Health Issues of Postmenopausal Women in Sri Lanka: A Community-based Pilot Study in Selected Public Health Midwife Areas.

Introduction: Menopausal health is vital for low-middle-income countries such as Sri Lanka as the proportion of postmenopausal women is projected to increase with time. However, research into health issues of postmenopausal women is limited in Sri Lanka. The objectives of this study were to describe the menopausal symptoms and noncommunicable diseases (NCDs) in postmenopausal women with an objective to derive recommendations to improve the healthcare delivery. Subjects and Methods: A descriptive cross-sectional study was conducted in sequentially selected public health midwife areas that were randomly selected from Kalutara district, Sri Lanka. The inclusion criterion was postmenopausal women with the exclusion criterion being women on menopausal hormone therapy. Results: The median (interquartile range) age at menopause was 50 (46-51) years. One or more NCDs were already diagnosed in 280 (65.3%) women. Dyslipidemia was diagnosed in 71.5%, hypertension in 58%, and diabetes in 30.5% of women. There were also 280 (65.3%) women with metabolic syndrome. Cardiovascular disease risk was more than 10% in 28.5% of women. The 10-year major osteoporosis fracture risk was 25.4%, whereas the 10-year mean hip fracture risk was 25.9%. Menopausal symptoms (one or more) were present in 420 (97.9%) women. Urogenital symptoms were present in 172 (40.1%) of women. A Menopause Rating Scale total score ≥4 was seen in 302 (70.4%) women. Conclusion: A high prevalence of NCDs, osteoporosis-related fracture risk, and menopausal symptoms were observed in the study sample. The burden of NCDs and the hitherto unidentified risk of osteoporosis in postmenopausal women in Sri Lanka will have palpable socioeconomic implications in the future.