Ph.D. Research Scholar, II Associate Professor & Head, III Assistant Professor,

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1 Problems and Symptoms of Women Working Through Menopause (A Study with Reference to IT & ITES Women Executives at Chennai, Bangalore, Hyderabad and Pondicherry) I shakila. P, II DR. P. Sridharan, III DR. S. Thiyagarajan I Ph.D. Research Scholar, II Associate Professor & Head, III Assistant Professor, I,II,III Dept.of International Business, School of Management, Pondicherry University, Pondicherry Abstract Background: Menopause is a step of a woman s life when hormonal changes cause menstruation to stop permanently. Menopausal symptoms can affect women s health and differ between different races and societies. Some symptoms can last for years and affect a woman s quality of life. The average age of menopausal for women is 51 but the exact age may vary from woman to woman. Objectives: The aim of this study is to identify the symptoms faced by women during the menopause period and to find out the difficulties faced by them during the menopause period. Materials and Methods: In this cross sectional study, women aged equal or more than 40 years, working in MNC companies were selected by multistage randomized sampling. A questionnaire was used for data collection. The data from each questionnaire was analyzed by using SPSS version 16 software. Results: This study showed that itching in private parts, irritation, hot flashes, night sweats are the most common symptoms associated with the menopause. Conclusion: Most of the menopause working women s is mentally irritated because they are physically affected by itching in private parts. Keywords Hot flashes, Night sweats, Sleep Disturbance, ns and Symptoms. I. Introduction Menopause is one area that has been shrouded in myths and taboos and the way women perceive menopause depends largely on the social belief about menopause in their society. Menopause is a natural and unavoidable event affecting all women at some stage in their life. Menopause is the time when a women stops having menstrual periods, it is not a disease or an illness. Menopausal symptoms will affect each woman differently and it is not possible to predict the severity and duration of these symptoms. Life expectancy is increasing and women may live about 30 years in the postmenopausal state. It is therefore important that health, even in the absence of symptoms, and quality of life is optimized during this time. Menopause is the permanent cessation of menstruation resulting from the loss of follicular activity of the ovaries. It is a stage when the menstrual cycle stops for longer than 12 months and there is a drop in the levels of estrogen and progesterone, the two most important hormones in the female body (World Health Organization [WHO], 1996). The onset of this physiological development not only marks the end of women s reproductive function but also introduces them to a new phase of life. Although menopause is a universal phenomenon, there is a considerable variation among women regarding the age of attaining menopause and the manifestation of menopausal signs and symptoms. The exact age of menopause varies from women to women. II. Review of Literature: According to (Adedapo et al., 2011), their aims of the study were to determine the features and perceptions of natural menopause among menopausal women in Benin-City, Edo State, Nigeria. Perceptions of menopausal symptoms are greatly influenced by social, cultural, and economic settings and may influence the mode of treatment for menopausal symptoms. The features of menopause have always been assumed to occur only to a minor degree of significance in Nigerian women. A descriptive cross-sectional study of 533 randomly selected Nigerian women in Benin City, Edo State who had experienced at least 24 continuous months of amenorrhea using a structured questionnaire. Although menopause is well-tolerated by women in our environment, it needs further investigation. Research priorities include the influence of sociocultural beliefs on sexuality at menopause and evaluation of HRT benefits. (UNISON Health and Safety guide to the menopause 2011) has examined and identified the symptoms associated with the menopause and they have analyzed how to overcome the menopause period in organization. The variables used in this study are hot flushes, sleep disturbance, urinary problems, heavy periods, and vaginal symptoms. Employers should ensure that all line managers have been trained to be aware of how the menopause can affect work. Survey method has been used in this study. inally, their findings and conclusion of the study is employers can ensure that, as part of a wider occupational health awareness campaign issues such as the menopause. Working time arrangements should be flexible and it should meet the needs of menopausal women. (Amanda Griffiths et al., 2010), their objectives of the study is to examine the range of experiences reported by women with regard to the menopause and