot flushes, night sweats, sleep disturbance, emotional disturbance, mood swings, irritability, anxiety, depression, stress and fatigue.

Lowdermilk and Perry (2004)

Perimenopausal Women

Perimenopausal women is defined as women who have natural transition period earlier menopause that is frequently symptomatic of hormonal imbalance and fluxes, in as initial as middle thirty’s or as late as fifty’s. Most often it starts during middle to late 40 years of life span, principal to menopause at an average age of 51.

In this study, the perimenopausal women are the women between the age group of 45-55 years with moderate and severe menopausal symptoms.

Marcy Holmes (2012)

HYPOTHESES

H1 : The mean post test level of menopausal symptoms is lower than the mean pre test level of menopausal symptoms in experimental group.

H2 : The mean post test level of menopausal symptoms in experimental group is significantly lower than the mean post test level of menopausal symptoms in control group among perimenopausal women.

H3 : There will be a significant association between the Post test level of menopausal symptoms in Experimental with their selected Demographic variables.

ASSUMPTION

The women may not be aware of menopausal symptoms

The women may not be aware of various non-pharmacological measures to relieve the menopausal symptoms

The nurses have an important role in giving awareness thereby reducing the menopausal symptoms among women.

DELIMITATION

The data collection period was limited to five weeks.

Sample size was 60.

PROJECTED OUTCOME

This study shows the effectiveness of soy on menopausal symptoms, the findings will help the women to know the prevalence and effective of soy during the menopausal period thereby it contributes the wellbeing of the women during the menopausal period.

CONCEPTUAL FRAMEWORK

Conceptual framework helps to express abstract ideas in a more reality understandable or precise form of the original conceptualization. The conceptual framework for this study was a direction from Wiedenback’s Helping Act of Clinical Nursing Theory (1969)

According to Ernestine Wiedenbach’s nursing nurturing and caring for someone in a motherly fashion. Nursing is a helping service that is rendered with compassion, skill and understanding to those in need for care, counsel and confidence in the area of health. The practice of nursing comprises a wide variety of services each directed towards the attainment of one of its three components.

Step I: Identification of the needs for help

Step II: Ministering the help needed

Step III: Validation that the need for help was met

Central Purposes:

According to the theorist, the nurse’s central purpose defines the quality of health she desires the effect and specifies what she recognizes to be her special responsibility in caring for the patient.

In this study, the central purpose is to reduce the menopause symptoms among perimenopausal women within the age group of 45-55 years.

STEP I: IDENTIFICATION OF A NEED FOR HELP

According to the theorists within the identification believed every individual experiences needs as a normal part of living. A need is anything that the individual may require to maintain or sustain him/herself comfortable or capably in his/her situation. Identification involves individualization of the patient, her experience, and recognition of the patient’s perception.

In this study, by conducting pre-test with the help of structured interview schedule questionnaire, through which the need to the women was identified. Most of the perimenopausal women had the menopause symptoms in the range of moderate and severe symptoms.

STEP II: MINISTERING THE NEEDED HELP

Ministration is providing the needed help. It requires the identification of the need for help, the selection of a helping measure appropriate to that need and the acceptability of the help to the women.

Ministering of help needed has two components viz., a. prescription and b. realities.

Prescription:

Plan of care to achieve the purpose which includes development, validation and following by administration

Soy ball and Structural Interview Questionnaire for menopausal symptoms:

In this study, prescription and plan of care for achieving the purpose by giving soy ball of 25 gms per day to perimenopausal women for 30 days in experimental group.

Realities:

According to the theorist, the realities of the situation in which the nurse is to provide nursing care. Realities consist of all factors viz., physical, physiological, emotional and spiritual. Wiedenbach defines the five realities as the agent, the recipient, the goal, means and facilities

Agent:

According to the theorist, the agent is the practicing nurse or her delegate is characterized by personal attribute capacities, capabilities and most importantly commitment and competence in nursing.

In this study, the investigator is the agent.

Recipient:

According to the theorist, the recipient is the patient, is characterized by the personal attributes, problem, capabilities and most important the ability to cope with the concerns or problems being experienced.

In this study, the recipients are women within the age group of 45-55 years.

Goal:

According to the theorist, the goal is the end result to be attained by nursing action.

In this study it refers in reducing the menopausal symptoms among perimenopausal women.

Means:

According to the theorist, the means comprises the activities and devices through which the practitioner is enabled to attain her goal. The means include skills, techniques, procedures and devices that may be used to facilitate nursing practices.

In this study it refers the administration of Soy balls for 30 days each ball weighing/containing 25gms of soy.

Facilities:

Communities

STEP III: VALIDATION THAT NEED FOR HELP WAS MET.

According to the theorist, the third component is validation. After help has been ministered, the nurse validates that the actions were indeed helpful. Evidence must come from the patient that the purpose of the nursing actions has been fulfilled.

In this study, validating the need for help was met by conducting post test with the help of structured interview schedule for both control and experimental group. Greene Climacteric Scale to assess the menopausal symptoms.

CHAPTER – II

REVIEW OF LITERATURE

A literature review is a "critical analysis of a segment of a published body of knowledge through summary, classification, and comparison of prior research studies, reviews of literature, and theoretical articles"

The review of literature has been done as follows:

PART – I An overview of

Menopause

Soy on menopause

PART – II Review of Literature

Section - A. Studies related to Prevalence of Menopause symptoms

Section - B. Studies related to Soy on Menopause

Section -C. Studies related to nurses’ role in reducing menopausal symptoms among women

PART – I

1. OVERVIEW OF MENOPAUSE

Menopause is generally considered complete when a woman has not had a period for one year. Menopause, often referred to as "the change of life", usually occurs between the ages of 45 – 55 years with the average age being 52 years.

