









































Pa
ge

 
1



Pa
ge

 
10

American Journal of  Physical Education 
and Health Science (AJPEHS)

Examining the Quality of  Life among Working Women in Agartala During the Menopausal 
Transition: An In-Depth Analysis

Sm Farooque1*, Raveena Basumatary1, Prasanta Kumar Das1

Volume 2 Issue 2, Year 2024
ISSN: 2992-9679 (Online) 

DOI: https://doi.org/10.54536/ajpehs.v2i2.2983
https://journals.e-palli.com/home/index.php/ajpehs

Article Information ABSTRACT

Received: May 31, 2024

Accepted: June 29, 2024

Published: July 01, 2024

Menopause is a critical phase in a woman’s life characterized by hormonal changes that can 
impact various aspects of  health, including the quality of  life. Despite the increasing number 
of  women in the workforce, there is a noticeable gap in specific challenges and experiences 
of  working women during the menopausal transition. The study aims to analyze the quality 
of  life among working women in Agartala during the menopausal transition. The study 
includes N=30 working women from diverse professional backgrounds in Agartala. Data 
were collected through the MENQOL (Menopause-Specific Quality of  Life) Questionnaire 
developed by John R Hilditch et.al, (1996).  Descriptive statistics and percentage analysis 
were employed to interpret the data. The researcher has concluded that the quality of  life 
of  the working women of  Agartala seems to experience greater physical, vasomotor, and 
sexual changes during this prolonged phase. The findings can contribute to developing 
targeted interventions and support systems aimed at enhancing the quality of  life for this 
demographic group. Additionally, the study may serve as a foundation for further research 
in other geographical regions, fostering a broader understanding of  menopausal experiences 
among working women.

Keywords
Vasomotor, Menarche, 
Menopause, MENQOL 
Questionnaire

INTRODUCTION
A part of  life we actually live is very small and the rest 
of  our life is just an existence of  time, Quality of  living 
indicate exactly that small part of  one’s life where they 
found themselves happily balanced in every possible 
perspective. With all the various combinations of  different 
activities, it encompasses various aspects that contribute 
to painting his own abstract with different functional 
events that measure their happiness and sadness and 
help to bring overall well-being and satisfaction (Lucius 
Annaeus Seneca, 65BC). The satisfaction is beyond just 
economic stability but includes factors like education, 
health, relationships, personal fulfillment, etc., all these 
events reflect different rays of  life, all the doings, habits, 
love and hate, the positive and negative perspectives of  
life by which one can lead a satisfactory life. A satisfactory 
life of  one with taking all, happiness and sadness, health 
and wealth, job satisfaction, family and society guide to 
idiosyncratic Quality-of-Life. 
In early days, the concept of  measuring quality of  life 
of  an individual is started with dissatisfaction of  daily 
living, specially economically unstable which direct the 
person towards negative perspective and motive of  life 
(Jenabi et al., 2015). From onward the purpose of  Quality 
of  Life is being measuring by many developed countries, 
who were focusing in living positive life style. According 
to WHO’s different developed and developing countries 
are focusing on positive health indicators which is the 
mortality and morbidity, that is why WHO’s take the 
step to develop items or ways to measure the Quality-of-
Life (WHO, 2012). The contribution of  every individual 
to lift up the status of  their countries is worldwide 

