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Prevalence of menopause symptoms and their association with lifestyle among Finnish middle-aged women
Abstract
The aim of this study is to report the prevalence of menopausal symptoms by severity among the Finnish female population and the association of their symptoms with lifestyle (smoking, use of alcohol, physical activity) and body mass index (BMI).
Health 2000 is a nationally representative population-based study of Finnish adults. Data were collected by home interview, three self-administered questionnaires and a clinical examination by a physician. This study included women aged 45-64 years (n=1427). All symptoms included menopause-specific symptoms. Both univariate analysis and a factor analysis based on symptom factors were performed by menopausal group. Multiple regression analysis included each symptom factor as a dependent variable and confounding and lifestyle factors (age, education, smoking, alcohol use, physical activity, BMI, use of hormonal replacement therapy (HRT) and chronic disease status).
Over one-third (38%) of the premenopausal, half of the perimenopausal, and 54% of both postmenopausal and hysterectomized women reported bothersome symptoms. The difference between pre- and perimenopausal women was largest and statistically most significant in the case of back pain and hot flushes. Physically active women reported fewer somatic symptoms than did women with a sedentary lifestyle. Smoking was not related to vasomotor symptoms.
Bothersome symptoms are common in midlife, regardless of menopausal status. Inverse association between physical activity and menopausal symptoms needs to be confirmed in randomized trials.
... Several studies done in various regions of the world have found that socio-demographic factors (Age, level of educational, occupational status, monthly income, and marital status [19][20][21][22]; personal factors (i.e. Body mass index, physical activity and duration of menopause) [21][22][23][24][25][26]; and behavioral factors (i.e. smoking status and alcohol consumption status) [23,27] are significantly associated with severity of menopausal symptoms. ...
... Body mass index, physical activity and duration of menopause) [21][22][23][24][25][26]; and behavioral factors (i.e. smoking status and alcohol consumption status) [23,27] are significantly associated with severity of menopausal symptoms. ...
... The data collection tool for assessing socio-demographic characteristics and factors related to severe menopausal symptoms was developed based on a review of relevant literature [10,23,30,31]. The Menopause Rating Scale (MRS) was used to evaluate the severity of menopausal ...
Background
Post-menopause is the permanent cessation of menstruation for 12 consecutive months at the age of 45 to 55 years. Post-menopausal women all over the world suffer from symptoms associated with menopause. Despite the fact that the population of menopausal women in Ethiopia is growing in parallel with their life expectancy, little is known about the severity and factors associated with menopausal symptoms among post-menopausal women. While previous studies in Ethiopia have primarily focused on the prevalence of severe menopausal symptoms, they have not thoroughly explored the underlying factors that may influence the severity of these symptoms. As a result, the specific factors that contribute to the severity of menopausal symptoms in Ethiopian women remain largely uninvestigated, leaving an important knowledge gap in this area. Therefore, this study was intended to assess severe menopausal symptoms and associated factors among post-menopausal women in Ambo town.
Methods
A community-based cross-sectional study was conducted from August 3 to September 3, 2022, in Ambo town. The source population encompassed all post-menopausal women residing in Ambo Town. From this broader group, the study population was all post-menopausal women living in the three selected kebeles (the smallest administrative unit of Ethiopia). The sampling unit for this study was the household with post-menopausal women. A simple random sampling method was employed using computer-generated random numbers using the sampling frame taken from the conducted preliminary survey. Data were collected using a structured, interviewer-administered questionnaire. The data were entered using Epi Info version 7.1 and exported to SPSS version 25.0 for analysis. Bivariate analysis was used to examine individual relationships between independent variables and severe menopausal symptoms. Multivariable analysis then evaluated the combined impact of independent variables on severe menopausal symptoms while controlling for confounding factors, offering a comprehensive understanding of the factors that significantly influence symptom severity. Odds ratios with 95% Cl were estimated to identify the associated factors of the outcome variables, and statistical significance was affirmed at a p-value ≤ 0.05.
Results
This study showed that one hundred thirty-three participants (30.4%), with a 95% CI (26.2%–35%), experienced severe menopausal symptoms during the past month. Age greater than 60 years [AOR = 3.2, 95% CI (1.3, 7.7)], not performing physical activity [AOR = 2.1, 95% CI (1.1, 4.4)], consuming alcohol [AOR = 1.8, 95% CI (1.1, 3.1), unfavorable attitude towards menopause [AOR = 1.8, 95% CI (1.1, 3.0)], and BMI > 29.9 kg/m² [AOR = 6.1, 95% CI (2.7, 14.2)] were associated with severe menopause symptoms.
