ABSTRACT

Corresponding Author:
Dr. D. Shakeela,
15-13-16/2, Akruti Annapurna Residency,
Krishna Nagar, M. R. Peta, Visakha Patnam, Andhra Pradesh.
E-mail: janakibabu@yahoo.co.in
DOI:10.14260/jemds/2015/2366

ABSTRACT

The World Health Organisation defines perimenopause as the period (2-8 yrs.) preceding menopause and the one year after final menses resulting from the loss of ovarian follicular activity.^(1,2) It can be described as a woman goes from a state of normal cyclicity to an ultimate state of permanent hypergonadotropic hypogonadism and amenorrhoea. This study has been designed to study changes in various parameters in perimenopausal women belonging to two socioeconomic groups. All the parameter was measured before the start of the study and at the end of study. After two years it was found that there was changes in parameter in both the group, but changes in high socioeconomic.

KEYWORDS

Perimenopause, Metabolic Parameters, Socioeconomic Status.

INTRODUCTION

The World Health Organisation defines perimenopause as the period (2-8 yrs.) preceding menopause and the one year after final menses resulting from the loss of ovarian follicular activity.^(1,2) It can be described as a woman goes from a state of normal cyclicity to an ultimate state of permanent hypergonadotropic hypogonadism and amenorrhoea. The rate of increase in mortality and morbidity has been accelerated due to CHD after perimenopausal period. Lipid profile used to change with age in both the sexes, but in male this change used to start in third decade, but in woman it starts in 5th decade.^(3,4)

In various study it has been found that ovarian hormone deficiencies or perimenopausal state is associated with reduced insulin sensitivity.⁽⁵⁾ Considering these facts, this study has been designed to study changes in various parameters in perimenopausal women belonging to two socioeconomic groups.

MATERIAL AND METHOD

This is a prospective study carried out in coastal district of Andhra Pradesh, in the Dept. of Physiology, Rangaraya Medical College. Before start of the study permission from the institutional ethics committee was obtained. Written consent was taken from the patient enrolled for the study in two languages. Forty women between age group 45 to 55 yrs. were selected; out of 40 patients 20 were housewives from middle class family having annual income of the family more than 5 lakhs/annum; rest 20 patients were from family where income was less than 2 lakhs per annum and these woman were working 6 to 8 hrs a day. They were selected as per exclusion criteria and enrolled for study.

DISCUSSION

Perimenopausal is a period of menstrual irregularity and hormonal variability. Cardiovascular disease risk factor used to increase.

Changes in LDL in perimenopausal period:-

There was significant increase in LDL concentration after two years of followup. The percentage change in mean LDL concentration in both the groups were increased, change in the group B was slightly more than group A. Various studies also found same result that changes in the LDL conc. used to occur in early transition peak of premenopausal period .^(7,8)

Changes in the HDL during perimenopausal period:-

Some studies found that there is significant fall in HDL during perimenopausal period, but others found that there is no significant change.^(9,10) Kennel et al., but in our study there was significant fall in HDL in group with good socioeconomic status, but fall in HDL was not significant in poor socioeconomic status women with 11.30% and 2.2% respectively.

Change in the triglycerides concentration during perimenopausal period:

The percentage increase in mean TG concentration was more in Group A than Group B that was 12.4% and 5% respectively, which was significant statistically. Poehlman et al., found that TG concentration was increased by 16%.⁽¹¹⁾

Changes in serum cholesterol concentration during perimenopause:

Changes in the serum concentration of cholesterol was less; it has increased by 3% and 3.7% respectively in Group A and Group B, which was as per the study of authors. 

Changes in C-peptide concentration:

It has been found in various study that perimenopausal stage is a stage of change in sensitivity of insulin or transition into insulin resistance, so by various authors it has been found that C-peptide insulin level used to increase.^(12,13) In our study also, we have found that there was significant increase in the C-peptide concentration after 2 yrs. in perimenopausal period.

Now regarding various clinical presentation of menopause, it has been found that frequent menses, hot flushes and vaginal dryness were common in both the group of women.

One of the important parts of our study is the difference in changes as per socioeconomic group. It has been found that changes in the parameter was less in low socioeconomic woman than in the good socioeconomic age group. Clinical presentation was same as the woman of working class, but as  having calories consumption less and utilization was more, so that may be one of the causes of that. It is similar to the study of other worker.⁽¹⁴⁾ But in Indian scenario, the studies are less and it has to be evaluated in detail.⁽¹⁵⁾

CONCLUSION

Aging process is one of the bitter truths of nature. The living thing who has taken birth has to grow old and die at some time. New born will replace them. But as we know that living condition and medical facilities has improved, so life expectancy has increased and we have more geriatric population. So graceful aging is the new concept and demand of these changing scenarios. That is why the better understanding of change in physiology is required. After two years it was found that there was changes in parameter in both the groups, but changes in high socioeconomic group was more. A thorough study of these changes is required by using more number of women and including more parameters and resources.

BIBLIOGRAPHY

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