Littleton Y Lyma et al (2005)

Menopause is a normal part of ageing for a woman and literally means "last period". The term, however, is commonly used to describe the years when the ovaries gradually begin to produce fewer eggs and less of the female hormones oestrogen and progesterone. This reduction in hormone production causes the periods to become progressively more irregular until they stop altogether, and produces physical and psychological symptoms in many women.

Melinda Ratini, DO, MS on June 11, 2012

 

Perimenopause, or menopause transition, is the stage of a woman's reproductive life that begins several years before menopause, when the ovaries gradually begin to produce less estrogen. It usually starts in a woman's 40s, but can start in a woman's 30s or even earlier. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. At this stage, many women experience menopausal symptoms

Melinda Ratini, DO, MS on June 11, 2012

Final Menstrual Period (FMP)

Menopausal Transition

Post Menopause

Perimenopause

MENOPAUSE

12 Months

The whole process of transition into menopause can be divided into Perimenopause and Postmenopause. Few studies have defined perimenopause based on the regularity of the menstruation only. Women are considered as postmenopausal if they have more than 12 months amenorrhoea or sometimes just 6 months of amenorrhoea. All those women getting their menstruation regularly and not reported any of the listed menopausal symptoms are defined as ‘not in menopausal transition’; those who are found to experience at least one menopausal symptom but having regular menstruation are considered as ‘premenopausal’; women who feel some changes in their menstruation either in the frequency of menstrual periods or in the flow of bleeding are defined as ‘perimenopausal’ women; and all those who have not got their periods during last one year are coded as ‘postmenopausal’. Greene Climacteric Scale which segregates category-wise ill-wellbeing in women.

C.G. Hussain Khan and Jyoti S. Hallad

Menopause literally means the "end of monthly cycles" from the Greek word ‘pausis’ (cessation). Menopause is filled with generally filled with frustrations, irritability and, mood swings, sleeping difficulties and the loss of hormonal stability.  

Halen Varney et.al (2005)

The artificial menopause type of menopause happens abruptly and can be very disruptive for women in many different ways. Artificial menopause is most commonly associated with surgical removal of the reproductive tract and ovaries (hysterectomy) or disruption of the blood supply that carries oxygen to the ovaries.  Other factors that can interfere with blood supply to the ovarian tissue can include Chemotherapy, Radiation therapy and Pharmaceutical drug therapies. Artificial menopause always requires bioidentical hormone replacement therapy. Most women experiencing the effects of artificial menopause are desperate for help with the way they feel and respond to treatments which are aimed at alleviating their physical symptoms as well as improving their overall quality of life.

Dr. Justin Hoffman (2011)

Menopausal Symptoms

The main symptoms of menopause will be the extensive range of physical and psychological indications. The first one is change in the pattern of a woman’s mensuration periods.

Some woman’s may have an irregular or short term period timings.

Some other menopausal symptoms include:

sexual desire (Loss of libido)

Sex discomfort

Changes in heart rate

Pain in head

Depression, tiredness and anxiety

These will usually happen for last two to five years before vanishing, though in some cases they can take long time. Symptoms in Vaginal like dryness will be there one gets old.

Night sweats and Hot flushes

Hot flush will start in face, neck or chest, before spreading upwards and downwards. It is a sudden feeling of upper body heat,

When start to sweat we can find red, patchy in and around the skin on face, neck and chest. There will a change in heart rate. It may feel like palpitations. When it happens at night are called night sweats.

Sleep problems

Due to this so many women who affected with menopausal will have trouble in sleeping. It is the main causes of anxiety. Lack of sleep makes irritable and it leads to short term memory and loss of concentration.

Vaginal symptoms

During this deficiency few will experience dryness in vaginal, discomfort or itching. It leads the sex difficult or painful manner (dyspareunia). This is known as vaginal atrophy. It may also happen shortly after the menopause, more women having them later on. In few cases, vaginal atrophy can persist for more than ten years after your final mensuration period. If one has vaginal symptoms, it may worse when she didn’t take proper treatment

Urinary symptoms

Urinary tract infection (UTI), such as cystitis, also feels frequently need to pass urine.

Perimenopausal symptoms

The symptoms of perimenopause can occur ten to fifteen years before tangible menopause occurs. It is actually the time one has to notable symptoms of menopause. The age when the symptoms of perimenopause occur varies from women to women. 99% of the women notice perimenopausal signs in the age of 45 to 55 age group; also it varies and may never experience any signs of that. The mean age of the final menstrual period is fifty-one. Women have to remove ovaries usually experience immediate surgical menopause.

Reeder et al (1997)

The Symptoms of Perimenopause

Night sweats, Hot flashes and coldness

Irregular cycle periods

Sleeping difficulties

Mental disturbance

Palpitations

Skin Dryness

Sexual desire

Dryness in Virginal

Inability to hold urine

There are many other symptoms like thyroid disorders may also occur.