vying. By 2020 statistical records only 47% of  Women 
are participating in working labour, where as in other 
hand 74% of  Men are contributing as working labour 
(United Nations Economist Network, 2020) and this gap 
between different gender has been relatively constant 
from since 1995. Earlier in 1960’s, women’s involvement 
and development were given significance only after 
their marriage to a man, even after giving an immense 
contribution to grow their family they were considered as 
nothing (Munley, 1975). Women’s life is like a full ride of  a 
roller-coaster, with constantly changing bumps. Not only 
the growing age but with constant vast physiological and 
psychological changes. Changes like stage of  menarche, 
conceiving a baby to Postpartum period and Lastly, the 
Menopausal phase (Cheng et al., 2007). Menopause is an 
obligatory biological change in women’s life (Matthews & 
Bromberger, 2005).
Menopause is the women’s last stage of  menstrual cycle 
with different changes in their body. Menopausal change 
has different stages which is also called menopause 
transition. Women experience menopause transition in 
four different stages: Pre-menopause phase leading up to 
menopause, which typically beginning in a woman’s 40s, 
although it can start earlier or later. During this phase 
the hormone levels, especially estrogen, start fluctuating, 
leading to changes in the menstrual cycle. Peri-menopause 
is often used interchangeably with pre-menopause when a 
woman experiences the final menstrual period. Hormonal 
fluctuations continue, and symptoms may intensify. 
Menopause phase, also known as menopausal transition is 
officially declared when a woman has not had a menstrual 
period for 1 consecutive year, at this stage, the ovaries 

1 Department of  Physical Education, Tripura University (A Central University), Agartala, India
* Corresponding author’s e-mail: smharish9@gmail.com



Pa
ge

 
11

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 2(2) 10-16, 2024

significantly reduce estrogen production and experience 
the occurrence of  typical menopausal symptoms, and 
post-menopause, which refers to the period that begins 
after menopause where women are at an increased risk of  
certain health condition such as osteoporosis and heart 
disease due to low estrogen levels (Ghosh et al., 2018).
In India, women experience menopause between the 
ages of  41.9 and 49.4 on average, and cultural and 
lifestyle differences contribute to the menopausal phase 
being associated with the loss of  sexuality, strength, 
energy, aging fears, and loss of  status (Pallikadavath et 
al., 2016) Negative sociodemographic factors impact 
premenopausal women, leading to unhealthy behaviors 
such as smoking, poor diet, and lack of  physical activity, 
resulting in higher BMI among menopausal women 
(Dąbrowska et al., 2016). Despite cultural constraints, 
Indian women globally excel. Regional variations exist, 
with the northeast region suggesting a higher status for 
women. However, female work participation rates in 
the northeast, except for Manipur, Assam, and Tripura, 
remain lower due to socio-demographic factors like family 
responsibilities, inadequate support, gender insensitivity, 
inflexible work policies, and physiological changes related 
to menstruation and menopause (Mahanta & Nayak, 
2013). These factors significantly impact women’s quality 
of  life.
What we been generalizing about the Quality-of-Life 
(QOL) of  women during this phase of  her life cannot 
be simple as it manifest till date,  generally women of  
rural area has been given the note that, they often carry 
a negative body image addressing negative body image 
during menopause involves self-doubt, negligence, 
cultural influences, physical changes like skin, vaginal 
and body composition changes which may guide them 
towards poor physiological support in their living, but 
this condition is been disregard by the society and not 
been given importance by the people, because it is the 
natural phenomenon and a phase in every women life 
(Medeiros de Morais et al., 2017), but every so often 
it should be foremost matter to swot about women’s 
living condition in this very fast moving society, for the 
positive growth of  society and nation. Quality number of  

studies are necessary to present an asset knowledge about 
menopause and its costs and benefits to our surrounding 
for women and nation betterment. Therefore, the 
objective of  this study is to examine and generalize the 
Quality-of-Life living by the working women undergoing 
the menopausal transition in different and living discrete 
lifestyle in Agartala, Tripura.

