As defined by the World Health Organization (WHO), menopause as the permanent absence of menstruation resulting from the cessation of ovarian follicular activity. It is commonly diagnosed after 12 months of amenorrhea because of aging changes in the ovary and in hypothalamic-pituitary-ovarian axis function [1]. There are five menopausal phases such as peri-menopause, early menopausal transition, late menopausal transition, Menopause /Post-menopause and late post-menopause [2]. There are also four types of menopause, natural menopause (menopause which is not induced by externalized means), premature menopause (before the age of 40 years), artificial menopause (deliberate removal of any organ that directly affects the menstrual process) and radiation menopause (caused by the use of radium, which circulates in the uterus) [3].
Women experience many changes over the course of life, menarche, pregnancy and menopause. The age at which the menopause occurs is determined by genetics, body mass index, age at menarche, parity, smoking history, surgery (oophorectomy), chemotherapy or radiotherapy [4]. The natural menopause is expected to occur is between 40 to 55 years for women worldwide. The mean age at natural menopause is 51 years in developed countries, while it is 48 years in poor and developing countries [5]. n sub-Saharan Africa, since women starts menopause at an early age, it will make them spend a larger proportion of their lives in post-menopausal phase [6]. In Ethiopia, according to Ethiopian Demographic and Health Survey (EDHS) 2016, 16.8% of menopause occurs among women aged 30–49 year [7].
During menopause, women are more likely to develop chronic diseases such as osteoporosis and cardiovascular disease. As a result, this particular group of women needs extra attention in order to better understand their specific set of health-related problems [8]. Women's health care demands fluctuate at different times of their reproductive lives, depending on physiological parameters and sociocultural context. Women must be aware of the physiological changes that may occur in their bodies throughout their lives [9]. The current system, in which public health programs focus on emerging health challenges, does not give adequate attention to middle-aged women. As a result, they are more susceptible to menopausal-related health conditions, which may raise their likelihood of developing chronic diseases [10].
Menopause-related symptoms impact a large proportion of women, however treatment seeking for all symptoms is not homogeneous, indicating a lack of understanding regarding the treatability of many of these symptoms [10]. According to surveys, the menopause is still considered a "taboo" topic in many settings. As a result, a proper understanding of specific physical, mental, social, and psychological changes that occur during menopause helps women be more prepared to deal with these changes [11, 12].
According to many scholars, a lack of knowledge of menopause symptoms leads to a stressful post-menopausal period. It also results in many clinical consequences which require medical treatment [13, 14, 15]. There is also evidence that revealed a lack of knowledge regarding menopause makes women more frightened to deal with the changes, which directly influences the way they cope with the symptoms [16].
Educating women about the expected symptoms in each phase of menopause can minimize the adverse emotional and psychological consequences of menopausal stages. According to the United Kingdom National institute for health and care excellence (NICE) recommendation, providing information to menopausal women’s and their family members is very essential for better understanding and management of the situation. In this regard, all women are expected to have some knowledge of the stages of menopause, common symptoms of menopause, lifestyle changes and interventions, risks and types of treatments for menopausal symptoms, long term health implications of menopause [17].
Several studies have been conducted to measure knowledge of menopausal symptoms among women of various ages. For example, a study conducted in Iran revealed that only 38.5% of 400 participants had good understanding of menopausal symptoms [18]. In another cross sectional study carried out in the United Arab Emirates, out of the total 177 participants, 33% showed good knowledge of menopause and menopausal symptoms [19]. Other studies in India and Iraq also found that around 20% and 40.3%, respectively, of their respondents, had a good knowledge of menopausal symptoms [20, 21].
Health policies and programs in developing countries, including Ethiopia, emphasize health promotion for women of reproductive age. As a result, women going through the menopausal process have not been getting enough attention. On studies done in Nigeria, Egypt and Botswana supported this where only 2%, 28% and 17% of women respondent had good Knowledge about menopausal symptoms [22–24]. In Ethiopia; a few studies have been done on this issue. For instance, in a community-based study done in Addis Ababa, the capital, only 22.5% of the 568 participants had good knowledge [25]. A Similar study done in Adama town revealed that out of 290 participants; only 20.9% of study participants had good knowledge of menopause [26].
Even though it’s a fact that menopause introduces a major change in the morbidity pattern in the middle life of women, the Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) program strategies do not address the late reproductive age group of these women. Moreover, in Ethiopia, studies on menopause and how its symptoms are being understood and dealt with in the community are minimal. Therefore this study aimed to assess the common menopausal symptoms being experienced and knowledge of these menopausal symptoms by middle-aged women in Debre Berhan Town, North Shewa, and Ethiopia. Predictors for “good knowledge” regarding menopausal symptoms were also assessed.