Reeder et al (1997)

The joys of post-menopause are many things to love being a post-menopause. There is a light at the end of the tunnel of heavy bleeding and hot flushes. No more worry about pregnancy. Most women find their voice and have no feeling of uneasiness about raising it. This does not happen overnight of course, and for many women it takes time to stop feeling bad about speaking up - but they realize they have nothing to lose and much to gain.

Dixie Mills (2011)

MANAGEMENT IN PERIMENOPAUSAL

It is classified as 1. Medical, 2. Hormonal, 3. Surgical 4. Diet 5. Other theropies.

Hormonal

Hormone replacement therapy will need when the decision is made to remove ovaries or if the ovaries are not functioning as a result to remove uterus. "Removing the ovaries is a hormonal catastrophe," warns Nosanchuk. Dr. If the women’s ovaries stop producing the needed amounts of estrogen at ages of 48 to 52, the most common menopausal age range that thay continue to produce significant amounts of testosterone.

Sascha Zuger 2012

Hormone Replacement Therapy

Hormone replacement therapy (HRT), also known as Hormone Therapy (HT) refers to the use of estrogen plus progestin for a woman who has an intact uterus or estrogen alone for a woman who has had a hysterectomy. Traditionally such therapy was provided as tablets but now is available in a range of formulations including skin patches, gels, skin sprays, subcutaneous implants and so forth. A popular alternative to conventional HRT is a synthetic hormone (derived from the Mexican yam) called tibolone. Hormone therapy can alleviate vaginal dryness; improve sleep quality and joint pain. It is also extremely effective for preventing bone loss and osteoporotic fracture.

Until recently study shows that the most widely used estrogen preparation worldwide in postmenopausal women were oral conjugated equine estrogens. Some Other oral oestrogen measures include synthetically derived piperazine estrone sulphate, estriol, micronised estradiol and estradiol valerate. Orally administered estrogen therapy also increases sex hormone binding globulin to a greater extent than non-orally administered estrogens. SHBG binds estrogen and testosterone in the blood and this may result in a clinically significant reduction in the bioavailability of these hormones. Oral administration of progesterone is convenient, however the oral micronized form is rapidly metabolized and inactivated in the liver and therefore high doses must be administered to achieve adequate circulating blood levels. Synthetic progestins are stronger to liver metabolism.

Medical

Low-dose antidepressants. Venlafaxine (Effexor), an antidepressant related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs), has been shown to decrease menopausal hot flashes. Other SSRIs, including fluoxetine (Prozac, Sarafem), paroxetine (Paxil, others), citalopram (Celexa) and sertraline (Zoloft). The 6 mg/24 hour dose of selegiline transdermal system (EMSAM) does not require dietary restrictions.

Gabapentin (Neurontin). This drug has been shown to significantly reduce hot flashes. Gabapentin may be taken with or without food. The recommended dose for postherpetic neuralgia is 1800 mg daily in 3 divided doses.

Clonidine (Catapres, others). Clonidine, a pill or patch, may significantly reduce the frequency of hot flashes.

Bisphosphonates. Doctors may recommend these nonhormonal medications, which include alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva), to prevent or treat osteoporosis.

Selective estrogen receptor modulators (SERMs). SERMs are a group of drugs that includes raloxifene (Evista). Raloxifene mimics estrogen's beneficial effects on bone density in postmenopausal women, without some of the risks associated with estrogen.

Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal tablet, ring or cream. This treatment releases just a small amount of estrogen.

(Medicine.net 2011)

Medications other than estrogen

The class of drugs known as selective serotonin reuptake inhibitors (SSRIs), typically used in the treatment of depression and anxiety, has been shown to be effective in reducing menopausal hot flashes. The SSRI that has been tested most extensively is venlafaxine (Effexor).

Progestin drugs have also been successfully used to treat hot flashes. Megestrol acetate (Megace) is sometimes prescribed over the short-term to help relieve hot flashes. Serious effects can occur if the medication is abruptly discontinued, and megestrol is not usually recommended as a first-line drug to treat hot flashes. An unpleasant side effect of Megestrol is that it may lead to weight gain. Another form of progesterone, medroxyprogesterone acetate (Depo-Provera) administered by injection, can also sometimes be useful in treating hot flashes, but may also lead to weight gain as well as bone loss.

Several medications may be used for preventing and treating osteoporosis.

The bisphosphonates, which include alendronate (Fosamax) and risedronate (Actonel).

Raloxifene (Evista), a selective estrogen receptor modulator (SERM).

Calcitonin (Miacalcin or Calcimar).

A prevention drug that may also be effective is PTH (parathyroid hormone), but this is not a usual first-line treatment.

Surgical

The second most frequent major surgical procedure among reproductive-aged women is the hysterectomy, which is an operation to remove the uterus. There is roomer like women mistakenly think that hysterectomy might help them escape the often distressing side effects of menopause deficiency. But it will not relieve from menopausal symptoms. That is a fact.

Risks associated with a hysterectomy is following:

Clots in blood vessels

Infection

Over bleeding

An adverse reaction when anesthesia is given

Problem or damage in Urinary track

Menopause in Pre stage

Blockage in Bowel

Cause to death (Rare)

Diets

Menopause can be prevented by diet. The following steps can be taken to help reduce the risk factors for other problems associated with menopause. It is suggested that postmenopausal women consume 1200 to 1500 milligram of elemental calcium.