METHODOLOGY
The selected participants (N=30) were middle-aged (42-
60 years old) sedentary working women of  Agartala 
(Kalhan et al., 2020), who were in their peri-menopause, 
menopause and in post-menopause phase. The researcher 
used a convenience sampling method for selecting the 
participants, and a total of  30 participants were selected 
for the study. Participants background information was 
collected, their basic demographic and field of  profession 
along with health history information was also collected 
including their menopausal status.
To examine the Quality-of-Life of  working women 
of  Agartala the Menopause-Specific Quality-of-Life 
(MENQOL) standardized questionnaire was used 
developed by John R Hilditch et.al, (1996) and it consists 
of  29 items dealt with 4 domains which are Vasomotor, 
Physical, Psychosocial and sexual. The MENQOL 
questionnaire shows a validity score of  4.7 out of  possible 
5 and with reliability score coefficients of  vasomotor = 
0.37, psychosocial = 0.79, physical = 0.81, and sexual = 
0.70 with Quality-of-life = 0.55 (Hilditch et al., 1996),. 
The questionnaire was distributed personally and before 
filling the questionnaire, a personal consent was filled by 
the subject to participate in the study. For the convenience 
of  the subject, questionnaire was converted in Bengali 
language and also in Google form questionnaire. All the 
information and instruction were written in 2nd page of  
the questionnaire. During filling up the questionnaire each 
question was explained personally by the researcher to the 
participants. The result was drawn by using descriptive 
statistic and percentage analysis.

RESULT AND DISCUSSION

Table 1: Mean score of  each statement of  Menopause-Specific Quality-of-Life (MENQOL) of  working women of  Agartala
Sl. No Questions Total no. of  Subject (N) Mean score
01 Hot flushes 30 2.53
02 Night sweats 30 2.23
03 Sweating 30 2.60
04 Dissatisfaction with personal life 30 0.83
05 Feeling anxious or nervous 30 1.27
06 Experiencing poor memory 30 2.80
07 Accomplishing less than I used to 30 1.90
08 Feeling depressed, down, blue 30 1.17



Pa
ge

 
12

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 2(2) 10-16, 2024

09 Impatience with other people 30 1.23
10 Willing to be alone 30 0.80
11 Flatulence / gas pain 30 2.13
12 Aching in muscles and joints 30 3.87
13 Feeling tired or worn out 30 3.23
14 Difficulty in sleeping 30 1.53
15 Aches in back of  neck or head 30 1.77
16 Decrease in physical strength 30 3.27
17 Decreased stamina 30 3.27
18 Feeling lack of  energy 30 3.07
19 Dry skin 30 1.77
20 Facial hair 30 2.20
21 Weight gain 30 0.07
22 Changes in appearance, texture or tone of  skin 30 1.20
23 Feeling bloated 30 0.63
24 Low back ache 30 3.77
25 Frequent urination 30 1.07
26 Involuntary urination while laughing or coughing 30 1.70
27 Change in sexual desire 30 2.83
28 Vaginal dryness during intimacy 30 1.97
29 Avoiding intimacy 30 3.20

Above Table 1 represent the Menopause-Specific Quality-
of-Life questions which indicates most common physical, 
emotional and social feelings and problems experienced 
by the women during their menopause. The table carries 
29 questions related to four different domains and it 
describe each question with the mean average score of  its 
statement given in Menopause-Specific Quality-of-Life 
(MENQOL) Questionnaire. In the above table it showed 
that the most common problem faced by menopausal 
working women individually are specify in Physical 
Domain. 
In Physical Domain, Question no. 12 which states that 

during menopausal phase women go through “Aching 
in muscles & joints” which shows highest mean 
average=3.87, followed by Question no. 24 which states 
that women experience “Low back ache” while they are in 
their menopausal phase with its mean average=3.77 and 
Question no. 16 & 17 which states that women experience 
“Decrease in physical strength” and “Decreased in 
stamina” during their menopausal transition with mean 
average=3.27. Above mentioned four questions are of  
Physical Domain, which manifest those Working women 
of  Agartala experience more physical changes then other 
domains during their menopause phase.

Table 2: Descriptive Statistics of  Menopause-Specific Quality-of-Life of  working women of  Agartala
Domains N Mean Standard Error Standard Deviation Confidence level
Vasomotor 30 2.45 0.11 ±0.20 0.49
Psychosocial 1.43 0.27 ±0.70 0.65
Physical 2.16 0.29 ±1.14 0.61
Sexual 2.67 0.36 ±0.63 1.57

Above table 2 shows the descriptive statistics of  
Menopause-Specific Quality-of-Life (MENQOL), 
of  subjects N=30. It depicts the four domains of  
MENQOL which was mentioned in table 02 along with 
its mean average score, standard error, standard deviation 
and confidence level. The table reveals that working 

women of  Agartala have sexual domain= 2.67±0.63, 
vasomotor= 2.45±0.20 and physical domain= 2.16±1.14, 
which shows the evidence that they have higher level of  
all physical and biological changes during menopausal 
phases, but they are less dissatisfying with their personal 
and social life with psychosocial domain= 1.43±0.70.