work and to harvest their views on changes that could be made to their work and working environment that would improve experience for them and for future generations of working women. Interview method has been followed, to collect the required data. They have collected 912 women respondents. Percentage analysis has been used in this study. The findings of this paper are there is a need of awareness of managers about the menopause as a possible occupational health issue for women. Need of increased flexibility of working hours and working arrangements. Better access to informal and formal sources of support. They want an improvement in the workplace temperature and ventilation. Hence, the conclusion of the paper is majority of the women felt that they need further advice and support regarding the menopausal phase. According to TUC survey, March 2003 examines the difficulties faced by the women during menopause period and to identify the 42

2 International Journal of Research in Management & variables, which are women, faced problem in their menopause period. Survey method has been used in this study. The sample consists of 500 safety representatives. The important variables are hot flushes, headaches, tiredness, and lack of energy, sweating, anxiety attacks, aches and pains, finally dry skin and eyes. Etc The findings of the paper are working places and working practices are not designed with menopausal women in mind. Woman is not comfortable in disclosing their difficulties to their managers. Temperature in the workplace appeared to be an issue for many women. M.M. Sagdeo and Dimple Aroara examined that their objectives of the study is to find out average age of menopause in rural and urban women and associated menopausal symptoms and its awareness and prevalence by predesigned questionnaire. They have interviewed 500 females in the age group of years. We have found out that, the percentage of all menopausal symptoms is more in urban women as compared to rural cases. Commonly observed symptoms are hot flushes, joint & muscular discomfort and physical & mental exhaustion. Large efforts are required to educate and make the women aware of menopausal symptoms including rural women. This will help in early recognition of symptoms, reduction of discomfort and enable them to seek appropriate treatment. R. Garcı a-campos et al., has examined a study on possible interaction of care of grandchildren with women s symptoms at post-menopause. A cross-sectional, community-based study was carried out recruiting 386 postmenopausal women at public places in the city of Leo n, Mexico. The data have been collected from each woman s interaction about their children and grandchildren, and of physical and emotional symptoms frequently found at menopause. Levels of follicle stimulating hormone and estradiol in serum were measured. Their findings of the study says that among other factors associated with symptoms at post menopause, such as hormone conditions, age and schooling, maternal investment in children and grandchildren may impose a physical and emotional cost that favors the onset of symptoms at post menopause III. Menopause Menopause has been defined as the period during which menstruation permanently ceases. When menopause happens naturally, it tends to happen on an average of 55 & above are called as post menopause. The age when women enter menopause is seems to be mostly determined by their genes. or many women who enter menopause naturally, their menstrual cycle first becomes irregular. On average, it stops completely within about 4 years. Other symptoms that can happen during this time include: Hot flashes, Night Sweats, Racing heart, Headaches, Joint Pains, Anxiety & Depression, Trouble sleeping, Mood swings, Poor memory, Low concentration. Some symptoms can last for years and affect a woman s quality of life IV. Stages of Menopause Menopause happens slowly over these stages: Peri menopause: In this stage, menstrual cycles are irregular but not stopped. On average, women are about 47 when they reach peri-menopause. About half of all women in the earlier stages to most women in the later stages of peri-menopause have symptoms like hot flashes. Women can still get pregnant in peri-menopause. Menopause: This is when women have had their final menstrual period. Women will not be able to pinpoint their final period until they have been completely free from periods for 1 year. Hot flashes, vaginal dryness, sleep problems, and other symptoms are common in this stage. Post menopause: This stage happens after women have had no periods for at least 1 year. Once a woman is post menopause, she will be referred to as postmenopausal for the rest of her life. V. Objectives of The Study To identify the symptoms faced by working women during the. To find out the difficulties faced by working women during the menopause period. VI. Methodology The data is purely of primary in nature. Multistage cluster sampling has been used for collecting the data. The total number of respondents is 