At least consume 1,000-1,500 mg of calcium daily. The following foods which contains calcium are as follows:

One cup of milk (regular/ fat free/skimmed) - 300 milligram

One cup of calcium fortified orange juice - 300 milligram

One cup of yogurt (regular/fat free) - about 400 milligram on average

One ounce of cheddar cheese - about 200 milligram

Three ounces of salmon (including the bones) - 205 milligram

25 - 100grams of soy/day along with milk water or food according to mother wish.

Melissa Conrad Stoppler, M D (2009)

Other alternative therapy

Exercise:

Women in perimenopause complain most often about hot flashes. Those who do not sweat easily are impacted more extremely with hot flashes. Exercise is particularly helpful in prompting the body into becoming a more consistent cooling mechanism. Exercising vigorously enough to work up a sweat trains the body into cooling efficiently. Keeping blood sugars stable is critical for controlling hot flashes. Stay hydrated by drinking at least a quart of water daily. In addition, a glass of cool water at the onset of a hot flash may keep it at bay.

Debbie Melvin (2011)

Exercises used in the resistance exercise: (a) Standing chess press (b) Strengthening back muscles in sitting point (c) Standing support abduction of both shoulders (d) Standing strengthening flexion of both shoulders (e) Standing strengthening flexion of both forearms (f) Standing support extension of both forearms (g) Support extension of both knees in sitting point (h) Support flexion of both knees in sitting position (i) Support dorsiflexion of both ankles in sitting position.

Arzu DaÅŸkapan (2010)

Homeopathy

Homeopathic treatment is safe and effective, particularly when use it in conjunction with lifestyle and dietary changes for treating headaches, hot flashes, mood swings, and various other troubles. Constitutional homeopathic remedies with the effective management of professional and experienced practitioner are a great choice to relieve from menopause symptoms.

Dr. Shah (2008)

Acupuncture

Few areas of women's health stir up as much confusion and debate as HRT, which is normally started when the first signs of menopause perform. While they may alleviate hot flashes and stop osteoporosis, they will also upturn the risk of breast, ovarian and uterine cancer and have a number of significant side effects. But HRT is not the only way out. Menopause is a zone in which Oriental Medicine shines. Acupuncture and Chinese herbal medicine have the capacity to detect energetic variations that occur in the body and quickly release symptoms such as hot flashes, irritability, and foggy mind.

Diane Joswick, L.Ac., MSOM

Acupressure

Acupressure is a healing method that has been used for more than 5,000 years. Acupressure works on the same premise that acupuncture does - stimulating meridians and energy points - except that acupressure uses finger pressure rather than needles. Mood swings, insomnia, hot flashes and other common symptoms of menopause can be treated with acupressure. Acupressure has no dangers or side effects but it doesn’t necessarily work for everybody. Acupressure may be administered for the following menopausal symptoms.

Dr. Susan Lark (2010)

2. OVERVIEW OF SOY ON MENOPAUSE

Soy [Glycine max (L.)] is in use for more than 5000 years in China and South East Asia as food. Epidemiological studies show its importance in prevention of several diseases. Recently, an upsurge of consumer interest in the health benefits of soybean and soy products is not only due to its high protein (38%) and high oil (18%) content, but also due to the presence of physiologically beneficial phytochemicals. Many of the health benefits of soy are derived from its secondary metabolites, such as, isoflavones, phyto-sterols, lecithins, saponins etc. Dry soybean contain 36% protein, 19% oil, 35% carbohydrate (17% of which dietary fiber), 5% minerals and several other components including vitamins.

Dietary soy has gained much attention since reports of reduced menopausal discomfort and reduced morbidity incidence of several hormone dependent diseases. Epidemiological studies in Japanese women suggest that consumption of soy products has a protective effect against menopausal symptoms.

Several human studies have tested the hypothesis that soy products alleviate post menopausal symptoms. In these studies, perimenopausal women as well as postmenopausal women who suffered menopausal symptoms consumed soy proteins for 4 weeks or longer. These studies show that the soy do have the beneficial health effects on menopausal symptoms.

PART - II

SECTION A: STUDIES RELATED TO PREVALANCE OF MENOPAUSE SYMPTOMS

Taher YA, (2012) conducted a study on Menopausal age, related factors and climacteric symptoms in Libyan women. The objective of the Studies was fluctuating hormone levels are known to influence a woman's mood and well-being. The study aimed to evaluate the onset of natural menopause in Libyan women together with the prevalence of postmenopause-related symptoms experienced. A cross-sectional survey was conducted in Tripoli city. 91 women were recruited from urban and rural areas. Data were collected using a structured questionnaire and included a number of lifestyle variables. The mean age of participants was 53 years, and the median age at menopause for postmenopausal women was 47 years. Out of 20 possible symptoms, the mean number of symptoms was 8.36. The most frequent symptoms were hot flushes and aching in muscles and joints (74.4%). Increasing level of education was positively associated with more symptoms, and increased tea or coffee consumption resulted in fewer symptoms. Of the total subjects, 8.1% reported no symptoms. In the four domains, 87.2% reported physical symptoms, 83.7% reported psychosocial symptoms, 76.6% reported vasomotor symptoms and 48.8% reported sexual symptoms. The data showed that the most common disease associated with the frequency of menopausal symptoms was osteoarthritis, followed by hypertension, heart diseases and diabetes mellitus. It was concluded that the age of menopause in Libyan women, as in other developing countries, is less than the median age reported for Western women. The menopausal women experienced various symptoms and morbidities as part of a normal life stage, and their quality of life was negatively affected by these symptoms.