Pa
ge

 
13

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 2(2) 10-16, 2024

Above figure 1, display the graphical presentation of  
mean value of  each domain, here the graph shows 
the value of  physical domain was 2.16, psychosocial 
domain was 1.43 followed by sexual domain was 2.67 

and vasomotor domain was 2.45. The graph reveals, that 
sexual domains show the highest mean value of  2.67 
and psychosocial domains shows lowest mean value of  
1.43.

Figure 1: The mean average value of  Vasomotor, psychosocial, physical and sexual domains on numerical rating

Table 2: Descriptive Statistics of  Menopause-Specific Quality-of-Life of  working women of  Agartala
Point scale 
→

No. of  Question "0" "1" "2" "3" "4" "5" "6"

Vasomotor 3 33.30% 2.20% 7.70% 18.80% 17.70% 20.00% 0.00%
Psychosocial 7 57.60% 0.40% 8.50% 17.60% 7.10% 7.60% 0.90%
Physical 16 41.40% 0.40% 8.30% 16.80% 19.10% 11.00% 2.70%
Sexual 3 34.40% 2.20% 3.30% 10.00% 24.40% 23.30% 2.20%

It was highlighted from the above table 3 that the 
percentage of  Menopause-Specific Quality-of-Life of  
working women of  Agartala were rated on numerical 
point of  ‘0’ to ‘6’ (from Not at all bothered to extremely 
bothered). The response over vasomotor domain (No. 
of  questions = 3) of  menopausal women were “0” 
= 33.30%, “1” = 2.20%, “2” = 7.70%, “3” = 18.80%, 
“4” = 17.70%, “5” = 20.22% and “6” = 0.00%. The 
response over psychosocial domain (No. of  questions 
= 7) of  menopausal women were “0” = 57.60%, “1” = 

0.40%, “2” = 8.50%, “3” = 17.60%, “4” = 7.10%, “5” 
= 7.60% and “6” = 0.90%. The response over physical 
domain (No. of  questions = 16) of  menopausal women 
were “0” = 41.40%, “1” = 0.40%, “2” = 8.30%, “3” = 
16.80%, “4” = 19.10%, “5” = 11.00% and “6” = 2.70%. 
And the response over sexual domain (No. of  questions 
= 3) of  menopausal women were “0” = 34.40%, “1” = 
2.20%, “2” = 3.30%, “3” = 10.00%, “4” = 24.40%, “5” 
= 23.30% and “6” = 2.20%.

Figure 2: The percentage of  mean average value of  Vasomotor, Psychosocial, Physical and Sexual Domains on 
numerical rating 



Pa
ge

 
14

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 2(2) 10-16, 2024

Figure 2, shows the graphical presentation of  percentage 
of  four domains of  MENQOL of  working women of  
Agartala. Here brown colour showed 31% of  sexual 
domain, orange colour represents 28% of  vasomotor 
domain, green colour showed 25% of  physical domain 
and yellow colour showed 16% of  psychosocial domain 
of  working women of  Agartala. The result showed 
that majority of  working women of  Agartala have less 
psychosocial changes during their menopausal phase.

