JMM

Original Article

Menopause Knowledge, Attitude, Symptom and

Management among Midlife Employed Women
Eun Kyung Kwak1, Hyun Soon Park2, Nam Mi Kang3
1

Department of Outpatient Clinic, Konkuk University Hospital, Seoul, 2Doctors Course in Nursing, Inha University, Incheon,
College of Nursing, Konkuk University, Chungju, Korea

Objectives: Midlife womens knowledge, positive attitudes and management toward menopause may
improve the quality of peri and post-menopause life. This study was to identify correlations of the
knowledge, attitude, symptoms and management toward menopause in middle-aged women.
Methods: We used a cross-sectional questionnaire study applying to 231 perimenopausal and menopausal
women aged from 40 to 59 years old. The completed data of 189 perimenopausal and menopausal women
were analyzed through t-test, ANOVA and pearsons correlation coefficient using the SPSS statistical
programme.
Results: The menopausal women showed significantly higher physical symptoms than perimenopausal
women. The menopausal women showed significantly higher psychosomatic symptom than perimenopausal
women. There was a significant correlation between the menopausal attitude and management.
Conclusion: This study suggests that the fundamental data of developing midlife womens symptom index (MSI)
and providing menopause management could be a strategy to encourage successful menopausal transition in
middle-aged women. (J

Menopausal Med 2014;20:118-125)

Key Words: Attitudes, Knowledge, Management, Menopause, Symptom

Introduction

caused by inappropriate managemen Peri- and post-menopause

women
The average life expectancyrangeis forecastedfmenopauseto besymptoms,35.98 an years between 40-60 years
attternsmidlife,andandphysical,themiddlepsychologi-aged
women

population

is

projectedMiddle-adaptationgedtogrow

underscoredconsiderablytheircrucialsocial.Manystatusmiddle

rapidlydirectly.
and

the

affecting

standard

eld
of

womens
living

health

has

been

haslosingimprovedtheir

alongwomanhoodwith andgrowattrach of the population of women,andwhichmay wassufferrelativelyfromthefasterphysical than that

of men population.Moreover,Womenin perithe-transitionmenopausal fromwomen m midlife to elder status are semoreof
lossikelyandto

worthlessnessundergovariousaft

and

complex

health

problems,

toandmatoernaldraw

rolesmedicasl

attentiontheirchild due to an increased risk ofpendlowentred. Womenqualityfacingofelderlypostmenopalife

Received: September 1, 2014 Revised: December 6, 2014 Accepted: December 8, 2014

Address for Correspondence: Nam Mi Kang, Department of Nursing, Konkuk University, 268 Chungwon-daero, Chungju 380-701, Korea
Tel: +82-43-840-3958, Fax: +82-43-840-3958, E-mail: nmkang03@kku.ac.kr
This manuscript is a condensed form of the first authors masters thesis from Konkuk University.
Copyright 2014 by The Korean Society of Menopause

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

118

Eun Kyung Kwak, et al. Menopause Knowledge, Attitude, Symptom, Management

mentdryskin accordingKorean twomeno men at

menopause
a richer life by looking at

period.

Lowexamine-level

depression,correlationsslightlyofknowledg high-

Thislife instudya

degree
of
positivewasaimedperspecti managementrelatively

self-identityandand

toprovide an opportunity

towardlessclimactericmenopaus

for inner

symptoms

are

found

in

maturityfostering.Sinceapp Koreanaboutmiddlemenopausalropriatepostmenopausalse agedwomenknowledge,.

lf-manag women at midlife
experience
tovariousalleviateproblems
discomfortanddifficcausedl
ty b in adapting to
climacteric
changesinKoreanhaswom
enadirectThe
specificeffectonpu elderly
womens health,
healtharepromotingasfollows:lifestyl
e1)topattinvernsstiga and

knowledge

is

low

atti

Menopause

inmanagemeKoreant

womenbefore. Middleandafter- a dec aged

women with more knowledge of menopause
were
more likely to manage menopause1.
Definitionbtter,and
ofthosekeyhavingterm more negative
attitudes toward menopause were
found to experience negative5
menopauseMidlifewomen1)symptoms.
Menopause knowledge

psychological

with severe menopause

adaptationattitudes,haveb symptomsMenopauseweremoreknowllikelydget
eensymptomsconsidereda oimplieshave th
n managemenas important a lower quality of

life. On standinghe

issues.