Pandey SN, et. al. (2010) conducted a study on Prevalence of premenstrual symptoms: Preliminary analysis and brief review of management strategies. The aim of the study is to determine the prevalence of premenstrual cyclic symptoms in peri-menopausal age. Women attending Bhavan's SPARC Maitreyi's Health Care Programme (HCP) for women around 40 years of age were included in the study. Last 200 women who attended from April 2002 to October 2004 are included for analysis. Out of these 107 qualified for final analysis as others were post hysterectomy or post menopausal. Thirty five symptoms listed under premenstrual tension syndrome were analysed. Forty one women (38.3%) had 3 or more symptoms whilst 15 (14.0%) had 5 or more cyclic symptoms. Five women (4.7%) reported that the symptoms were severe. Eleven women had sought treatment for premenstrual tension syndrome (PMTS). The commonest symptom was mastalgia or heaviness of breasts. Women reported anger attacks and reported depression. It was concluded that PMTS was common between 36 and 55 years. About half of them have experienced 3 more symptoms and 1 in 20 may require treatment.

KAKKAR V, et. Al. (2007) conducted a study on "Assessment of the variation in menopausal symptoms with age, education and working/non-working status in north-Indian sub population using menopause rating scale (MRS)" Maturitas. The MRS scale, a self administered standardized questionnaire was applied with additional patients related information for analysis. The results were evaluated for psychological, somatic and urogenital symptoms average age at which menopause set in the cohort was found to be 48.7±2.3yrs.The cohort was divided into peri (35-45) menopausal, early, menopause (46-51) and the postmenopausal (52-65). A significantly higher percentage of perimenopause women (36%) showed a psychological score³7 while a higher percentage of postmenopausal women showed somatic score and urogenital score ³7. Working women suffer more from psychological symptoms whereas non-working women showed a greater incidence of somatic symptoms. Educated women showed a lower incidence of psychological and somatic symptoms. Thus, the study concludes that age; level of education and working/non working status may also contribute to significant variation of menopausal symptoms

Bhanuprakash KV, et. al. (2007) conducted a study on Age-related changes in bone turnover markers and ovarian hormones in premenopausal and postmenopausal Indian women. This study characterizes age-related changes in bone turnover markers in relation to ovarian hormones. The data (N=236) were divided into 5-year age bands and three groups: premenopausal (Group I, N=139), perimenopausal (Group II, N=30), and postmenopausal (Group III, N=67). Age-related increases in mean parathyroid hormone (PTH), osteocalcin (OC), and collagen telopeptide (CTx) levels were observed. Women in Group II (N=37) with osteopenia had lower levels of E1G (P<0.001) with normal FSH levels as compared to 50 women in the same group with normal bone mineral density (BMD). Their mean OC levels were reduced (P<0.05) and CTx levels were significantly elevated (P<0.01). The mean E1G levels were significantly lower (P<0.001) and mean CTx levels were significantly higher (P<0.001) in 30 peri-menopausal women (Group II) compared to premenopausal women. In 28 postmenopausal women (group III) the mean BMD levels and E1G were significantly lower (P<0.001) with elevated FSH levels (P<0.001). Increased CTx levels (P<0.0001) reflected a higher rate of bone resorption. These observations suggest that peri-menopausal women with low E1G, elevated FSH should be screened for osteoporosis, and it may be valid to combine simultaneous measurements of bone turnover markers with ovarian hormones when screening women at risk for osteoporosis.

Peeyananjarassri K, et al (2006) conducted a study "to evaluate menopausal symptoms and quality of life in middle-aged women", a Hospital-based, cross-sectional study was conducted. A survey was conducted among 270 women aged 45-65 years who attended the gynecological and menopause clinic, Songklanagarind Hospital. MENQOL questionnaire was the instrument. The average age at menopause of the postmenopausal women was 48.7 years (range 40-57 years). The prevalence of the classical menopausal symptoms-hot flushes, night sweats, and vaginal dryness--in the women aged 45-65 years were 36.8%, 20.8 and 55.3%, respectively. The three most prevalent symptoms in perimenopause were aching in muscles and joints, experiencing poor memory, and change in sexual desire. Within the four domains (vasomotor, psychological, physical, and sexual symptoms), more suffering was reported in the perimenopausal and postmenopausal subjects than in the premenopausal subjects (p<0.001). Peri and postmenopausal women had a significant decrease in quality of life compared to premenopausal women.

SECTION - B. STUDIES RELATED TO SOY ON MENOPAUSAL SYMPTOMS

Yang TS, et. al (2012) Department of OBG, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan conducted a study on Effects of standardized phytoestrogen on Taiwanese menopausal women. The study was to investigate the effects of standardized soy extract on climacteric symptoms, lipid profiles, bone markers, and serum isoflavone concentration in healthy Taiwanese postmenopausal women. A multicenter, open-labeled, randomized, prospective, comparative study design was used. A total of 130 outpatients who had undergone natural menopause were randomly administered either 70 mg or 35 mg soy extract daily for 24 weeks. The evidence suggests that the soy extract treatment that was administered to both groups for 1 month could help reduce climacteric scores (reductions of 19.66% [p<0.01] and 18.85% [p<0.01] in the 35 mg and 70 mg groups compared with baseline, respectively), and the efficacy was more potent after 6 months of treatment. Soy isoflavone significantly reduced the total cholesterol (reductions of 4.50% [p<0.01] and 3.06% [p<0.05] in the 35 mg and 70 mg groups, respectively) and low density lipoprotein cholesterol levels (reductions of 4.67% [p<0.05] and 5.09% [p<0.05] in the 35 mg and 70 mg groups, respectively) in patients with total cholesterol > 200 mg/dL after 6 months of treatment. In patients with high bone turnover (urinary deoxypyridinoline/creatinine > 7.4 nM/mM), soy extract treatment reduced the deoxypyridinoline/creatinine level by 10.53% (p<0.05) and 11.58% (p<0.05) in the 35 mg and 70 mg groups, respectively. Serum levels of isoflavone increased in both groups after 6 months of treatment. It was concluded that Soy extract is highly efficacious at relieving menopausal symptoms and demonstrates a positive effect on the cardiovascular system and skeleton.