DISCUSSION 
The Quality of  Life during menopause is a complex and 
multifaceted subject, encompassing various physical, 
psychological and social dimensions. The outcomes of  
this study manifest that the Working women of  Agartala 
during their menopausal phase experience more physical 
and biological changes as it’s the normal and necessary 
changes occur in body, menopause symptoms such as 
hot flashes, night sweats and changes in sleep patterns 
with hormonal fluctuations which lead them to vaginal 
dryness, affecting their sexual well-being impacts in their 
physical comfort and overall health condition. 
In this study Physical and Biological changes have been 
covered by Vasomotor domain = 28%, Physical domain 
= 25% and Sexual domain = 31% as compare to their 
Psychosocial domain = 16% which directly indicates 
one’s personal and social life satisfactory questions during 
menopause. The current study revealed that women 
have to go through different troublesome issue during 
menopausal transition in their life span and many long-
term health conditions, including the risk of  osteoporosis 
and cardiovascular diseases. Addressing these concerns 
positively impacts the overall quality of  life (Hilditch et al., 
1996). During menopausal transition coping mechanisms 
with menopausal phase is daily life was very challenging, 
the effectiveness of  coping strategies, such as exercise, 
mindfulness, and social engagement, plays a crucial role 
in determining the quality of  life during menopause. 
Women continuously endure different physical and 
mental changes during their menopausal transition phase 
(G K, 2013).  This natural changes in women body seems 
to effect differently in every individual, several studies 
have shown the results that the basic and prior knowledge 
about the menopause and positive support from family 
and society brings healthy and good surrounding for the 
menopausal women as they need to be taken care during 
their transitional phase (Ilankoon et al., 2021). 
Clutural attitudes towards menopause and societal 
expectations regarding aging can impact a woman’s 
perception of  the life stage, the level of  awareness and 
acceptance within a clutural context playes a role in 
shaping the overall good environment, with several study 
it is seen that working women who are literate seems to 
have more knowledge and basic information about their 
medical condition compare to illiterate women, it was seen 
that more than 54.1% of  women keep negative attitude 
towards their own menopausal transition in rural areas, 
but working women and their families have opposite 

attitude towards this transition. Study have shown that 
working women have less psychosocial problems with 
less than 27.5% depression problem compare to other 
females who have prevalence of  43% of  depression 
symptoms during menopause, this have been notice due 
to increasing level of  estradiol in women body, which was 
mostly found in peri-menopause phase (Mishra & Kuh, 
2006). But, it have been noticed that due to slender time 
to take care of  themselve due to busy schedule of  work, 
in a result working women experience more menopausal 
symptoms (Sánchez-Rodríguez et al., 2017), because of  
such reasons female suffer more physical and biological 
problems like muscle ache problem, extreme sweating 
issues, hot flushes, viginal dryness, decrease in level of  
estrogen then psychosocial changes (Kakkar et al., 2007). 
During this phase women have to take care of  her 
physical, mental, social and also personal life because in 
this phase women body changes vastly, one of  the major 
reason is sudden drop of  oestrogen and 17-estradiol 
from 100-250 ml to 10-30 ml which leads to loss of  the 
saturated receptors of  cells from the body and make the 
body weaker naturally, they started losing their strength to 
work and stamina to move their body efficiently, due to 
which they started gaining weight, feeling of  aniexty and 
mood swing can be noticeable (Dalal & Agarwal, 2015). 
Women facing menopause often demonstrate resillence 
and strength as they navigate the physical, emotional, and 
societal challenges associated with their life stages.
Apart from embracing all the difficult outlook many 
women approach menopause with positive perspective and 
maintaining healthly life during menopause give positive 
body image and helps to keep good personal and social 
life, it also seems to be very effective for the women who 
have been suffering from triumph physical and biological 
problems due to menopausal transition (Nazarpour et al., 
2021). This study reveals that the working women mainly 
from academics, medical, janitors sectors seems to have 
more severe physical problems and have comparatively 
good personal and social life even when they are agony 
from different physical and biological changes during 
their menopausal phases, they abide the fact of  ageing and 
their bodily changes and accept it positively (Kopenhager 
& Guidozzi, 2015). It displays that even with daily work 
exhaustion and working environment with adequate 
knowledge about physical and mental changes during 
menopausal phase leads to good and positive Quality-of-
Life with sense of  liberation, freedom from menstruation, 
contraception and newfound autonomy of  menopasual 
women (Whiteley et al., 2013). 
In accordance with the researcher understanding and 
with different proven studies, it have been vindicated 
that working women was found to be more physically 
tired, exhausted with daily work and during this period 
they phase very discomfort towards their body image, 
and due to very less time to work on themselves it was 
very hard for them to maintain good and healthy physical 
life style which leads them to more painful physical 
menopausal transition (Kakkar et al., 2007), but still 



