The Effects of Mandala Coloring on Women During Menopause

May 8, 2026 updated by: Kevser Katkaya, Kahramanmaras Sutcu Imam University

The Effect of Mandala Coloring on Menopausal Symptoms, Sexual Quality of Life, and Self-Esteem in Women During the Menopause Period

The aim of this clinical study is to determine the effect of mandala coloring on menopausal symptoms, sexual quality of life, and self-esteem in women during menopause period. The main questions the study aims to answer are as follows:

  1. Does mandala coloring reduce the severity of menopausal symptoms in women?
  2. Is there an increase in self-esteem levels among women who participate in mandala coloring after the intervention?
  3. Is there an increase in the quality of sexual life among women who participate in mandala coloring after the intervention? Researchers will compare the intervention group (those who participated in mandala coloring) with the control group (those who did not participate in any intervention) to evaluate the effectiveness of mandala coloring.

Participants

  • Participants in the intervention group will attend 30-minute mandala coloring sessions once a week for 4 weeks.
  • Participants in the control group will not receive any intervention during the same period.
  • Both groups will be assessed using a questionnaire at the beginning of the study and at the end of the 4th week (pre-test/post-test).

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Menopause is a natural, biological process that marks the end of a woman's fertile years. Every woman's menopause is unique. The experience, severity, duration, and physical and psychological effects of menopause are all unique. During this period, women must contend with both the processes of aging and the hormonal changes that occur during menopause. These changes can sometimes negatively impact an individual's life, reducing their quality of life. Menopausal symptoms can often appear one to two years before their last menstrual period and up to 15 years afterward. These symptoms, such as decreased sexual desire, decreased estrogen levels, mood disorders, illnesses associated with menstruation, decreased genital sensation, vaginal dryness, physical discomfort, and bone loss, can lead to a loss of sexual desire and alienate a person from their partner. This, in turn, leads to a decrease in self-esteem, a feeling of unease about one's own characteristics and ongoing physical and psychological changes. Consequently, individuals' anxiety levels increase, and their ability to cope with symptoms decreases. Studies have highlighted the benefits of alternative methods for coping with anxiety in women undergoing menopause. Music therapy and art therapy are examples. Studies have also demonstrated the therapeutic effects of mandala coloring, an art therapy activity. This study aims to examine the effects of mandala coloring on menopausal symptoms, quality of sexual life, and self-esteem in menopausal women.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
70

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Turkey (Türkiye)
      • Kahramanmaraş, Turkey (Türkiye), 46050
        • Saçaklızade Family Health Center No. 30

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Being between the ages of 40 and 65,
  • Not having experienced menstruation for at least one year,
  • Having a score of 15 or higher on the MSDS (meaning having experienced at least moderate menopause),
  • Not having received hormone replacement therapy for menopausal symptoms,
  • Not having undergone surgical menopause,
  • Experiencing at least one vasomotor symptom of menopause (hot flashes, night sweats, sudden sweating attacks, palpitations, chills and shivering attacks, etc.).
  • Being able to read, write, speak, and understand Turkish,
  • Not having previously received mandala art therapy training or regularly practicing mandala coloring,
  • Not having an allergy to mandala coloring materials,
  • Not practicing spiritual practices such as yoga or meditation,
  • Agreeing to participate in the study.

Exclusion Criteria:

  • Having a physical symptom that may prevent mandala coloring,
  • Having communication and perception problems,
  • Having difficulty understanding or speaking Turkish,
  • Having a psychiatric illness or taking psychiatric medication,
  • Having experienced a loss in the last 6 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Mandala coloring
Participants will take part in 30-minute mandala painting sessions once a week for four weeks.
Other: Mandala coloring
Mandala coloring is a structured creative art activity based on colouring mandala shapes, which consist of circular and symmetrical patterns, increasing focus and promoting relaxation. As one of the art therapies, mandala colouring can have a therapeutic effect on individuals.
Other Names:
  • Mandala art activity
No Intervention: Control group
No intervention will be applied to participants in the control group within 4 weeks.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Menopausal Symptoms
Time Frame: Time Frame: Fromenrollmenttotheend of intervention at 4 weeks.
The primary outcome measure in this study is the severity of menopausal symptoms as assessed by the Menopause Rating Scale. This scale is an 11-item measure developed by Heineman et al. (1996) to assess the severity of menopausal symptoms. The minimum score that can be obtained on the scale is 0, while the maximum score is 44. An increase in the score obtained from the scale indicates an increase in the severity of the complaints experienced, while also showing that quality of life has been negatively affected. In this study, the validity and reliability of the scale in Turkish were conducted by Can Gürkan (2005). The Turkish version of the scale will be used. Within the scope of the current study, it is expected that women in menopause who engage in mandala coloring will show improvement in menopause symptoms. In other words, the Menopause Rating Scale scores of women in the experimental group will be lower than those of women who do not practice mandala coloring.
Time Frame: Fromenrollmenttotheend of intervention at 4 weeks.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Sexual Quality Of Life
Time Frame: Time Frame: From enrollment to the end of intervention at 4 weeks.
In this study, the secondary outcome measure is the level of sexual quality of life assessed using the Sexual Quality of Life Scale. The scale, developed by Symonds et al. (2005), consists of 18 items designed to measure women's sexual quality of life. Participants are expected to respond to the items based on their sexual life over the past four weeks. The lowest possible score on the scale is 18, and the highest possible score is 108. A higher score on the scale indicates a better quality of sexual life. The Sexual Quality of Life Scale - Female Turkish Form will be used in this study. Its validity and reliability in Turkish were conducted by Gölbaşı (2010). Within the scope of the current study, it is expected that women in menopause who practice mandala coloring will show an increase in their sexual life quality. In other words, the Sexual Life Quality Scale scores of the women in the experimental group are higher than those of women who do not practice mandala coloring.
Time Frame: From enrollment to the end of intervention at 4 weeks.
Self-Esteem
Time Frame: Time Frame: From enrollment to the end of intervention at 4 weeks.
Another secondary outcome measure in this study is the level of self-esteem, assessed using the Coopersmith Self-Esteem Inventory Scale. The scale was developed by Stanley Coopersmith (1967). It consists of 25 items with opposite responses such as "Like me" or "Not like me." The content includes the person's outlook on life, family relationships, social relationships, and resilience. The lowest possible score on the scale is 0, and the highest is 25. A low score on the scale indicates low self-esteem, while a high score indicates high self-esteem. Turkish reliability and validity studies were conducted by Aksoy (1992) and Pişkin (1997). Within the scope of the study, it is expected that women in menopause who practice mandala coloring will experience an increase in their self-esteem levels. In other words, the scores obtained by the women in the experimental group on the Coopersmith Self-Esteem Inventory Scale are higher than those of women who do not practice mandala coloring.
Time Frame: From enrollment to the end of intervention at 4 weeks.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Kahramanmaras Sutcu Imam University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 25, 2026

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
February 25, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 25, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 11, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 31, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 12, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
May 11, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • KahramanmaraşSIU-NURSİNG-KK-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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