life improved with

Appropriatecharacteristics; measures

the use tiallyoftere

menopause

for

understandingof2)woment managementassessment.Thus,
o examinethat certain
mescalesuresthat measur need to be devised
physical, mental,
to
promotechildmenopsocialknowledge,andpsych beauseringmanagementpotential,inmenopau
ologicattitudesalndchange Korean
middle-aged
women.
A
ssymptoms occur during inhighmenstrualquality ofcyclifeandcanflow,be
menopause

m
maintained
when
menopausehelpsmanagement;themwit relatedmenopausalproblemsage,
h grea3)tero

areovariantimelyhormone

prevented

and

idreadntinessfymenop to

adequately
managedeffect.
cope with3 these changes. Inandrecentothersyears,usingthmenopausre
tudes, symptoms and
management

is a wide spread of opinion Polithat

andpotentialLaRocco. developmental crisis can

be brought as menopause is considered as a

The most common andturning point in womens life2).
severe
ThisMenopauserecognitionattitudeconfronts
symptomsdifferencearein
various changes in different
memorymenopauseloss,kn
Menopausephysiologicalattitudephnomemeans
owledg recurrent fatigue,
a evaluatin physical, psychological,
exhaustionandandmanage

emotionalnication,and

Peri-menopausal
andsocialmentaspectslcha medical Forcaremanagement.
6

nges.Amongabou these,

and prevention of symptoms

arising from menopause, periphysical health is
foundexpressedtoaccountf 3)andMenopausestmenopausals
ymptomwomen
eelingsfor
andlargethoughtsportio

need to be well aware of theirMenopausehealth

statussymptomandis
physiologic

of
was

physdeficalned

changes

in

andwh

advancewas

tonotaccordinglybeenobservedcontrolfor
perceived

of menopausal

atheirfull own mind with positive thinkingcause.

such as pregnancy or breas
http://dx.doi.org/10.6118/jmm.2014.20.3.118

119

JMM

Journal of Menopausal Medicine 2014;20:118-125

menopausal symptoms and

the standards of the prevent chronic diseases related1)

Menopausewithmenopauseknowledgeinph
world
ysical,questi psychological, emotional,
hechalthracteoristga
socialThe modifiedandspiritualscale
nicszationncluded(
8
aspectsofwasPolitusedforanin
WHO).a Ittotal
indicates the scores changes in lifestyle patternsItthisin
stumidydle.-Aagedcorrectwomenanswer.
on the
religion,MidlifeWom ear indicates the scores
enseducationalSym measuredanswerith
ptomattainment,Inde addedscale0pointdeveloped.The scoresby
x

12

13

Songto assess menopause managementof12o ina maximumclimactericof29.

women.

11

(MSI)
2) Menopause attitude questio
developedandbycon
Menopause attitude was measured
sistingImetal.andof
10
9
66economicitems
Methods
by Choideveloped
by NeugartenT
forstatus. The
tool consisted of
a total of 27
obstetr
1.
Data
collection
and
analysisincluding
postmenopausal
women and 73
6 items on negative r The study
ofitemsa totalfor
population was
periofcomprisedpostmenopausalof189expectati
7menopausalitemso on,midlife 3 ite employed women aged
n the nu
between3 40items-59
women.
yearsonsymptomand thecontrol, 4 i
miscarriages, the
number of chil

subjects were randomly selectedand

2womitenmslivingonunpredictabilityinSeou

year and month of l. and Gyeonggi area. All subjectsfrom

the last mens
were1to
4) Menopause
either4.Theprofesscoresionrangedlor nonmanagement in
professional women workinga
menstrual cycle
before menopa
maximuminuniversityof108.hospitalsThem
Men
ean inwas u Seoul and Gyeonggi
opause
region, andby
manag
dividingtheywerethefullytotalinformedbythe
ement
num about the study purpose and
implies
indicatedmethodsand
disacti
positivedatacollectionattitude. C
vitieso
mfort.
procedures by research
implem
assistantswas0.94Fully. informed consent
ented
was obtained from all participants prior to
by
the survey research. Anonymous
women
themse
questionnair3)Menopauseweredistributeds
lves to
ymptomquestion
alleviat
10
e
individually and collected

throughoutMSIwith

Measurement a maximum of 346.

subscalesbetweenA

Higher MSI s The scale consisted of a

prildividedand into

totalexperienceof129

May, 2006. A total of

initems,menopause73itemssymptomfor

231
questipsychosomati measuring menopause
cnnaires areaswere symptoms,coefficient27it
returnedwasused. ems forwas
as Among these 189 menopause0.97. attitude,
were used
17 items for menopause
fordevelopeddataan management and 12
alybasedis,onexclud items for menopause knowledge4).
ingtheCornell42