Pa
ge

 
15

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 2(2) 10-16, 2024

working women manage to maintain balance and good 
psychosocial domain during their menopausal phase, by 
embracing a positive perspective on menopause, women 
can not only navigate the physical and emotional changes 
more gracefully but also contribute to reshaping societal 
narratives around aging and women’s health (Yazdkhasti 
et al., 2015).

CONCLUSIONS
Based on this study, the researcher has concluded that the 
quality of  life during menopause is a nuanced interplay of  
physical, psychological, and social factors by rolling down 
the challenges women face during their menopausal 
transition. During this period, the working women of  
Agartala seem to experience greater physical, vasomotor, 
and sexual changes during this prolonged phase. 
Particularly in the context of  greater physical changes, 
it reveals a nuanced and complex landscape. Women 
undergoing this natural life transition navigate many 
challenges, from hormonal fluctuations to changes in 
body composition impacting their physical and emotional 
well-being. Despite these challenges, there exists a 
resilient and positive perspective among many women, 
emphasizing the transformative nature of  menopause. 
This period signifies not just an end but a new beginning, 
where women can embrace wisdom, prioritize self-care, 
and redefine priorities. By fostering open discussions, 
advocating for supportive workplace environments, 
and challenging societal norms, women can navigate 
the physical changes of  menopause with a sense of  
empowerment. As research continues to shed light on 
psychosocial parameter of  working women of  Agartala 
which is in good scale with maintained socioemotional 
status and multifaceted aspects of  menopause, which has 
becomes imperative to recognize that the quality of  life 
during this phase is a subjective and individual experience. 
Through understanding, empathy, and a holistic approach 
to women’s health, we can collectively contribute to 
a positive and enriching journey through the physical 
changes associated with menopause.

Acknowledgment
We extend our sincere appreciation to all those who have 
contributed to the completion of  this manuscript. This 
work would not have been possible without the support, 
guidance, and collaboration of  numerous individuals and 
organizations.

REFERENCES
Cheng, M.-H., Lee, S.-J., Wang, S.-J., Wang, P.-H., & 

Fuh, J.-L. (2007). Does menopausal transition affect 
the quality of  life? A longitudinal study of  middle-
aged women in Kinmen. Menopause, 14(5), 885–890. 
https://doi.org/10.1097/gme.0b013e3180333a58

Dąbrowska, J., Dąbrowska-Galas, M., Rutkowska, M., 
& Michalski, B. A. (2016). Twelve-week exercise 
training and the quality of  life in menopausal women 

– clinical trial. Menopausal Review, 1, 20–25. https://
doi.org/10.5114/pm.2016.58769

Dalal, P., & Agarwal, M. (2015). Postmenopausal 
syndrome. Indian Journal of  Psychiatry, 57(6), 222. 
https://doi.org/10.4103/0019-5545.161483

Ghosh, D., Singha, P. S., & Parida, P. (2018). 
Postmenopausal Health of  Indian Women: A Review. 
Current Women s Health Reviews, 15(1), 64–69. https://
doi.org/10.2174/1573404813666171201150725

Hilditch, J. R., Lewis, J., Peter, A., van Maris, B., Ross, 
A., Franssen, E., Guyatt, G. H., Norton, P. G., & 
Dunn, E. (1996). A menopause-specific quality of  
life questionnaire: development and psychometric 
properties. Maturitas, 24(6), 161–175. https://doi.
org/10.1016/0378-5122(96)01038-9

