Windagreena050/ns17@student Unusa Ac Id

RELATIONSHIP OF NUTRITIONAL STATUS AND HISTORY OF
REPRODUCTIVE HEALTH WITH OSTEOPOROSIS RISK IN MENOPAUSED

WOMEN IN WISMA TENGGER AREA RT 01 RW 06
SURABAYA
Winda Greena Febriani
S1 Nursing Study Program, Faculty of Nursing and
Midwifery, Nahdlatul Ulama University Surabaya
Windagreena050/ns17@student.unusa.ac.id
ABSTRACT
People in the Wisma Tengger area have an age of 50 years, especially mothers. The
problem that often occurs is that some women in the Wisma Tengger area complain of pain
when doing physical activities, sudden leg cramps when climbing stairs and having a low
body mass index can affect the reproductive history of the age of first menstruation
(menarche) so that it can cause calcification of the bones (osteoporosis). ). The purpose of
this study was to determine the relationship between nutritional status and reproductive
health history with the risk of osteoporosis in menopausal women in the Wisma Tengger
area RT 01 RW 06 Surabaya in 2021. This study was an analytical observational study
with a cross sectional approach. This study uses non-probability sampling using purposive
sampling technique with a sample size of 36 people. This research data collection using a
questionnaire sheet. Data analysis using Chi Square test statistical test. The results showed
that from 36 respondents there were 24 respondents (83%) Positive Risk of osteoporosis
and there was late menarche 20 respondents (55.5%) Positive at risk of osteoporosis. There
is a relationship between nutritional status and reproductive history with osteoporosis risk
for postmenopausal women in Wisma Tengger RT01 RW06 Surabaya (p-value = 0 < 0.05).
Keywords : nutritional status, reproductive health history, risk of osteoporosis,
menopausal women.
ABSTRAK
Masyarakat diwilayah Wisma Tengger mempunyai usia ≥50 tahun terutama ibu-ibu.
Masalah yang sering terjadi sebagian ibu-ibu diwilayah Wisma Tengger mengeluh nyeri
saat melakukan aktivitas fisik, tiba-tiba keram kaki saat menaiki tangga dan mempunyai
indeks massa tubuh rendah dapat mempengaruhi riwayat reproduksi usia pertama kali haid
(Menarche) sehingga dapat menimbulkan pengapuran tulang (osteoporosis). Tujuan
Penelitian ini adalah untuk mengetahui Hubungan Status Gizi Dan Riwayat Kesehatan
Reproduksi Dengan Resiko osteoporosis Pada Wanita Menopuse Di Wilayah Wisma
Tengger RT 01 RW 06 Surabaya Tahun 2021. Penelitian ini merupakan jenis penelitian
observasional analitik dengan pendekatan cross sectional. Penelitian ini menggunakan
pengambilan sampel secara nonprobability sampling dengan menggunakan teknik
purposive sampling besaran sampel 36 orang. Pengumpulan data penelitian ini
menggunakan lembar kuisioner. Analisis data dengan menggunakan uji statistik Uji Chi
Square. Hasil penelitian menunjukkan dari 36 responden terdapat 24 responden (83%)
Positif Resiko osteoporosis dan terdapat menarche lambat 20 responden (55,5%) Positif
beresiko osteoporosis. Terdapat hubungan antara status gizi dan riwayat reproduksi dengan
resiko osteoporosis terhadap wanita menopause di wilayah Wisma tengger RT01 RW06
Surabaya (p-value = 0 < 0.05).
Kata Kunci : Status gizi, Riwayat Kesehatan Reproduksi, Resiko Osteoporosis,
Wanita Menopause.
NAHDLATUL ULAMA UNIVERSITY SURABAYA
CAMPUS A JL. SMEA NO. 57 SURABAYA (031) 8291920 , 8284508, FAX (031) 8298582
KAMPUS B RS. ISLAM JEMURSARI JL. JEMURSARI No. 51-57 SURABAYA
Tel. (031) 8479070 , Fax. (031) 8433670
Websites: www.unusa.ac.idEmail : info@unusa.ac.id
PRELIMINARY Research in several cities in 2019