TheMenopausequestionnairemanagement

questionnaires with about quest general characteristics

omitted or6comprisedMenopauseof
pointinsincerescalea themanagitementshatwas wasmeasur
nswersranged. from related with socio1 (No
demographicsurementcharacteristics,scale
developedconsistingobtetricbySongofa
m
uch). The scores characteristics and health
habitsof17.itemsThe sociodividedranged from 2.
demographicinto5subsc

13

120
http://dx.doi.org/10.6118/jmm.2014.20.3.118

Eun Kyung Kwak, et al. Menopause Knowledge, Attitude, Symptom, Management

graduateshigherat23in.8%theandgroupprimary
withschoolbetter graduates at 3.7%.
Professionalsexualoccupationslifethanwerethe
exercise management,

41group.P8%,< wit while non-professional

meal

occupations.05).
management,rangedfrom Thweredifference58.2%.Economicwassignific
sexualminimumlifeof 0 to a
management, selfregulating
managementeanscore
andwas
professional61.5159.74.
Th management. High or
low
scoresmanagwemrentdete
rminedwere22atbasedmini
mum and
on
to
than

statusHighwasin 4Moderate.2%,in 68.Low8%,

in 27.0%. The mean age of
Of all respondents, menstrualin cyclemeal
andwas sexualregularlifein 59managemen.3%,
but irregular in 40.7%. In
tuaddesition,toward59.menopause3%hdmenstr
ual.Nosignif discomfort, while 40.7% had
notin.self-regulating and profession No
significant difference was fo

the median. The scores rangedthemeanfromscoreaminimumwas44.of99 22 7.6

2. Menopause knowledge,
a maximum of 71. The median was 45. A score higher
tomsattitude,accordingsymptoommenopause
the
median indicated
good

man and
menopause
median indicated
bad management
performan
symptoms was higher in The scores of
management. Cronbachs
alpha coefficiTherewentre
menopause knowledgeperformancewerein4
wasno statistical0.75.
meal,pointssexualat life
differ
than

the

ledge according to
menopause man minimum and 11 points at maximum. The
groups. However,mean score was
menopause knowle
17.93

2.39.
The
scores
of
Resul
menopause
attitude
ranged
ts
group from a minimum of 33 to a
with
poor maximumTable2.Differenceof
meal
mana
geme of108,menopauseandknowledgetheaccording
nt
meanto
menopause
good meal
management (N =
189)
managementP<.01).No( si score was 60.86 10.12. The scores of
gnifican menopause symptom
1. Characteristics of
womenwere found in
sexual life, self-The
mean age was 52.06
years,managementandth
e(Tablemost common2).
religion was Christianity at
There59.8%.wereUniverss
tatisticaltygraduatesdiffere
nc accounted for 23.3%,
followedbetweenbyhightw
oschogroupslgraduates.H
owever,atmen 49.2%,
middle school

Table 1.
Menopause
knowledge,
attitudes,
symptoms and
management (N
= 189)

Menopause knowledge
Menopause attitudes
Menopause symptoms
Menopause
management
SD: standard deviation

High*
(mean
SD)
Exercise management
activities

7.98 1.58
17.2
Meal management
4 2.07
18.1
Sexual life management
3 2.41
Self-regulating
17.5
management
7 1.80
17.9
Professional management
2 2.34
17.7
Menopause management
2 2.38

Low*
(mean P
SD) value
7.99 1.52
18.1
8 2.42
17.7
3 2.33
18.0
6 2.55
17.9
3 2.41
18.1
2 2.36

.961
.007
.233
.194
.968
.223

High > average, Low <

average
*Mean SD, P value < .
01
SD: standard deviation
http://dx.doi.

org/10.6118/ 0.3.118
jmm.2014.2 121

JMM

Journal of Menopausal Medicine 2014;20:118-125

Table 4.
Menopause
Table 3. Menopause
attitude, symptom
attitudes and
and management
symptoms score
difference according score difference
between
to menopause
perimenopause
management (N =
and menopause (N
189)
= 142)