100. The sample of 100 respondents selected for the study are the women working in IT & ITES industries in the age group of at Chennai, Bangalore, Pondicherry and Hyderabad. The statistical tool used for analyzing the data is Analysis of Variance (ANOVA). The questionnaire consists of a series of questions concerning women s age, demographic variables, signs, and symptoms related to menopause. The variables of the study include demography of the respondents and menopause. Demographic variables are marital, educational qualification, total monthly emoluments, type of organization, arrangements, work life and entertainment. The menopause variable has 22 items and these items have been separated into problems and symptoms. The problems have been classified into physical problems and mental problems. The symptoms have been classified into physical symptoms and mental symptoms. The physical problems includes 7 items like heart palpitations, weight gain, urinary infection, bladder infection, headache, joint pains, painful periods and the mental problems includes 7 items like mood swings, sleep disturbance, memory problems, decline in sexual desire, difficulty in concentrating, crying spells and painful intercourse. The physical symptoms includes 4 items like night sweats, skin itching, itching in private parts, tiredness and the mental symptoms like hot flashes, anxiety, depressed moods and irritation. VII. Results and Interpretation A. Stage 1: In this stage, to analyze the effect of independent variables like marital, educational qualification, total monthly emoluments, type of organization, arrangements, work life and entertainment ANOVAs has been used. The dependent variables are, physical & mental problems and physical & mental symptoms. ANOVAs give the results by comparing the means of the categories in the grouping variables. Let us go through the below tables for the results. All Rights Reserved, IJRMBS

3 Table 1: Anova for the total of the physical problems faced by women during the Physical problems Unmarried Diploma Graduate Postgraduate k-60k k-80k k-1L IT BPO KPO General irst Second Yes Shift arrangements policies or Married No Yes No Table 2: Anova for the total of the mental problems faced by women during the Married Mental problems Unmarried Diploma Graduate k-60k k-80k k-1L IT BPO KPO General irst Second Yes No Yes No Table 3: Anova for the total of the physical symptoms faced by women during the M e a n Married Unmarried Diploma Graduate Postgraduate k-60k k-80k k-1L IT BPO KPO General irst Second Yes No Shift arrangements policies or Physical Symptoms Yes No Table 4: Anova for the total of the mental symptoms faced by women during the Married Unmarried Diploma Mental Symptoms Graduate k-60k k-80k k-1L IT BPO KPO General irst Second Yes No Yes No B. Inference for Stage 1: rom the above tables it can be inferred that overall there is no effect of any of the independent variables on Mental or Physical problems and Mental or Physical Symptoms except for marital type of organization, which seems to have influence on physical 44

4 International Journal of Research in Management & symptoms and marital, which seems to have influence on mental problems. The type of organization includes BPO, KPO, and IT industries. There is a mean difference between the types of organization. Highest mean is for KPO, followed by IT and then BPO. The physical symptoms are night sweats, skin itching, itching in private parts and tiredness, which vary from women to women. In the same way for marital between married and unmarried women, there is a mean difference and this difference is statistically significant. The result shows there is a higher mean for married women, on mental problems, and the lower mean for unmarried women. The mental problems are mood swings, sleep disturbance, memory problems, decline in sexual desire, difficulty in concentrating, crying spells and pain during intercourse. However, based on the results of total of the items it is not clear which of the particular item shows significant in the independent variable and hence we planned to pick the top two items from physical, mental problems and symptoms. C. Stage 2: In this stage, the effect of independent variables on top two items in each dependent variable was studied. Based on the mean the top two items from physical, mental problems and symptoms have been taken for the analysis. The top two items taken for physical problems are urinary infection and painful periods, sleep disturbance and difficulty in concentrating for mental problems. The top two items taken for physical symptoms are skin itching and itching in private parts, hot flashes, and irritation for mental symptoms. The independent variables remain the same which is already explained in stage one. Top two items and the demographic variables will be tested with the help of ANOVA. Table 5 (a): Physical problems faced by women during the Married Unmarried 4.19 Urinary Infection Diploma 4.09 Graduate k-60k k-80k k-1L 4.43 IT 4.20 BPO 4.31 KPO 4.33 General 4.32 irst 4.23 Second 4.29 Yes 4.30 No 4.26 Yes 4.16 No Table 5 (B): Physical problems faced by women during the Married 4.32 Unmarried Diploma 4.36 Graduate k-60k k-80k Painful 80k-1L 4.43 periods IT 4.32 BPO KPO 4.38 General 4.26 irst Second 4.35 Yes No 4.27 Yes No 4.35 Table 6(a): Mental problems faced by women during the menopause phase M e a n Married Unmarried 4.12 Diploma 4.45 Graduate Sleep Disturbance k-60k k-80k k-1L 4.14 IT 4.28 BPO 4.33 KPO 4.24 General 4.37 irst 4.26 Second 4.29 Yes 4.37 No 4.26 Yes 4.39 No All Rights Reserved, IJRMBS