Conclusion and recommendation
According to this study, one in three postmenopausal women experienced severe menopausal symptoms. In conclusion, several factors were significantly associated with severe menopausal symptoms. Positive predictors of severe menopausal symptoms include; age over 60 years, lack of physical activity, alcohol consumption, unfavorable attitudes towards menopause, and a BMI greater than 29.9 kg/m². These results highlight the role of both lifestyle behaviors and individual characteristics in determining the severity of menopausal symptoms. Therefore, we recommend implementing targeted support programs specifically for post-menopausal women. Promoting regular physical activity through tailored exercise programs and reducing alcohol consumption through education and counseling are essential. Additionally, educational interventions should aim to foster a positive attitude towards menopause. Weight management strategies, including both nutrition and exercise, should be prioritized for post-menopausal women with a BMI greater than 29.9 kg/m².
... Studies addressing the association between alcohol drinking and VMS have reported mixed results [12][13][14][15][16][17], including a positive association [12,13], no association [14,15], and an inverse association [16,17]. However, alcohol consumption in most previous studies was not the main exposure and relied on average alcohol consumption without considering abstainer bias [12,17]. ...
... Studies addressing the association between alcohol drinking and VMS have reported mixed results [12][13][14][15][16][17], including a positive association [12,13], no association [14,15], and an inverse association [16,17]. However, alcohol consumption in most previous studies was not the main exposure and relied on average alcohol consumption without considering abstainer bias [12,17]. ...
... Studies addressing the association between alcohol drinking and VMS have reported mixed results [12][13][14][15][16][17], including a positive association [12,13], no association [14,15], and an inverse association [16,17]. However, alcohol consumption in most previous studies was not the main exposure and relied on average alcohol consumption without considering abstainer bias [12,17]. Currently, there are scarce data to address the role of specific drinking patterns in the development of VMS compared with lifetime abstainers as the reference. ...
The role of alcohol consumption in the risk of vasomotor symptoms (VMS), the most cardinal climacteric symptoms, is not well established. We examined their relationship with early-onset VMS among premenopausal women. Moderately-to-severely bothersome VMS, the primary outcome, was assessed using the Korean version of the Menopause-Specific Quality of Life questionnaire. The alcohol consumption categories included lifetime abstainer, former drinker, or current drinker, categorized as light, moderate, heavy, and very heavy. Compared with the lifetime-abstinence (reference), the multivariable-adjusted odds ratio (95% CIs) for prevalent VMS in alcohol consumption of <10, 10–19, 20–39, and ≥40 g/day were 1.42 (1.02–1.99), 1.99 (1.27–3.12), 2.06 (1.19–3.57), and 3.52 (1.72–7.20), respectively (p trend <0.01). Compared with the lifetime-abstinence, the multivariable-adjusted hazard ratios (95% CIs) for incident bothersome VMS among average alcohol consumption of <10, 10–19, 20–39, and ≥40 g/day were 1.10 (0.85–1.41), 1.03 (0.70–1.51), 1.72 (1.06–2.78), and 2.22 (1.16–4.23), respectively (p trend = 0.02). Increased alcohol consumption positively and consistently showed a relationship with increased risk of both prevalent and incident early-onset VMS. Refraining from alcohol consumption may help prevent bothersome VMS in premenopausal women.
... They include excessive perspiration and hot flushes (vasomotor symptoms) [5][6][7][8], urogenital atrophy, and irregular menstruation. However, there is a wide range of other common menopausal symptoms including the following: nervous tension, heart palpitations, headaches, lack of energy [9], insomnia [10][11][12][13], depressed mood [14,15], vaginal dryness, urinary incontinence and sexual concerns or problems [16][17][18], cognitive symptoms, painful or stiff joints, reduced bone mass [19][20], and hair thinning or loss as well as increased hair growth on other areas of the body (face, neck, chest, and upper back). ...
... Several studies have confirmed an association between psychological symptoms, somatic complaints, and menopausal status [9,19,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54], but cross-cultural differences indicate that reporting symptoms are not universal. What is more, there is no consistency regarding which symptoms are the most prevalent among peri-and postmenopausal women. ...