The average community in the including the city of Surabaya, shows that
Wisma Tengger area I often encounter osteoporosis in Indonesia should be
has activities that are at risk for fractures, watched out for. Patients with
especially mothers aged 50 years. osteoporosis by 29% of 101.161
Without them knowing it, menopause respondents(Ministry of Health, 2019).
occurs when there is a decrease in ovarian Based on secondary data from the
function. A sudden drop in estrogen Sememi Public Health Center aimed at
levels can cause various the Wisma Tengger area, RT 01 RW 06
symptoms(Nugroho, 2014). Some Surabaya, the number of menopausal
women in the Wisma Tengger area have women is 50, 40 respondents (80%) are at
a low BMI and complain of pain when risk of osteoporosis, 10 (20%).
doing physical activities, suddenly
Factors that cause osteoporosis in
having leg cramps when climbing stairs,
menopausal women include gender, age,
which can cause calcification of the
race, family history, body type,
bones (osteoporosis). The results of the
menopause, nutritional status, history of
interviews that I conducted at this time,
reproductive health, diet, smoking habits
mothers in the Wisma Tengger area did
and drinking alcohol. Menopausal
not know that menopause could be at risk
women and have reached bone mass also
for osteoporosis, and some mothers did
increase the need for calcium,
not consume calcium intake.
reproductive health stops the menstrual
the prevalence of osteoporosis in cycle, and the ovaries stop producing
Asian women has decreased from 32.5% estrogen, estrogen is a female
to 25.1%, but this figure is still high reproductive hormone and this hormone
compared to the data for white women stimulates osteoblasts for bone formation
(10.8%). In 2020, the prevalence of and decreases the activity of osteoclasts
osteoporosis in Indonesia in women aged that damage bones. To minimize the risk
50-70 years and age 70 years, of osteoporosis, you can consume foods
respectively, is 23% and 53%, in men it rich in calcium that are high in food or
is 38%.>(Ministry of Health, 2019). East from calcium supplements
Java Province has a higher prevalence of
increase bone mineral content and
osteoporosis risk (22.2%) than the
bone density and reduce the risk of
national prevalence rate (10.3%).
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fractures during menopause, avoid foods Nutritional Status Descriptive

that can accelerate bone loss (eggplant, Items Frequency Percentage
(%)
potatoes, tomatoes, black tea, sour fruits,
a. BMI (Body Mass
red meat and reduce sugar consumption) Index)
Malnutrition 29 80.6%
and to avoid nutritional status Normal Nutrition 7 19.4%
menopausal women by consuming More Nutrition 0 0.0%
b. LILA
adequate calcium needs by consuming KEK 24 66.7%
milk, yogurt, cheese, bone fish, broccoli, Normal 12 33.3%
c. Nutritional
and nuts (Desfita, 2020). So that it can Assessment
Based on BMI 29 80.6%
minimize the risk of osteoporosis during 7 19.4%
and Lila
menopause. Malnutrition
Good Nutrition
RESEARCH METHODS
NUMBER OF 36
This research is an analytic RESPONDENTS
observational research type with a cross Based on table 1 above, from 36
sectional approach. respondents, almost all of the respondents

(81%) belonged to the nutritional
The population in this study were
category (BMI = 18.5) and it was found
all mothers aged 50 years who had
that most of the respondents (67%)
menopause and were at risk of
belonged to KEK (chronic energy
osteoporosis in the Wisma Tengger Rt01
deficiency (CED <23.5 cm)) so that from
Rw06 Surabaya area of 40 respondents
the assessment of nutritional status based
from the data obtained at the Sememi
on BMI and Lila it was obtained
Health Center. Collecting data in this
almost all of the respondents (80.6%) in
study using a questionnaire sheet. Data
the calculation of BMI and LILA
analysis using Chi Square test statistical
Malnutrition: BMI < 18.5 and/or Lila <
test.
23.5.
RESEARCH RESULT
Table 2. The frequency distribution of
Table. 1 Frequency distribution of
respondents based on Nutritional Status
respondents based on age, BMI (Body
is calculated from BMI and LILA seen
Mass Index) and Lila calculations for
from the respondent's age, final
postmenopausal women with
education, main occupation and income
osteoporosis risk in Wisma Tengger
that affects menopause with osteoporosis
RT01 RW06 Surabaya, July 2021.
risk in the Wisma Tengger Region RT01
RW06 Surabaya, July 2021.
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respondents were malnourished, almost