Attitudes

Attitude

Menopause P
Perimenopause* *
value
(mean
(mean SD)
SD)

s
higher in the perimenopausal group compared to the
a
c
l menopausalP < group.01). (Difference of psychosomatic
o Menopause symptoms
p
gement.
score
higher in higher
the symptoms
symptoms
waswas
significantly
Meal management
Meal management
r
e
group compared to theP< .menopausal05).The
dwith better self-regulating
ri
Sexual life group
management
Sexual life management i
o results suggested
Self-regulating
Self-regulating
n
d that
management
management
g
(t physicalmanageme
4. Menopause
Professional management
t
= nt
1.and
Professional management o
psychosomatic
overall
menopause attitudes according to menopausal period.
symptoms
m
Menopause management
Menopause
management
e <
High
> average, Low
were markedly
n
average
higher in
*Mean SD,
perimenopausal*Pv
meno o
to menopausal period was
< .01
Symptoms
alue<.001
pause p
SD: standard deviation
a
menopausal
group thancompared
women
knowl
Exercise management activities
u
edge
Exercise management activities
61.92
c
62.84

subscale, difference of physical symptoms was significantly

122

h
t

t ://dx.doi.org/10.6118/j
pmm.2014.20.3.118

Menopause

-.021

attitudes

Menopause

-.010

group
Menopause

.014

.116

(
.221*

Eun Kyung Kwak, et al. Menopause Knowledge, Attitude, Symptom, Management

age. exhi Differences were found in

menopausedifferenceattitudesaccordingacctord
to

menopausal

3ingthe degr to age, educational

women.attainmenstudy,occupation.Therefore,andfurthe

Significantofwomendiffere rspouse.studieIn regards to menopause

nceunderstudyofWomenw knowledgewarrantedandattitudetoclarifyaccordi
aslfn-oft lowesig regulatingngthe exactto general characteristics,
management

wasmoresignificanteducated anddifferenceyounger

foundage

womeninmenopa were more likely to have

withinmenopausalhighered knowledgecommonsymptomabout
ucationwomen

backgromenopausewassevere. fatig The mean score of

compared

tomenopause women,knowledgeand

perimenopausalP=0.wome wasskin9.0rashout inof nona-men perfect score

n011)toward.(t

of 17.0 points,leastshowingcommona

menopause=-2.607,

andsignificantsymptomwasdifferencnasalb

postmenopau However, noaccording to educational

attainmentwomen,andandfrequenttheaveragely

significant

differencepositivewasattitu ing down monthly household income.

Womenwomen.withTeseinsufficientfindingssug
deseenin
thanactivitywomenandbef gestor th incorrect knowledge about
menopauseinsymptomneed
5

exercise, meal, sexual life

stuandy.professional
management (Table 4).
The group with a lower
score i

betwetobenencouragedmenopausal a to
participate in health managwomement.
activities for better knowledge

14

andIn

regardscare. to menopauseAlow
knowleveledgeof management on p
had a higher score in meal,
sex

16

5.

Correlations
ofaccording to educational background,lifewas
lessfoundeducatedonthe studyAwomrecentof
knowledge,management,attit were more likely to be 5concernedThestudy
udes,while
reportedwithmnopauseurognital. atroph
sympthegroup
mean score on knowledge aboutandchildotherwit
bearingsymptomspotential,according
to
toms and management
symptom
and
A positive correlation menopause
menstrualChangesirregularityinsexual
attitudes and menopauseP
waslifehighduring. cl
Table 5).
These findings support the resultscauses of
5

12,14,15

menopapreviouse,studiesbutrather.
menopause

Discussion

knowledge

toaddition,becrucialt

According to general
characterislimactics,eric
symptomdifferenceand
inthethedegr knowledge
levels about

isin

Thus,

wasngesfound.In
import

improving

ability

to

managesustainmenopausesexual.Thelifeoutco
me.Taking

thes

indicates

that

wider

databasemultidimensionalisrequiredto
developnursing educainterv tional programs

menopausegement.wasM tailored
enopausefundbysymptoms forAlthmenoughpausesevereinorderpaintoandi

mprovediscomf the degree The

findings
supported
thatoftenthe
of
knowledge
onknowledgeneglected,andimplyingattitudethat m
menopausestagesofinthe are meaningfully related to urgenteconomicin
midlifemenopausalwomen. statusKorean andwomeneducation.
transit

level. But, the relationship

betweenAccordingknowledgetoastudyand
KimofattitutheandesKCDLe
http://dx.doi.org/10.6118/jmm.2014.20.3.118

123

17

JMM

Journal of Menopausal Medicine 2014;20:118-125

dywerewas educationfoundthatl the

background, religion and
monthelymeinopausecome, shadowingthe
signiremarkably

menopause
management was
comparablestudies

18

ficant difference Theseina

withbeforelargerand

studyprevioussymptofstudiesSom,ng.pych

aftersample sizes

osomatic symptom t reported contradictory

menopause,

resultswomen.Thein

showing no

outcomesaroundtheseemmenopausetobe.

significantconsistent
differenceresults..Th
eseMiddlere-aged w
sults are attributable
to