Chedraui P, et. al (2011) Instituto para La Salud de La Mujer, Guayaquil, Ecuador conducted a study on " The effect of soy-derived isoflavones over hot flushes, menopausal symptoms and mood in climacteric women with increased body mass index. Risk-benefit issues raised after the WHI have significantly increased the use of alternative treatments for the menopause. Despite this, data regarding the effect of soy isoflavones over mood and menopausal symptoms in high risk populations is still lacking. The objective of the study was to evaluate the effect of soy derived isoflavones over hot flushes, menopausal symptoms and mood in climacteric women with increased body mass index (BMI). Fifty symptomatic climacteric women aged 40 to 59 with increased BMI (≥ 25) were recruited to receive oral 100 mg/day of soy derived isoflavones (Climasoy) for 3 months. Hot flushes (frequency/intensity), menopausal symptoms (Menopause Rating Scale [MRS]) and mood (Hamilton Depressive Rating Scale [HDRS]) were evaluated at baseline and at 90 days. The results found, a total of 45 women completed the study. After 3 months of soy isoflavone supplementation hot flushes significantly decreased in percentage, number and severity (100% to 31.1%; 3.9 ± 2.3 to 0.4 ± 0.8 and 2.6 ± 0.9 to 0.4 ± 0.8, respectively, p < 0.001). MRS scores (total and for subscales) reflecting general menopausal symptoms also significantly decreased compared to baseline. Regarding mood, after three months total HDRS scores and the rate of women presenting depressed mood (scores ≥ 8) significantly decreased (16.3 ± 5.4 to 6.9 ± 5.2 and 93.3% to 28.9%, respectively, p < 0.05). In Conclusion, in this high risk climacteric population, soy derived isoflavone treatment improved mood as well as vasomotor and general menopausal symptoms. More research is required to determine if the positive effect over mood is a direct or an indirect one through hot flush alleviation.

Duru Shah, Sangeeta Agrawal (2006) A Double-blind, Randomized, Placebo-controlled Trial to Evaluate the Efficacy of a Phytoestrogen Formulation on Indian Women with Menopausal Symptoms". A prospective randomized double blind study was conducted to evaluate the effects of herbo mineral phytoestrogen formulation containing soya isoflavones in Indian women with signs and symptoms of menopause among 60 peri and post menopausal women in a public hospital. Women with symptoms related to menopause were randomized to either group A or group B (placebo) menopausal symptoms were graded along a scale of kupper man index at base line and changes were noted every 2 months and there after for a total of 6 months. The group that received herbo mineral phytoestrogen showed 40% of improvement in psychological symptoms compared to placebo group .Improvement was noted in vasomotor symptoms, symptoms relating to sexual activity and urinary symptoms in group A. Study concluded that herbo mineral phytoestrogen containing soya isoflavones is effective in management of symptoms in menopausal women.

Hakimi S et al (2010) conducted this cross-sectional study was to describe menopausal symptoms in Iranian women in Tabriz, north-west Islamic Republic of Iran. A total of 200 women aged 45–55 years completed a Farsi version of the Greene climacteric scale. The mean total Greene scores for 20 items (1 item was excluded) were 29.34 (SD 9.84) for perimenopausal and 28.14 (SD 10.15) for postmenopausal women. Perimenopausal and postmenopausal women did not differ significantly in any of the subscales or individual items, except on 2 items: "difficulty in sleeping" and "parts of the body feeling numb or tingling". Comparisons with studies in other countries show that women in Tabriz suffer more menopausal symptoms than European woman. The mean age of perimenopausal women was 47.3 (SD 3.4) years and of postmenopausal women was 52.5 (SD 4.2) years. Around one-third of the women (38% of the perimenopausal and 32% of the postmenopausal group) had only primary education.The scores of the 20 items of the Greene climacteric scale were used. There were statistically significant differences in the mean symptom scores between perimenopausal and postmenopausal women on only 2 items: "difficulty in sleeping" [1.10 (SD 1.23) versus 1.70 (SD 1.16) respectively] and "parts of the body feeling numb or tingling" [1.24 (SD 1.15) versus 0.84 (SD 1.05) respectively]. "Hot flashes"received the highest mean score in both the peri- and postmenopausal group [2.50 (SD 0.70) versus 2.42 (SD 0.78) respectively].