Items Nutritional status
87% of respondents were not working.
BMI & LILA
Good Malnu (Does not have income) and respondents
Nutrition trition with nutritional status based on income,
1. Respondent Age
Less than 55 years old 5 (45%) 6 (55%) most of them income > 4,000,000,
55-64 years old 2 (9%) 20 (91%) mostly 60% of good nutrition, totaling 3
65-74 years old 0 (0%) 2 (100%)
75+ years old 0 (0%) 1 (100%) people.
2. Last education
No school 0(0%) 2 (100%) Table 3. Frequency distribution of
Elementary School (SD) 0 (-) 0 (-) respondents based on reproductive
Junior High School (SMP) 0 (0%) 7 (100%)
High School (SMA) history based on menarche (age of first
College 3 (14%) 19 (86%) menstruation) and risk of osteoporosis in
(Diploma/Bachelor/
Magiste) 4 (80%) 1 (20%) postmenopausal women in Wisma
3. Main Job Tengger area RT01 RW06 Surabaya,
Not Working (no income) 4 (13%) 27 (87%)
Merchants (kiosks, shops, 0 (0%) 1 (100%) July 2021.
online, resellers, etc.)
Manufacturers 0 (-) 0 (-) Items Descriptive
(baking/cooking, Frequ Percentage
handicrafts/handicrafts, ency (%)
etc.) Menarche
Service providers (tailor, 0 (-) 0 (-) (Age of first
laundry, ART, salon, etc.) menstruation)
Employees (private/PNS) 3 (75%) (25%) Fast
Menarche 0 0.0%
Retirees (private/PNS) 0 (-) 0 (-) (< 12 years)
Normal
Menarche 16 44.4%
(10-14 years)
Slow
Menarche 20 55.5%
4. Income (≥ 15 years)
4,000,000 0 (-) 0 (-) Osteoporosis
> 4,000,000 3 (60%) 2 (40%) Risk
Positive risk of 24 66.67%
osteoporosis
Based on the table above, of 36
Negative no
respondents with nutritional status based risk of 12 33.33%
osteoporosis
on the age of respondents 55-64 years,
Total 36
almost 91% of respondents were respondents
malnourished, nutritional status
respondents based on high school
education were almost entirely 86% of
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Based on the table above, from 36 between nutritional status and

respondents, most of the respondents reproductive health history with the risk
(55.5%) in the calculation of of osteoporosis in postmenopausal
reproductive history saw from menarche women in the Wisma Tengger area RT01
(late menarche: 15 years) and obtained RW06 Surabaya.H1
most of the respondents (66.67%) in DISCUSSION
1. Nutritional status in menopausal
calculating the risk of osteoporosis in
women
women menopause by category (have Nutritional Status Research
osteoporosis-positive risk if T score > Results Based on the calculation of BMI
mean T score). and LILA with factors that affect
menopause, table 1 shows that almost
Table4.Cross tabulation of the
all of the 36 respondents (80.6%)
relationship between nutritional status
belong to poor nutritional status.BMI <
and reproductive health history with the
18.5 and/or Lila < 23.5.
risk of osteoporosis in postmenopausal
women in the Wisma Tengger area RT01 According to Widjayanti (2021)
RW06 Surabaya, July 2021. During menopause there is a decrease in
Osteoporosis Risk estrogen levels, this causes changes in
Negative Positive metabolism. Changes in body
Nutritional Status
(BMI-LILA) 5 (17%) 24 (83%) metabolism can increase cholesterol,
Malnutrition 7 (100%) 0 (0%) lack of body calcium, disorders of the
Good Nutrition
Reproductive bones (osteoporosis) and weight gain.
History (menarche) Women with good nutritional status
Fast Menarche 0 (-) 0 (-)
Normal Menarche 16 0 (-) experience menopause at a normal age,
(44.4%) while women with obesity experience
Slow Menarche 0(-) 20 (55.5%)
menopause more slowly(Diane, 2015).
p-value = 0 < 0.05
According to Wisnu (2012), age
in women has a significant relationship
Based on table above, from 36
with the occurrence of osteoporosis
respondents with poor nutrition there
during menopause. this study 91% aged
were 24 respondents (83%) Positive at
55-64 years so it can explain that the
risk of osteoporosis and in late menarche
higher the age of menopausal women,
respondents there were 20 respondents
the proportion of osteoporosis is also
(55.5%) Positive at risk of osteoporosis.
getting bigger.
= accepted, namely there is a relationship
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According to Puspareni (2020), 18.5 and/or Lila < 23.5 because

