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The purpose of this review study is to evaluate sexual function and its effective factors in menopause. After reviewing the selected articles, 27 papers were selected based on the criteria for entering the study and the goals set.

Description

Metrics details. The present work aimed at determining the prevalence of menopausal symptoms and factors associated with the Quality of life among postmenopausal women. This cross-sectional work was carried out on postmenopausal females referring to health centers of Hamadan city chosen by stratified random sampling. The ificance level of statistical tests was regarded as less than 0.

Also, vasomotor symptoms had the highest score, and sexual symptoms had the lowest score rather than other dimensions. Based on thevasomotor symptoms were the most dominant symptom. Therefore, it is necessary to improve physical activity levels, focusing on job status, recommend taking an omega 3 s supplement, and planning education and promotion intervention for cessation or prevention of smoking among postmenopausal women to increase the MENQOL is essential.

Peer Review reports.

Due to a decrease in the estrogen level of blood, menopause causes several symptoms and complications in women, including termination of reproductive capacity resulting in the complete cessation of ovarian function [ 12 ], vasomotor instability, decreased psychological function, forgetfulness, and vaginal and urinary tract infections [ 3 ].

Regarding cultural and ethnic differences, the severity and frequency of these symptoms vary in different countries [ 14 ]. Factors such as genetics, dietary habits, level of activity, and daily exercises cause differences in the natural age of menopausal in various communities.

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Low self-efficacy, extensive cultural conflicts, and socioeconomic inequalities, belief and gender inequalities, knowledge of the menopausal process, and stressors are the most ificant factors influencing the menopausal Quality of life QOL [ 5 ]. As a result, vasomotor symptoms show a higher prevalence in African American and Western women than Asian women [ 6 ]. The World Health Organization WHO has defined the QOL as people's insights into their life status within the value and cultural systems where they live and concerning their expectations, goals, concerns, and standards [ 7 ].

The multidimensional QOL has been accepted nowadays [ 6 ]. Changes in life expectancy have led to an increase in post-menopausal life expectancy in women. Each woman spends at least one-third of her life during the menopausal period [ 8 ]. Statistics show an increasing of postmenopausal women worldwide.

Inmore than million women were living in the postmenopausal period, and this rate will reach 1. According to some newer statistics in the US, people reach menopausal age every day, and about 50 million will be menopausal over the next decade.

Iran is also expected to have about 5 million women with menopausal byleading to demographic changes and population aging [ 10 ]. The mean age of menopausal in Iran is lower than that in other countries due to several factors. Based on the of various studies in Iran, the QOL of menopausal females has been reported at a moderate level [ 1112 ].

Women make up half of Iran's population. Therefore, gaining information and knowledge of their conditions in various dimensions and planning to reform their conditions to affect society and family health seems necessary [ 13 ]. Also, given the role of women as the key members of family health and transmitting the model of education and promoting a healthy lifestyle to the next generation, acquiring knowledge of this period's symptoms and enhancing their QOL is of great necessity [ 514 ].

The current descriptive-analytical cross-sectional work was performed on women aged 45—60 years covered by Hamadan health centers in Using the data of studies [ 15 ] and the formula for determining the sample size [ 16 ], the minimum sample size was determined at people. In the present research, the participants were selected using the stratified sampling method. Accordingly, after listing health centers in Hamadan, some of these centers were selected using a cluster sampling method.

Then, after gaining permits from the centers' authorities, the samples were selected from the population covered by each center.

Finally, some women aged 45—60 years covered by the centers were selected, and the data were collected. The inclusion criteria were being 45—60 years, having normal menopausal, living in Hamadan, lack of alternative hormone therapy in the past six months, no history of hysterectomy, and lack of known systemic illness.

The exclusion criteria also included non-responding to all items of the questionnaire and having any physical and mental illness based on their self-report. All methods were performed in accordance with relevant guidelines and regulations.

Sexual function and factors affecting menopause: a systematic review

The word informed consent was obtained from all women; they were informed about the confidentiality of the information and the project's purpose, and only if they would like, they were enrolled in the study. The data collection tool used in this study consists of two parts completed by the women through the self-reporting method. The first part includes demographic information such as age, education level, economic status, marital status, smoking, job, physical activity, and supplemental Omega-3 s intake.

This scale, which also was used in this study, is adopted to the Persian language and is appropriate for Iranian culture [ 1719 ]. The validity and reliability of the questionnaire have been confirmed in several similar studies.

The coefficients were 0. This questionnaire was on a seven-point Likert scale ranging from 0 to 7. It is essential to be mention, with increasing MENQOL scores, levels of bother experienced from the symptom are increased as well.

