Menopause and osteoporosis....A double whammy?? A cross-sectional study among peri- menopausal women in Vadodara, India
Objective: To find prevalence of musculoskeletal(MS) symptoms and correlate MS score with clinical and derived parameters among peri-menopausal women
Methods: Analytical cross-sectional study was conducted in field area of Department of PSM,Medical College Baroda.Study tool was developed and validated with the Menopausal Rating Scale(MRS).Taking prevalence 40%(p),at 95% confidence and power 80,sample size was estimated to 145(npower2.0)each,for rural and urban area.290 peri-menopausal age group women(45-55 years;defined by Indian Menopausal Society-IMS) were interviewed purposively.MS symptoms experienced by them(scored 0-4) were documented.VitaminD and S.Calcium levels,BMI and BMD were measured after written consent.Based on BMD score and FRAX tool,10 year risk of osteoporotic fracture and hip fracture was calculated.Based on BMI values,a variant of FRAX tool was used to get 10 year risk of osteoporotic fracture and hip fracture.Osteoporotic self assessment tool for Asians(OSTA),based on age(years) and weight(kg) was calculated and correlation between MS score was determined using Spearman’s Correlation coefficient (Ƿ-rho)
Results: Joint pain(74%) was the most common MS symptom followed by joint and muscular discomfort(72%).Median MS score difference was statistically significant in menopausal and pre-menopausal groups(p<0.0001).There was weak positive and weak negative correlation;statistically insignificant;between MS score and OSTA,VitaminD and S.Calcium levels(Ƿ= 0.11;CI:-0.005 to 0.22,Ƿ=0.059;CI:-0.05 to 0.17 and Ƿ=-0.018;CI:-0.13 to 0.09) respectively.BMD showed negative correlation with MS score(Ƿ-rho=0.29,p=0.0003).All fracture risk estimations for osteoporotic and hip fracture estimation(derived parameters) based on BMD and BMI were positively correlated with MS score(p<0.05)
Conclusion: Peri- menopausal women experience a myriad of MS symptoms.Derived parameters like FRAX tool and OSTA need to be evaluated for their importance for correlation of symptoms.