the provision of health education will respondents did not know that food
help women to improve their intake during menopause and did not
knowledge, attitudes and behavior. One know what foods were good for
of the supporting factors in increasing menopause, mothers in the Wisma
knowledge is the level of education. In Tengger area also rarely consumed
this study 86% of high school education vitamins to improve their nutrition. This
so that education can affect the is because respondents in this study On
perspective of menopausal women on average, they have entered the age of
their nutritional status. old people who have no income or no
longer work so that they cannot fulfill
according to Pitriani (2019)Work
their nutritional intake such as drinking
is something that must be done
milk and taking vitamins every day
especially to support family life. Work
because their opinions are also
is a time-consuming activity. Working
uncertain because they only depend on
for mothers will have an influence on
children's gifts.
family life. In table 5.2 of this study
(87%) there is a significant relationship 2. Reproductive history in
menopausal women
between nutritional status and work
The results of the Reproductive
because the average respondent is a
History Research based on Menarche
housewife.
(Age at First Menstruation) with factors
According to Pitriani (2019), the that affect menopause table 3 shows that
nutritional problem due to poverty, the of the 36 respondents almost entirely,
indicator is the economic level of the most of the respondents (55.5%) in
family, which is related to the calculating the reproductive history of
purchasing power of the family. menarche Late menarche: 15 years.
However, in table 5.2 this study 60% of Reproductive history in
income> 4,000,000 good nutrition menopausal women can be seen from
amounted to 3 people from 36 menarche. The earlier a woman
respondents and the average in the experiences menarche, the slower she
Wisma Tengger area was mothers who experiences menopause. On the other
entered menopause. hand, the slower the menarche, the
earlier the menopause. This study is in
Respondents have poor
accordance with Kasdu's theory which
nutritional status (80.6%). HaveBMI <
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says that there is a relationship between 4. Risk of Osteoporosis in menopausal

the age of the first menstruation and the women
age of a woman entering menopause. Research Results Osteoporosis
The younger a person experiences Risk with Factors Affecting Menopause
menstruation for the first time, the older Table Based on table 3 above, from 36
or longer he enters menopause. There is respondents, it was found that almost
also a family pattern that applies in most of the respondents (66.67%) have
general, for a woman whose mother or a positive risk of osteoporosis if the T
older sister experiences menopause score > the mean T score.
earlier, she also tends to experience the According to Renidayati (2013),
same thing, and vice versa.(Senolinggi, osteoporosis occurs due to an imbalance
2015). between the higher demineralization
Respondents have (55.5%) in the process and the bone mineralization
calculation of late menarche process. This porous bone is especially
reproductive history: 15 years. Mothers common in menopausal women. The
in the Wisma Tengger area have decrease in the hormone estrogen
menstruation for more than 15 years causes women to have a higher risk of
because based on the interviews I did, osteoporosis, especially during
on average, they have a thin body menopause because the hormone
posture since adolescence so that a low estrogen decreases resulting in an
BMI can be obtained which can cause a increase in the speed of bone loss this
delay in menstruation for more than 15 occurs because estrogen helps absorb
years, but some of the respondents said calcium into the bones so that when
that their families also have delayed estrogen levels decrease, women will
menstruation so that it can also cause experience calcium loss from bones
late menarche due to heredity. This quickly.
corresponds to (Yunitasari, 2015) that Most of the respondents (66.67%)
heredity has late menarche from the have a positive osteoporosis risk if the T
family can cause late menarche and lack score > the mean T score because the
of nutrition with a low BMI can affect respondent has complaints of spinal
sexual maturity during adolescence so pain when doing physical activity at the
that it can cause a history of late age of menopause, this is because
menarche in reproduction which affects women in the Wisma Tengger area
menopause. rarely exercise or walk to stimulate joint
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muscles and do activities outside the the nutritional status, the more positive
house in the morning to sunbathe the risk of osteoporosis in menopausal
looking for Vitamin D. This is women.In nutritional status,
appropriate (Wiyasa, 2019) that lack of osteoporosis is more commonly found in
exercise, sunbathing for vitamin D people who are smaller and shorter. For
during menopause can cause women who are short and small or thin,
osteoporosis because entering peak bone mass will not be as high as in
menopause causes the speed of decline
those who are large, so osteoporosis is
in bone mass to increase so exercise is
more likely to occur. Excess belly fat can
very important to train balance or
form estrogen which is actually good for
strength in bones so that they are not
bone growth. Being underweight also
prone to osteoporosis.
indicates low bone mass density.
4. Relationship between nutritional
Women who have a low body mass index
status and risk of osteoporosis in
(BMI) should be aware of their risk
postmenopausal women in Wisma
Tengger RT 01 RW 06 Surabaya factors for osteoporosis. Osteoporosis is
Research Results based on cross a bone disorder caused by metabolic
tabulation relationship between disorders in which the body is unable to

