Document Type : Research Article


1 Department of Nursing, Faculty of Medical Sciences, Israa University- Gaza, Gaza Strip, Palestine

2 Faculty of Medical Sciences, Israa University- Gaza, Gaza Strip, Palestine

3 Unit of Planning and Institutional Performance Development, Ministry of Health, Gaza Strip, Palestine

4 Dean Faculty of Medical Sciences, Israa University- Gaza, Gaza Strip, Palestine


Background: Menopause is accompanied with symptoms that could be bothersome to the point that quality of life can be affected. The present study aimed to assess the prevalence and severity of menopausal symptoms and quality of life among women in their peri- and post-menopausal phase.
Methods: This quantitative cross-sectional study was conducted from February to August 2022 on 332 peri-menopausal (n=162) and post-menopausal (n=170) women aged 45-55 years. They were recruited from the women who visited primary health centers in the East Gaza governorate using convenience sampling. The menopausal rating scale and a validated Arabic World Health Organization Quality of life-BREF (WHOQOL-BREF) were used. Descriptive and inferential analysis were applied and P<0.05 was considered as the level of statistical significance.
Results: The mean (SD) of the Menopausal Rating Scale (MRS) score was 2.27±0.49 vs 1.90±0.55 in the post-menopausal and peri-menopausal women, respectively. The most prevalent symptom was joint and muscle problems in peri-menopause (45.7%) and post-menopause (67.6%). The mean score of Quality of Life (QoL) dimensions, namely physical, social, environmental, and psychological domains was lower among the post-menopausal women compared to that among the peri-menopausal ones (3.19±0.73 vs 3.44±0.80, 3.46±0.72 vs 3.62±0.71, 3.50±0.60 vs 3.52±0.62, and 3.59±0.75 vs 3.68±0.77, respectively). Quality of life as well as the associated physical and social aspects were found to be significantly associated with menopausal symptoms (P=0.003 and P=0.048, respectively). Age (51–55 years; P<0.001), marital status (widowed/divorced; P=0.044), income (<300USD; P<0.001), and post-menopausal status (P<0.001) were significantly associated with severity of menopausal symptoms.
Conclusions: Menopausal symptoms are common in the post-menopausal status. Their severity was found to increase as menopause status progressed. Psychological symptoms were the most severe symptoms reflecting the need for proper psychological supporting efforts. Menopausal symptoms with severe manifestations impair the quality of life and are associated with socio-demographic and clinical variables.


How to Cite: Kahlout K, Elsous A, Alshorafa A, Ghazal M, Yaghi R, Askari E. Investigating the Prevalence and Severity of Menopausal Symptoms and Quality of Life in Peri-menopausal and Post-menopausal Palestinian Women: A Cross-Sectional Study. Women. Health. Bull. 2023;10(1):13-22. doi: 10.30476/WHB.2022.96809.1194.