Th resulted from some Korean

womensuggestwho
thatacceptcomprehenenopausive educa
as a natural transition proceass
soonwithoutas possibletakinganyon

disinterestproperlyb

responseknowledge measure after

menopause.

indevelopingphysiol

Factorsmanagementaffectingofmenbonep

ogic,and implesocia

ausemineralshould be density (BMD) were

and psychological

anthropometKoreanic

changes

measurements,midlifewomen.serEducatio

andgramsproblemsf

nm a concentrations of minerals aond

orpreventivethataris

menopausenutrient intakesymptomsin

emanagementdurin

arperithough menopausal women, while

g b menopause and

age,middlemenarche-

beyond. The

agedage,womenserum. con centrations of

awarenessinsteadof

bone

ofmanagingmenopa

biochemicalPhysical,markers,mental,dieta

usemenopausal s

rypsychologicalpattern, walking time and

management and

exercise frequencytobetakenseemedinto

operation

considerhavegreaterion influence on BMD

ofpanusersing.

in

intervention are

postmenopausprogralms.womenIn.additio

thought to be

n,Forthesethe tail reasons, education on

crucial.

appropriatemenopausaldieteducaisthioug
htnalinterventitobe

The structured
teaching
programme was
found to be

19

crucial.

an effective strategy
to increase
theConclusionko
wledgefwomen

status,

symptoms and severity of According to

14

regarding
menopausal
symptoms and its
management.

Factors affecting
menopause
managementThisstu

correlations ofOverall,knowedge,it
isattitudes,thought thatsymp it toms and
management toward
menopause,singplan aforpositivehealth
correandwellbei lation was found
betweenS attitudeinthe

andmenopauseman ,demonstrating. com

agementbydevelopi

12

parable results with this studyThe.

ngthis a study.

Accordingfindings ofto thisPark

Women with

studyandLee,are Korean postmenopausal

positive

attitudespromotion women hadwomenmoreat nperigative-or

attipostmenopausaludes toward

towaprogramd

menopauseforthem menopause and a low levelappliedof

toperformingthegeneralhealthwomen- pop

and m

promoting behaviors. Hot

were more likely to flushreasons:isone of the most commonly

managefoundmeno reported symptoms during
pauseofdiscomfortb menopauFirst,e
andfurtheritismultidimensireferredtonal

etterin. theLim
menopause a that

20

women with positive as vasomotor symptoms alongStudiesclarifywithnightrelationshipssweats.

have
reportthered thatisa
significanttom andincremanagementseinth
attitudesmenopause
regardingphysiologicalmenpausal symptomsan
knowledge of women
washadablethe
14
its manag.Thementyobtained menwopauserking-relatedwomen.
tolowmanadegree of and
information through various
menopause through sources,Second
anditionaltherolestudiesofmassare
regular
21
exercismanagement media has been
greatlyTherefore,increxactasedfurther.cau
ses for the absence of s
124

http://dx.doi.org/10.6118/jmm.2014.20.3.118

Eun Kyung Kwak, et al. Menopause Knowledge, Attitude, Symptom, Management

210MS,. Lee YS. A study on the m

3.Noroozi E, Dolatabadi NK,
EslamipracticeAA,
HassanzadehandthequalityA, of lif Davari S.
nopause symptoms in
midlife
Knowledge and
employedmenopausalwom attitudeKorantowardSocMatmenopausernChil
ensymptomsaccording.Psy
d Health 19 phenomenon among women
chosomto Me
aged1840Song.-45 ARyears.An.
menopause management.
analysisJEduc of the re Health Promot
Third, the degree of implementing menopause
manage
2013;
2: 25. climacteric symptoms and
ment was low in overall of midlife working women. Hence,
managem
nursing care needs to be provided to minimize menopausal

4.Han MJ,
Lee JH. Factors
discomfort by developing menopause
management
programs
influencingmiddle-agedselfwomenidentity.JKoreanand Acad menopausal
symptoms on level of308depression-22. in
middle aged women. Korean J Women
Conflict of Interest
Health19NursPark.
2013;J,Choi19:M,275Lee-84.S, Choi Y,

for middle-aged women.

No potential conflict of interest relevant to this article

w

reported.
Nurs 1998; 28: 28090.

management
of study
menopause
and
5.Lim KY. The
of menopausebetweenits
relatedbonequalmityneralof densitylife bo
and management of climactericandin
14Patel.
V, Koshy S, Ravindra
nutrientamiddle-intakeagedfemaleinpreHN.and
E
population
in
Korea.
Public

HealthKoreanWklyJNutrRep
44:6: 60929--40.
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.2014.20.3.118

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