The Prevalence of Depression Among Menopausal Female Teachers in Nairobi County, Kenya

Abstract

Background: Menopause is generally well-tolerated in most women. Many studies, albeit inconsistent findings have shown that during the menopausal phase, women are 2 – 5 times more likely to get depression than in any other phase of their reproductive life cycle. The rate of depression declines 2 to 4 years after the Final Menstrual Period (FMP). Study objective: The aim was to determine the prevalence of depression in menopause, the associated severity of menopausal symptoms with depression among female teachers in primary and secondary schools in Nairobi County, Kenya. Method: The study used a descriptive cross-sectional study design. The calculated sample size was 296. Using multi-level sampling procedure, schools were randomly selected from four constituencies: Langata, Embakasi East, Westlands and Starehe in Nairobi County. Participants were equally distributed across the four constituencies with proportional sampling in primary and secondary schools. The tools used for the study included sociodemographic questionnaire, menopausal rating scale (MRS) and patient health questionnaire (PHQ-9). Data Analysis: All completed forms were thoroughly checked for errors. Collected data was entered into Google forms. The data was analysed using SPSS V.22. Variables that were continuous have accompanying standard deviations. Bivariate analysis using Fischer’s exact test was used to confirm correlation between variables using crude odds ratio. Results: The prevalence of depression in menopause was at 49% with 35% (N=104) of the respondents reporting mild severity. Menopausal symptoms using the MRS scale were found in 92% of respondents with 53% (N=156) reporting moderate symptoms. 51% (N=152) had their Final Menstrual Period (FMP) less than 18 months ago. 85% (N=212) of the respondents were under GoK. Married respondents were 56% (N=165) with 48% (N=141) of their spouses having tertiary level of education. 76% (N=224) of the participants had at least 4 (four) children and all the respondents reported to exercise at least 30 minutes every day. Conclusion: Depression is evidently common among menopausal teachers and is associated with moderate to severe menopausal symptoms. Absence of spouse and a teenage last born were significantly associated with menopausal depression. Married respondents with spouses of tertiary level of education reported fewer cases of depression. Locally, menopausal depression showed a higher prevalence compared to other forms of reproductive depression: PMDD 31% and PPD 11.1%. There were no studies on perimenopausal & post-menopausal depression. Further studies are necessary to better understand the scope of menopausal depression in order to guide appropriate interventions that can provide early detection and treatment for those at risk and affected by depression.