5 Table 6(b): Mental problems faced by women during the Married 4.23 Unmarried Diploma 4.36 Graduate k-60k k-80k Difficulty in Con- 80k-1L 4.29 centrat- ing BPO IT 4.25 KPO 4.24 General 4.21 irst Second 4.32 Yes No 4.26 Yes 4.19 No Table 7(a): Physical symptoms faced by women during the Skin Itching Married 4.19 Unmarried 4.19 Diploma 4.09 Graduate k-60k k-80k k-1L 4.29 IT 4.20 BPO 4.15 KPO 4.24 General 4.11 irst 4.21 Second 4.21 Yes 4.19 No 4.19 Yes 4.26 No Table 7(b): Physical symptoms faced by women during the Itching in private parts Married 3.31 Unmarried 3.62 Diploma 3.45 Graduate k-60k k-80k k-1L 3.14 IT 3.45 BPO 3.08 KPO 3.71 General 3.37 irst 3.40 Second 3.29 Yes 3.11 No 3.45 Yes 3.29 No Table 8(a): Mental symptoms faced by women during the Hot flashes Married 4.37 Unmarried 4.31 Diploma 4.64 Graduate k-60k k-80k k-1L 4.14 IT 4.32 BPO 4.33 KPO 4.48 General 4.42 irst 4.32 Second 4.38 Yes 4.33 No 4.37 Yes 4.48 No

6 International Journal of Research in Management & Table 8(b): Mental symptoms faced by women during the Irritation Married 4.14 Unmarried 4.06 Diploma 4.09 Graduate k-60k k-80k k-1L 4.14 IT 4.18 BPO 4.13 KPO 4.05 General 4.26 irst 4.15 Second 4.03 Yes 4.07 No 4.15 Yes 4.10 No D. Inference for Stage 2 rom the above tables, it can be inferred that overall, there is no significant difference between the dependent variables and the factor variables yet that there is a significant difference between the dependent variable physical and mental symptoms namely itching in private parts & irritation, the factor variables in type of and arrangements viz tables 7(b) and 8(b). Table 7 (b) shows that the type of organization, BPO, KPO, and IT industries, have an influence on physical symptom (Itching in private parts). When you closely observe the mean of type of organization it can be inferred that the highest mean is for KPO, followed by IT and then BPO. Therefore, the result shows that when compared with physical symptom of itching in skin and private parts, women are physically affected by itching in private parts. Generally, during the menopause transition, the ovaries begin to produce less estrogen in preparation for the cessation of menstruation (i.e. menopause). This decrease in estrogen is the primary cause of itching in private parts during menopause, which typically begins in a woman s 40s to 50s. (Shaila misri and Xanthoula kostaras, July 2002; Lokita pandit and Ouslander joseph. G, October 1997). Stress is also another major trigger of severe cause for itching in private parts. (Lokita pandit and G. Ouslander joseph, Oct 1997; D.W. Sturder and N. Panay, December 2010). Table 8 (b) shows that the arrangements include general, first and second have an influence on irritation. There is a statistically significant mean difference between the arrangements in the organization. The results show that the highest mean falls in women working in general followed by first and the lowest mean falls in women working in second. Therefore, the result shows that when compared with mental symptom of hot flashes and irritation, women are affected by the mental symptom of irritation a lot. Here, in this study women works in three s out of which general shows a higher mean which infer that the women working in general may tend to bear more workload in the organization followed by first and then second. However, overall it can be concluded that, the menopause working women are mentally irritated because they are physically affected by itching in private parts. VIII. Discussions There are various problems and symptoms identified among menopause working women. The physical symptom identified among the menopause women is itching in private parts and the mental symptom identified among the menopause women is irritation in the work and arrangements. Most of the problems and symptoms show insignificant difference because almost all problems and symptoms are faced by the menopause women, it may be because the sample is from same sector viz IT and ITES industries and they face equal job stress due to huge workload in the organization. Some of the symptoms like itching in private parts and irritation show significant result. show significant result may be because of the perception differentiation among married and unmarried menopausal women. So, the mental symptom and physical symptoms of itching and irritation can be minimized if women perform a lot of physical exercises like restorative yoga (asanas, pranayana, savasana), meditation etc for at least 15 minutes daily to reduce the severity of itching and irritation to a great extent. Women should try to perform yoga poses and postures correctly with proper breathing techniques. They also need to participate in lot of entertainment like singing, dancing, spending time with family and children. Studies have shown that diets rich in foods that promote estrogen levels (such as soy, apples, alfalfa, cherries, potatoes, rice, wheat, and yams) are great menopause treatments (Journal of North American Menopause Society in 2012). IX. Conclusion The study reveals that women need to participate in lot of physically related exercises and entertainment. During the women need to change their food habit to minimize the problems for their symptoms. Recent studies have shown that a diet rich in soy flour and flaxseeds promotes, prevents, and reduces the menopause symptoms (S. Dodin et al July 2013; Mayo clinic researchers 2007). During the menopause phase women need to do simple changes in lifestyle which will lead to huge benefits in fighting with menopausal symptoms and to achieve a higher overall level of health (Towey et al 2006). undamentally, techniques for stress reduction, such as yoga or meditation, combined with regular exercise and an improved diet can be a great natural menopause treatment. Menopause women need to avoid caffeine and alcohol consumption, oilbased products such as petroleum jelly and baby oil, vinegar, yogurt, and intake vitamins B, C, D, E like fish, milk, nuts, cereals and dried fruits. (Lindh-Astrand et al 2004). They should try to sleep for seven to eight hours per night and stay hydrated. These changes will help alleviate many symptoms, but for some women it may not address the problem directly at the hormonal source and so further treatment may be necessary. Alternative medicine has proven to be an excellent menopause treatment in a safe and natural way. This level of approach can involve several therapies. Herbal supplements are the most prominent, though in addition women may turn to such menopause treatments as acupuncture, biofeedback, massage, or aromatherapy. All these treatments can be effective and valid (NP Gordon, DS Sobel, EZ Tarazana, September 1998). Generally women has to be aware of the kind of signs and symptoms that they would face in menopausal phase and the HR of a company should also be aware of the problems and symptoms of menopausal women in order to arrange the All Rights Reserved, IJRMBS

7 required for a menopausal women and the menopause women should also be ready to talk about their problems frankly to their superiors. Therefore, finally it can be concluded that working time arrangements has to be comfortable and flexible to meet the needs of menopausal women. Especially in developing countries, the awareness of menopause health issues is less and the women are also feeling it as taboo topic, hence they are not open and so women face lot of issues in their working place. References [1] S. Dodin, A. L. (July 2013). The effects of flaxseeds dietary supplement on lipid profile, Bone mineral density and symptoms in menopausal women: A randomized, doubleblind, wheat germ placebo- controlled clinical trial. The Journal of clinical endocrinology and metabolism. [2] Saka MJ, S. R. (2012). Behavioral pattern of menopausal Nigeria women. Ann Trop Med Public Health, [3] Adedapo B. Ande, O. P. (2011). eatures and perceptions of menopausal women in Benin city, Nigeria. Annulas of African medicine, [4] Unison Health & safety guide to the menopause (2011). The Menopause and work. [5] Women s Experience of Working through the Menopause. (December 2010). A report for the British Occupational Health Research oundation. downloads/ Women s Experience of Working through the Menopause Dec 2010.pdf [6] Panay, D. W. (Dec 2010). Recommendations for the management of postmenopausal vaginal atrophy. Climacteric [7] Amanda Griffiths, S. M. (2010). Women s experience of working through the Menopause. Institute of work, health & organisations. [8] Towey M, Bundy C, Cordingley L (2006) Psychological and social interventions in the menopause. Current Opinion in Obstetrics & Gynecology. 18, 4, [9] Lindh-Astrand L, Nedstrand E, Wyon Y, Hammar M (2004) Vasomotor symptoms and quality of life in previously sedentary postmenopausal women randomized to physical activity or estrogen therapy. Maturitas. 48, 2, [10] Survey, T. (March 2003). Supporting women through the menopause. [11] Kostaras, S. M. (July 2002). Women and Reproductive Mental Health. The Canadian Journal of Diagnosis, [12] NP Gordon, D. S. (1998). Use of interset in alternative therapies among adult primary care clinicians and adult members in a large health maintenance organisation. Western journal sof medicine, [13] R.Garcia-Campos, H. A.-Z. (n.d.). Symptoms at menopause and care of Grandchildren. Climateric. [14] M.M. sagdeo, D. A. (n.d.). Menopausal symptoms: A comparative study in rural and urban women. [15] symptoms.com/vaginal-dryness. htm 48