Jenabi, E., Shobeiri, F., Hazavehei, S. M. M., & Roshanaei, 
G. (2015). Assessment of  Questionnaire Measuring 
Quality of  Life in Menopausal Women: A Systematic 
Review. Oman Medical Journal, 30(3), 151–156. https://
doi.org/10.5001/omj.2015.34

Kakkar, V., Kaur, D., Chopra, K., Kaur, A., & Kaur, I. 
P. (2007). 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, 57(3), 306–
314. https://doi.org/10.1016/j.maturitas.2007.02.026

Kalhan, M., Singhania, K., Choudhary, P., Verma, S., 
Kaushal, P., & Singh, T. (2020). Prevalence of  
menopausal symptoms and its effect on quality of  life 
among rural middle aged women (40–60 Years) of  
Haryana, India. International Journal of  Applied and Basic 
Medical Research, 10(3), 183. https://doi.org/10.4103/
ijabmr.IJABMR_428_19

Kopenhager, T., & Guidozzi, F. (2015). Working women 
and the menopause. Climacteric, 18(3), 372–375. 
https://doi.org/10.3109/13697137.2015.1020483

Mahanta, B., & Nayak, P. (2013). Gender Inequality in 
North East India. SSRN Electronic Journal. https://
doi.org/10.2139/ssrn.2202044

Matthews, K. A., & Bromberger, J. T. (2005). Does the 
menopausal transition affect health-related quality of  
life? The American Journal of  Medicine, 118(12), 25–36. 
https://doi.org/10.1016/j.amjmed.2005.09.032

Medeiros de Morais, M. S., Andrade do Nascimento, R., 
Vieira, M. C. A., Moreira, M. A., Câmara, S. M. A. 
da, Campos Cavalcanti Maciel, Á., & Almeida, M. 
das G. (2017). Does body image perception relate to 
quality of  life in middle-aged women? PLOS ONE, 
12(9), e0184031. https://doi.org/10.1371/journal.
pone.0184031

Mishra, G., & Kuh, D. (2006). Perceived change in 
quality of  life during the menopause. Social Science & 
Medicine, 62(1), 93–102. https://doi.org/10.1016/j.
socscimed.2005.05.015

Munley, P. H. (1975). Erik Erikson’s theory of  
psychosocial development and vocational behavior. 
Journal of  Counseling Psychology, 22(4), 314–319. https://



Pa
ge

 
16

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 2(2) 10-16, 2024

doi.org/10.1037/h0076749
Nazarpour, S., Simbar, M., Majd, H. A., Torkamani, Z. 

J., Andarvar, K. D., & Rahnemaei, F. (2021). The 
relationship between postmenopausal women’s body 
image and the severity of  menopausal symptoms. 
BMC Public Health, 21(1), 1599. https://doi.
org/10.1186/s12889-021-11643-6

Pallikadavath, S., Ogollah, R., Singh, A., Dean, T., Dewey, 
A., & Stones, W. (2016). Natural menopause among 
women below 50 years in India: A population-based 
study. Indian Journal of  Medical Research, 144(3), 366. 
https://doi.org/10.4103/0971-5916.198676

Sánchez-Rodríguez, M. A., Castrejón-Delgado, L., 
Zacarías-Flores, M., Arronte-Rosales, A., & Mendoza-

Núñez, V. M. (2017). Quality of  life among post-
menopausal women due to oxidative stress boosted 
by dysthymia and anxiety. BMC Women’s Health, 17(1), 
1. https://doi.org/10.1186/s12905-016-0358-7

Whiteley, J., DiBonaventura, M. daCosta, Wagner, J.-S., 
Alvir, J., & Shah, S. (2013). The Impact of  Menopausal 
Symptoms on Quality of  Life, Productivity, and 
Economic Outcomes. Journal of  Women’s Health, 22(11), 
983–990. https://doi.org/10.1089/jwh.2012.3719

Yazdkhasti, M., Simbar, M., & Abdi, F. (2015). 
Empowerment and Coping Strategies in Menopause 
Women: A Review. Iranian Red Crescent Medical Journal, 
17(3). https://doi.org/10.5812/ircmj.18944