According to the definition of WHO, menopausal health was considered menstruation cessation without medication for at least 12 months [ 4 ]. Before the study, necessary explanations were provided for the subjects regarding the study's objectives, and their informed consent was obtained. The subjects were selected and included in the study in terms of exclusion and inclusion criteria.

The factors associated with the quality of life among postmenopausal women

The demographic characteristics questionnaire and QOL questionnaire of postmenopausal females were completed through a face-to-face interview. SPSS V. The Mann—Whiney test and the Kruskal—Wallis test were used to compare different dimensions of QOL according to individual characteristics. The mean age of the women was About Other demographic and characteristics of participants are presented in Table 1. Generally, the most dominant symptom, reported by Besides, vasomotor symptoms with 2. In the other words, we found that vasomotor symptoms had the highest mean scores and sexual symptoms had the lowest scores in all domains Table 3.

The present work was performed to determine the prevalence of menopausal symptoms among postmenopausal females and factors associated with the Quality of these women's lives in Hamadan city. Based on the obtainedthe lowest symptoms belonged to the sexual dimension, which is in line with the outcomes of the study conducted by Chedraui et al.

So, it can be stated that enhancing information and knowledge alongside high education level, increasing support and counseling [ 10 ], and improving adaptation and adaptive behaviors in postmenopausal periods may improve the MENQOL in the sexual dimension among this group of menopausal women. The findings indicated a ificant association Older 45 hot sex Aracena the total QoL score and job, economy status, smoking, exercise, and supplemental Omega-3 s intake.

In general, employed women may have better access to health care services and adapt to postmenopausal symptoms. On the other hand, based on the of Fallahzadeh et al. Overall, it seems that menopausal women are more likely to have menopausal complications because of the stresses of working at home.

So, it may be necessary to de and implement effective educational and promotional interventions to improve the sense of usefulness in menopausal women. The poor economic status may cause the severity of menopausal symptoms. In this sense, Li et al. His finding is also similar to that reported by Fallahzadeh et al. However, being employed and having high-income levels may be increased access to healthcare or the level of coping mechanisms for menopausal symptoms.

Nicotine dependence and smoking may reason the severity of menopausal Symptoms amongst postmenopausal women Smokers. These are consistent with the funding of Copeland et al. However, cigarette smoking and hookah smoking have antiestrogenic properties, which may health risks associated with menopause symptoms.

A high physical activity level may reduce the menopausal symptom. This funding is similar to the of other studies [ 2728 ]. Concerning, exercise has long been proven to be as effective as relaxation and meditation, as well as aerobic exercise, induces weight loss and increases in their hot flashes' severity and reductions in the risk of memory problems. It should be noted that exercise and physical activity in this group of women le to increased social interactions, and group aerobic exercise le to improved mental health and Quality of life in this group of people.

So, having exercise play improvement of women's Quality of life in menopausal women.

There was an association between menopausal symptoms and supplemental Omega-3 s intake in postmenopausal women. Saimin et al. Studies showed that supplemental omega-3 s could improve overall health conditions [ 3031 ]. So, de and planning intervention programs for a healthy lifestyle [ 32 ], for the improvement of women's Quality of life in menopausal women seems to be essential. Additionally, in the psychosocial, physical domains, women who were in the postmenopausal stage less than 5 years ago had lower scores than those who were in the postmenopausal stage more than 5 years ago.

Also similar to that reported by Fallahzadeh et al. Nevertheless, some women experience symptoms earlier during the time since menopause while some experience them at a later time. Concerning, older women might have learned to handle menopause-related symptoms over time.

In the present study, the highest MENQOL in menopausal women belonged to the vasomotor dimension, and the lowest belonged to the sexual dimension. In line with this result, several studies by Barati et al. Moreover, Reproductive hormones seem to play a ificant role in this regard.

In this period, dramatic changes occur in hormone levels, including reduced severe estrogen, which in Vasomotor symptoms VMS such as hot flushes and night sweats. Some studies have reported an increase in the frequency of vasomotor symptoms, which is consistent with the current work [ 38 ]. Following the outcome, physical symptoms were the most experienced and complained factors, among other dimensions in the postmenopausal period. In agreement with the findings in the current work, Ceylan et al. It seems that factors such as reproductive hormones play a major role in this regard.

As a result, dramatic changes in hormones, including a severe reduction in estrogen, occur, leading to physical symptoms during this period. This result is in accord with paying attention to menopausal in health care services programs to enhance women's life expectancy seems to be useful in this field. The major limitation of the present study is its self-reporting and descriptive cross-sectional nature. Therefore, it is recommended to investigate the subject of the present study as a longitudinal or trial study.

Given the complexity of MENQOL dimensions, a qualitative study of menopausal phenomena and understanding other related factors can also be helpful. In general, the of the present work revealed that vasomotor symptoms were the most dominant symptom.

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