SECTION - C. STUDIES RELATED TO NURSES’ ROLE IN REDUCING MENOPAUSAL SYMPTOMS AMONG WOMEN

Vaghela Kishor and Bhalani Kailesh (2012), Government Medical College, Bhavnagar, conducted a study on " Level of Education and Awareness about menopause among women of 40 to 60 years in Bhavnagar & Surat cities of Gujarat" The objectives of the study was to study the level of awareness about menopause and its problems in women of 40 to 60 years with different levels of education. Pretested questionnaire were filled up for 500 Women of 40 to 60 years of age from cities of Surat and Bhavnagar. The results showed, 25.9% of illiterate women were aware about menopause by definition, while 89.3% of women having education above standard 12 were aware about the same. Only 44.4% of illiterate women were aware about the availability of treatment for the menopausal troubles, while 84.7% of women having education above standard were aware about the same. In conclusion as education level increased, awareness towards menopause and related problems also increased in the women of 40 to 60 years of age of Bhavnagar and Surat city. A structured questionnaire was used for data collection in this study. It had questions related to awareness of menopause, menopausal symptoms they experienced, remedies they were seeking for menopausal symptoms, awareness about hormone replacement therapy (HRT) and also had questions asking their opinion about strategies to improve the awareness of menopause. The education level improves the possibility of seeking treatment by women suffering from menopausal troubles. The difference observed in awareness about availability of treatment between illiterate women, women studied up to standard 12 and women studied above standard 12 is significant (P<0.001). Comparing women with education up to standard 12 and women with education above standard 12 for their perceptions about having prior knowledge about menopause, how awareness about menopause can be increased, their preference for treatment provider for menopausal troubles and their priority to health above other things. 89.2% of women perceived that they should have knowledge about menopause and related issues prior to arrival of menopause.More than 93% of women having education of up to and above standard 12 perceived the need while only 66.7% of illiterate women perceived the need. The difference observed between the groups was significant (P<0.001). Most illiterate women (59.3%) felt that awareness about menopause can be increased with the help of the doctor. Educated women opined that awareness can be increased by media and seminars. The difference in the opinion between different groups is significant (P<0.001). As education level increased, awareness towards menopause and related problems also increased in the women of 40 to 60 years of age of Bhavnagar and Surat city

Medrela-Kuder E. (2011) conducted a study on Level of knowledge on the hazards and ailments of menopause among women at pre-menopausal age" The aim of the project was to evaluate women's knowledge about symptoms, health hazards and preventive or mitigative measures against ailments of this life period. The study was conducted among 100 randomly chosen women, aged 42-49, experiencing the pre-menopausal time of life. The research tool was an anonymous questionnaire of own authorship. The results showed that it was menopausal symptoms the women were more familiar with rather than the health hazards resulting from hormonal deficiency. The surveyed indicated the following symptoms of this life period: mood fluctuations (82%), nervousness (74%), decreased elasticity of the skin (70%), hot flashes (69%), fatigue (66%), feeling unwell physically (65%), depressed mood (59%), tendency to cry (52%), sleep disturbances (50%).

CHAPTER – III

METHODOLOGY

In this chapter, the study includes research approach and design of the study, settings of the study, population, criteria for sample selection, sampling procedure and sample size, instrument and scoring procedures, developing and testing of the tool, method of data collection and plan for data analysis.

RESEARCH APPROACH

The Evaluative research approach was selected for the study

RESEARCH DESIGN

Quasi Experimental nonequivalent pretest posttest control group design was selected.

Quasi Experimental design which is represented as below

Group

Pre-Test

Intervention

Post-Test

Experimental Group

01

X

02

Control Group

01

-

02

The Symbols Used:

01 - Collection of demographic data. Pre-test to assess the level of menopausal symptoms among the perimenopausal women using the Greene Climacteric Scale in experimental and control group.

X - Intervention for the experimental group, the soy ball was given once in a day for 30 days.

02 - Posttest done with the same Greene Climacteric Scale to assess the menopausal symptoms among perimenopausal women in experimental and control group.

SETTINGS OF THE STUDY

The study was conducted in Nanchiyampalayam, Dharapuram. Nanchiyampalyam is an urban area which is 5 kms away from Dharapuram. The total population of Nanchiyampalayam is 6770. The total female (1879), male is (2061), the menopausal women with age group was 45 – 55 years (295). It consist of Tirupur Streets, RC street and Nadar Street. Control group mothers were taken from Nallamanpettai and Bagiravan street, Which is an urban area situated 2kms away from Dharapuram. Total population in both street are 3670 people the total female 1520, Menopausal women with age group 45-55 yrs (205). The people get medical aid from the Government hospital at Dharapuram. One primary school and one higher secondary school are there for educational purpose. Water and electricity facilities are available. The common occupation in the village is agriculture. Most Of the people are coolie workers going for construction work and others include tailors and shop workers.

POPULATION

In this study, the population selected was perimenopausal women. SAMPLE

Samples were perimenopausal mothers in Nanchiyampalayam.

CRITERIA FOR SAMPLE SELECTION

INCLUSION CRITERIA

1. The women with in the age group of 45 – 55 years

2. The women who are having moderate and severe menopausal symptoms

3. The women who are available during the data collection

EXCLUSION CRITERIA

1. The women who are ill.

2. The women who are having diabetic, hypertension and cardiac diseases.

3. The women who have undergone hysterectomy

4. The women who are not willing to participate in this study.

SAMPLE SIZE

The samples for the study consist of 60 women between the age group of 45 – 55 years. (30 women in experimental group) and (30 women in control group)

SAMPLING TECHNIQUE

Non probability Purposive sampling method was used in this study.

INSTRUMENT AND SCORING PROCEDURE

The tool consists of 2 parts.