nutritional status and risk of absorb and utilize the substances
osteoporosisthere is menopause based on needed for bone maturation and the
Table 4 above of 36 respondents with bones become lighter and more fragile
poor nutrition there are 5 respondents than usual.(Rosiardani, 2017).
(17%) Negative Risk of Osteoporosis and From the results of further
there are 24 respondents with poor analysis using the Chi Square test, there
nutrition (83%) Positive Risk of is a p-value = 0 <0.05, the result is =
osteoporosis. In good nutrition accepted, namely there is a relationship
respondents there are 7 respondents between nutritional status and the risk of
(100%) Negative risk of osteoporosis. osteoporosis in postmenopausal women
Illustrates that the relationship in the Wisma Tengger area RT01 RW06
between nutritional status and risk of Surabaya. There is a relationship because
osteoporosis is relatively strong, meaning the average respondent has poor
that the better the nutritional status, the nutritional status at the time of
more negative the risk of osteoporosis in menopause because they do not know
postmenopausal women and the worse that nutritional status increases during
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menopause and they also do not know menopause. On the other hand, the slower
which foods are good to eat at the time of the menarche, the earlier the menopause.
menopause so there are still many This study is in accordance with Kasdu's
respondents in this study who have poor theory which says that there is a
nutritional status and have a low BMI and relationship between the age of the first
Lila which can lead to a risk of menstruation and the age of a woman
osteoporosis.H1 entering menopause. The younger a
5. Relationship with reproductive person experiences menstruation for the
history in postmenopausal women in first time, the older or longer he enters
Wisma Tengger RT 01 RW 06 menopause(Senolinggi, 2015). In women
Surabaya who have late menarche will experience
Research Results based on cross menopause more quickly and this will be
tabulation relationship between associated with a low DMT and can be at
reproductive history and risk of risk for osteoporosis.
osteoporosisthere is menopause based on From the results of further
Table 5.4 above of 36 respondents with analysis using the Chi Square test, there
normal menarche there are 6 respondents is a p-value = 0 <0.05, the result is =
(16.6%) Negative Risk of Osteoporosis accepted, namely there is a relationship
and there are 10 respondents (27.7%) between reproductive history and the
Positive Risk of osteoporosis. In
risk of osteoporosis in menopausal
respondents with late menarche there are
women in the Wisma Tengger area RT01
20 respondents (55.5%) Positive risk of
RW06 Surabaya. There is a relationship
osteoporosis.
because this research was carried out in
Describing that there is a
the local area where they have the same
relationship between reproductive history
behavior so that on average the
as seen from menarche and the risk of
respondents in this study have slow
osteoporosis is relatively perfect, that is,
the more respondents experience late menarche due to heredity and can also
menarche, the more positive the risk of be triggered by a bad BMI before
osteoporosis in postmenopausal women. entering menopause so that late