1. Al-Safi ZA, Santoro N. Menopausal hormone therapy and menopausal symptoms. Fertil Steril. 2014;101(4):905-15.‏ doi: 10.1016/j.fertnstert.2014.02.032. PubMed PMID: 24613533. ## 2. Wang X, Wang L, Di J, Zhang X, Zhao, G. Prevalence and Risk Factors for Menopausal Symptoms in Middle-Aged Chinese Women: A Community- Based Cross-Sectional Study. Menopause. 2021;28(11):1271-1278. doi: 10.1097/GME.0000000000001850. PubMed PMID: 34469934; PubMed Central PMCID: PMC8547757. ## 3. Freeman EW, Sherif K. Prevalence of hot flashes and night sweats around the world: a systematic review. Climacteric. 2007;10(3):197-214. doi: 10.1080/13697130601181486. PubMed PMID: 17487647. ## 4. Yisma E, Eshetu N, Ly S, Dessalegn, B. Prevalence and Severity Of Menopause Symptoms Among Perimenopausal And Postmenopausal Women Aged 30-49 Years In Gulele Sub-City Of Addis Ababa, Ethiopia. BMC Womens Health. 2017;17(1):124. doi: 10.1186/s12905-017-0484-x. PubMed PMID: 29216870; PubMed Central PMCID: PMC5721600. ## 5. Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, et al. Executive summary of the Stages of Reproductive Aging Workshop+ 10: addressing the unfinished agenda of staging reproductive aging. Menopause. 2012;19(4):387-95.‏ doi: 10.1097/gme.0b013e31824d8f40. PubMed PMID: 22343510; PubMed Central PMCID: PMC3340903. ## 6. Nisar N, Sikandar R, Sohoo NA. Menopausal symptoms: prevalence, severity and correlation with sociodemographic and reproductive characteristics. A cross sectional community-based survey from rural Sindh Pakistan. J Pak Med Assoc. 2015;65(4):409-13. PubMed PMID: 25976577. ## 7. Karmaker N, Majumdar S, Dasgupta A, Das S. Quality of Life Among Menopausal Women: A community-based study in a rural area of West Bengal. J Midlife Health. 2017;8(1):21-27. doi: 10.4103/jmh.JMH_78_16. PubMed PMID: 28458476; PubMed Central PMCID: PMC5367220. ## 8. Orley J, Kuyken W. Quality of life assessment: international perspectives. Berlin: Springer-Verlag; 1994. p. 41-60. ## 9. Smail L, Jassim G, Shakil A. Menopause-Specific Quality of Life Among Emirati Women. Int J Environ Res Public Health. 2019;17(1):40. doi: 10.3390/ijerph17010040. PubMed PMID: 31861588; PubMed Central PMCID: PMC6981970. ## 10. World Health Organization. WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment; 1996. Available from: ## 11. Eljedi A, Mikolajczyk RT, Kraemer A, Laaser U. Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study. BMC Public Health. 2006;6:268. doi: 10.1186/1471-2458-6-268. doi: 10.1186/1471-2458-6-268. PubMed PMID: 17074088; PubMed Central PMCID: PMC1634853. ## 12. Schoenaker DA, Jackson CA, Rowlands JV, Mishra GD. Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents. Int J Epidemiol. 2014;43(5):1542-62.‏ doi: 10.1093/ije/dyu094. PubMed PMID: 24771324; PubMed Central PMCID: PMC4190515. ## 13. Nassar B, Nabresi N, AlSaudi L, Belkebir S. Menopausal symptoms and quality of life among Palestinian women visiting primary care clinics in Nablus, a cross sectional study 2018-2019.‏ Graduation research project. Available from: ## 14. Blumel JE, Chedraui P, Baron G, Belzares E, Bencosme A, Calle A, et al. Menopausal symptoms appear before the menopause and persist 5 years beyond: a detailed analysis of a multinational study. Climacteric. 2012;15(6):542-51.‏ doi: 10.3109/13697137.2012.658462. PubMed PMID: 22530706. ## 15. Rathnayake N, Lenora J, Alwis G, Lekamwasam S. Prevalence and severity of menopausal symptoms and the quality of life in middle-aged women: a study from Sri Lanka. Nurs Res Pract. 2019;2019:2081507. doi: 10.1155/2019/2081507. PubMed PMID: 31354992; PubMed Central PMCID: PMC6632501. ## 16. Sharad PP, Devi NS. A descriptive study to assess the menopausal symptoms and quality of life among menopausal women in selected areas of Pune city. City. Int J Health Sci, 2022;6(S6):1904-1913.‏ doi: 10.53730/ijhs.v6nS6.9989. ## 17. Lan Y, Huang Y, Song Y, Ma L, Chen P, Ying Q, et al. Prevalence, severity, and associated factors of menopausal symptoms in middle-aged Chinese women: a community-based cross-sectional study in southeast China. Menopause. 2017;24(10):1200-1207. doi: 10.1097/GME.0000000000000906. PubMed PMID: 28609386. ##