PART – I : Demographic variables such as Age, Marital Status, Religion, Occupational Status, Education, Monthly Income, Diet ,Type of Family ,Number of Pregnancy

PART – II : Greene Climacteric Scale. It consists of 21 symptoms in the four point rating scale.

SCORING PROCEDURE AND INTERPRETATION:

The Greene Climacteric Scale (Melissa Joy Thiel, M.D., P.C.) It consists of 21 symptoms in four point rating scale as " Not at all" (1), "A Little" (2), "Quite a bit" (3), "Extremely" (4) and the total score in the Greene Climacteric Scale is 84. For No symptoms the scoring ranges between 1-21; for Mild symptoms the scoring ranges between 22-42; for Moderate and Severe symptoms the scoring ranges between 43-63 and 64-84 respectively.

The Greene Climacteric Scale (Melissa Joy Thiel, M.D., P.C). It consists of – a standardized tool was used to assess the menopausal symptoms.

LEVEL OF SYMPTOMS

SCORE

Percentage

No Symptoms

1-21

25%

Mild

22-42

26 – 50%

Moderate

43-63

51 – 75%

Severe

64-84

76 – 100%

VALIDITY

Validity of the tool was obtained from one OBG medical expert and 4 nursing experts. Hence the tool is considered as valid.

PILOT STUDY

The Pilot study was conducted on 6 samples in R.C Street at Dharapuram. The written consent was taken from the counsellor. The oral consent was obtained from each sample. The purpose of the study was explained to the samples prior to the study. Samples were selected by using non probability purposive sampling technique. On the first day 6 samples were selected it includes 3 experimental and 3 control group and demographic variables were collected. The pretest was assessed by using the Greene Climacteric Scale by interview method for 15 minutes and on the same day of the pretest soy ball (25gms) was given to each experimental perimenopausal women for 7 days. The post test was done on the 7th day by using the Greene Climacteric Scale.

The findings of the pilot study showed that the mean pretest score was (53.3±0.59) and the mean post test score was (51.6±0.59) in the experimental group. The mean pretest score was (49.6±0.59) and the mean post test score was (51.3±0.59) in the control group. The pilot study revealed that the study is feasible and practicable to conduct main study.

PROCEDURE FOR DATA COLLECTION

The study was conducted in Nanchiyampalayam ,Dharapuram . The data were collected for a period of 5 weeks. Before conducting the study, written consent was obtained from the Municipal commissioner, Dharapuram. The oral consent was obtained from each participant. The non-probability purposive sampling technique was used to select 60 samples out of which 30 were in experimental group from Nanchiyampalayam and 30 in control group from Nallammanpettai and Bairavan Koil Street. The investigator went door to door to select samples for experimental and control group. In first week, pretest was conducted by using Greene Climacteric Scale by interview method for 15 minutes for experimental and control group. On first and second day, pretest was done to experimental group for 30 samples. And third and fourth day, pretest was done for control group for 30 samples. The time spent for each sample is fifteen minutes for both experimental and control group. From the fifth day, the samples of experimental perimenopausal women were given the soy balls once a day for 30 days. After the 30 days of intervention, for experimental group, post test was conducted by using the same scale. For control group, no intervention was given and post test was conducted after 30 days by using the same scale. The data collected were tabulated and analyzed using descriptive and inferential statistics.

PLAN FOR DATA ANALYSIS

Sl.No

Data analysis

Method

Purpose

1

Descriptive analysis

Frequency

Percentage

Mean

Standard Deviation

To Assess the demographic variables.

To assess the pre and posttest level of menopausal symptoms among perimenopausal women in experimental and control group

2

Inferential Statistics

Paired ‘t’ test

To compare the pre and posttest level of menopausal symptoms in experimental

Independent ‘t’ test

To compare the posttest level of menopausal symptoms between experimental and control group

Chi-square test

To find out the association between the posttest level of menopausal symptoms among perimenopausal women and their selected demographic variables in experimental group.

PROTECTION OF HUMAN SUBJECTS

The research proposal was approved by the dissertation committee prior to conducting the pilot study and the main study. A written permission was obtained from the Municipal commissioner, Dharapuram Municipality, Dharapuram for the conduction of study. Confidentiality was maintained by the researcher throughout the study among the samples both in experimental and control group.

CHAPTER – IV

DATA ANALYSIS AND INTERPRETATION

This chapter deals with the analysis and interpretation of the data collected to assess the effectiveness of Soy on menopausal symptoms among perimenopausal women with in the age group 45 – 55 years at selected areas in Dharapuram.

Data has been analyzed and tabulated as follows:

SECTION A: Description of demographic characteristics of samples.

SECTION B: Assess the pre and posttest level of menopausal symptoms in experimental and control group.

SECTION C: Compare the pre and posttest level of menopausal symptoms in experimental group

SECTION D: Compare the posttest level of menopausal symptoms between experimental and control group

SECTION E: Find the association between the posttest level of menopausal symptoms among women with their selected demographic variables.

SECTION A: DESCRIPTION OF DEMOGRAPHIC VARIABLES.

Table-1: Frequency and Percentage Distribution of Demographic Variable of Samples among perimenopausal women in experimental and control group.

n = 60

S. No

Demographic Variables

Experimental

Group

Control

Group

F

%

F

%

1.

1.1.

1.2.

Age (in Years)

45-50 years

51-55 years

25

5

83.3

16.7