Reproductive health that has a risk of menarche can cause a decrease in mass
osteoporosis can be seen from menarche. density. bone fast so that it can be at risk
The earlier a woman experiences of osteoporosis.H1
menarche, the slower she experiences
CONCLUSION
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Based on the results of research and Menopause Maternal Age.

https://ejurnal.poltekkes-
discussion of HRelationship between
manado.ac.id/index.php/jidan/arti
Nutritional Status and Reproductive cle/download/332/298, 56-64.
Ministry of Health RI. (2019). Data &
Health History with Risk of Osteoporosis
Condition of Osteoporosis
in Menopausal Women in Wisma Disease in Indonesia.
https://pusdatin.kemkes.go.id/arti
Tengger RT 01 RW 06 Surabaya.
cle/view/16010400003/data-dan-
conclusions can be drawn as follows: condition-disease-osteoporosis-
di-indonesia.html, 1-3.
1. Most menopausal women in Wisma
Nugroho, BI (2014). women's
Tengger RT 01 RW 06 Surabaya reproductive health problems.
Yogyakarta: Nuha Medika.
almost all have poor nutritional
Pitriani, SM (2019 ). Environmental
status in menopausal women. Health Epidemiology. Makassar:
Nas Media Pustaka.
2. Most menopausal women in Wisma
Prabasiwi, A. (2011). Factors Associated
Tengger RT 01 RW 06 Surabaya With Menarche Age.
http://lib.ui.ac.id/file?file=digital/
have a history of slow reproduction
2016-11/20440275-S-FDP-
based on menarche. Adila%20Prabasiwi.pdf.
Renidayati. (2013). Risk Factors for
3. Most menopausal women in the
Osteoporosis in Menopausal
Wisma Tengger area RT 01 RW 06 Women .
http://ners.fkep.unand.ac.id/index
Surabaya menopausal women are at
.php/ners/article/view/100, 130-
risk of osteoporosis. 135.
Rosiardani, SA (2017). Relationship
4. There is a relationship between
between nutritional status and
nutritional status and the risk of lifestyle with the incidence of
early menarche.
osteoporosis in postmenopausal
http://repository.unair.ac.id/7662
women in Wisma Tengger RT 01 4/2/KKC%20KK%20FKP.N.194
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RW 06 Surabaya.
18%20Ros%20h%20SKRIPSI.p
5. There is a relationship between df, 90-110.
Senolinggi, MA (2015). Relationship
reproductive history in menopausal
Between Menarche Age and
women in the Wisma Tengger area Menopause Age in Women in
Kakas District, North Sulawesi.
RT 01 RW 06 Surabaya
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4/6278, 138.
Desfita, SS (2020). Fermented Soy Milk Vishnu, W. (2012). Risk Factors for
And Honey Potential To Improve Osteoporosis in Patients Over 50
Bone Health Menopausal Years Old.
Women. Yogyakarta: Depublish https://media.neliti.com/media/p
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Diane, LJ (2015). Analysis of Menarche risk-factor-osteoporosis-pada-
Age and Nutritional Status of p.pdf, 5-11.
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Osteoporosis Management.
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Tel. (031) 8479070 , Fax. (031) 8433670

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RELATIONSHIP OF NUTRITIONAL STATUS AND HISTORY OF

REPRODUCTIVE HEALTH WITH OSTEOPOROSIS RISK IN MENOPAUSED

PRELIMINARY Research in several cities in 2019

fractures during menopause, avoid foods Nutritional Status Descriptive

sectional approach. respondents, almost all of the respondents

respondents were malnourished, almost

Based on the table above, from 36 between nutritional status and

According to Puspareni (2020), 18.5 and/or Lila < 23.5 because

says that there is a relationship between 4. Risk of Osteoporosis in menopausal

Research Results based on cross a bone disorder caused by metabolic

tabulation relationship between disorders in which the body is unable to

osteoporosis in postmenopausal women. entering menopause so that late

Based on the results of research and Menopause Maternal Age.

Wiyasa, IW (2019). Postmenopausal

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