Date of Award

12-2024

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Jai Das

Second Advisor

Dr Iqbal Azam

Third Advisor

Dr. Nadeem Zuberi

Department

Community Health Sciences

Abstract

BACKGROUND: Hormone replacement therapy, or HRT, is frequently used to treat menopausal symptoms and enhance postmenopausal women's quality of life. However, there are significant differences in the use of HRT across various socioeconomic and cultural contexts, especially in low- and middle income nations where availability and awareness may be restricted. The purpose of this study was to determine the prevalence of HRT use, investigate its effects on postmenopausal women's quality of life QoL, and investigate correlations with sociodemographic variables such age, marital status, socioeconomic status (SES), and educational attainment. There is now not much literature available for Asian countries, while the majority is available for Western countries. AIMS To investigate the frequency, which factors influence, and how HRT use affects postmenopausal women’s Quality of life QoL in a varied Karachi healthcare population in a private tertiary hospital setting. METHODS: This study used an analytical cross-sectional design of 138 post-menopausal women to investigate the frequency of HRT and the impact of hormone replacement therapy (HRT) on the quality of life of healthcare professionals within various groups at Aga Khan University Hospital in Karachi. An analytical cross-sectional study design allows for the simultaneous assessment of both exposure (HRT) and outcome QoL among participants within a specific timeframe.
RESULTS: At Aga Khan University Hospital, we investigated how (HRT) affected postmenopausal women. The prevalence of HRT was found out to be 22.46% in this population. With a very significant value of 0.0000 (95% CI: 2.82 - 22.95, χ² = 21.51), our results indicated that HRT users were 7.69 times more likely than non-users to report a higher quality of life. This clearly implies that HRT is associated with an improved standard of living. 9 | P a g e Examining menopausal symptoms, we found that the two groups differed significantly. Only 43.93% of HRT users reported having insomnia, compared to 77.01% of nonusers (p = 0.00, χ² = 21). Additionally, memory problems were more prevalent among non-HRT users (83.87%) than in HRT users (59.8%) however the result was statistically significant (p=0.05,χ² = 19.8) indicating that HRT may help with problems like lack of sleep and poor memory problems. It's interesting to note that some symptoms, like dry vagina and weight gain, were common in both groups. Compared to non-recipients (67.29%), HRT users gained weight more frequently (80.65%), however the difference was not statistically significant (p = 0.06,χ²=13.7). Although there was a statistically significant difference (p = 0.03), vaginal dryness was nevertheless common in both groups. According to significant p-values of 0.04 (χ² = 20) and 0.06 (χ² = 11.46), respectively, HRT users also reported less hot flushes and night sweats. Moreover, HRT users were less likely to be dissatisfied with menopausal symptoms (p = 0.05, χ² = 23.4). Additionally, we discovered a strong correlation between the prevalence of anxiety and depression with HRT use. Only 32% of HRT users reported having anxiety or depression, compared to 51% of non-users (OR = 0.45, 95% CI: 0.17 - 1.12, p = 0.060, χ² = 3.54). This implies that using HRT may be associated with a higher quality of life as well as a lower risk of anxiety or depression.
CONCLUSION: According to the results, HRT can help postmenopausal women feel better and have less menopausal symptoms. Despite these advantages, there are notable regional differences in the uptake of HRT. In South Asia, where cultural attitudes, limited access to healthcare, and a lack of knowledge about HRT affect its use, higher rates of HRT consumption are found, in stark contrast to lower rates in Western countries. Many women find it difficult to benefit from treatments like HRT because of low socioeconomic level in some areas, which also makes it harder for them to access and understand menopausal management choices. In order to improve the quality of life for postmenopausal women, our findings underscore the necessity of stepping up public health 10 | P a g e initiatives aimed at raising awareness and accessibility of HRT, especially in underprivileged populations.

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1

Last Page

45

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