... Psychological symptoms remained the same or slowly decreased in prevalence among women in late perimenopause compared with postmenopause. A cross-sectional study of 1427 women from Finland aged 45-64 years found that mental symptoms dominated the list of reported symptoms during the menopausal transition [19]. Occurrence of pains and vasomotor problems was equally frequent among Brazilian women [45]. ...
The aim of the study was to assess the prevalence of menopausal symptoms, and the use of menopausal hormone therapy (MHT) and nonconventional methods of alleviating menopausal symptoms and their health benefits in peri- and postmenopausal women. A sample of 349 peri- or postmenopausal women were studied, all of whom had experienced menopausal symptoms. A pre-tested questionnaire was used to assess the kinds of menopausal symptoms experienced, the types of therapies used, and the health benefits of using MHT or alternative therapies (AT). The mean age of peri- and postmenopausal women was 49.55 (± 2.51) and 61.32 (± 6.77) years, respectively. The most common symptoms in both groups of peri- and postmenopausal women related to mental health. Altogether 45% of women used MHT and 27.8% AT. Those using MHT reported significant benefits in their sexual life (p < 0.001), whereas those using AT reported significant benefits of better sexual life (p < 0.001), skin condition (p < 0.001), and physical activity (p < 0.05).
This study indicated that the most common symptoms connected with the menopausal transition were mental ailments. In order to prevent them, the women more frequently applied MHT in comparison to alternative methods, with postmenopausal women using MHT more often than perimenopausal women. Satisfaction was found with both conventional and alternative treatments for the relief of menopausal symptoms.
... 12968/ ijtr.2020.0118 The association between physical activity and menopause-related quality of life ReseaRch © 2021 MA Healthcare Ltd dose of oestrogen should be administered for the shortest period of time (Moilanen et al, 2010). However, many women refuse to undergo hormone replacement therapy because of its possible adverse effects such as bloating, migraines, nausea, vaginal bleeding. ...
... Evidence from studies concerning the effects of regular physical activity and exercise on vasomotor and other menopausal symptoms is conflicting. There are studies that state that physically active women have fewer menopausal complaints (Moilanen et al, 2010;Skrzypulec et al, 2010;Canario et al, 2012;Mendoza et al, 2016); while Whitcomb et al (2007) declare that they have more issues. Despite the fact that many studies do not support the association between physical activity and vasomotor symptoms (Greendale and Gold, 2005;McAndrew et al, 2009;Haimov-Kochman et al, 2013;Mendoza et al, 2016), other studies observed that women who did not experience hot flashes were highly active (Canario et al, 2012). ...
... However, it is not clear how physical activity affects sexual health. The rate of joint and muscular discomfort was less in physically active women as compared to sedentary women, as reported previously (Moilanen et al, 2010;Canario et al, 2012;Mendoza et al, 2016). ...
Background/aims
Menopause can cause drastic changes that trigger severe symptoms in women and, in turn, influence their quality of life. Many women no longer prefer hormone replacement therapy because of its potential adverse effects. Hence, it is crucial to establish alternate interventions to alleviate menopausal symptoms. The aim of this study was to estimate the relationship between quality of life and level of physical activity in menopausal women.
Methods
A total of 260 postmenopausal women were recruited in this cross-sectional study. The Menopause Rating Scale and International Physical Activity Questionnaire – Short Form were used to assess quality of life and physical activity respectively.
Results
Women with higher levels of physical activity had fewer total menopausal, somato-vegetative and psychological symptoms (P<0.001); no differences were found in vasomotor and urogenital symptoms.
Conclusions
Women with low physical activity levels presented with greater menopausal symptoms. Regular physical activity can be recommended to alleviate symptoms following menopause, thereby improving quality of life.
... 29 Our relatively lower VMS prevalence may be due to methodological differences. For example, responses in Moilanen et al. were captured over an approximately 10-month interval compared with a 2.5-month interval in our study 28 ; the lower prevalence rate in our study may be partially attributable to the comparatively shorter window of data collection, which, importantly, occurred during the winter. Prevalence rates from Moilanen et al. were based on an extensive home interview, self-administered questionnaires, and a physician-conducted exam, compared with an online survey here, which may have contributed to differences in prevalence. ...
... Prevalence rates from Moilanen et al. were based on an extensive home interview, self-administered questionnaires, and a physician-conducted exam, compared with an online survey here, which may have contributed to differences in prevalence. 28 As for the study by Lindh-Åstrand et al., the maximum age for eligibility was lower than the maximum age of women included in our study. 29 Thus, it is possible that VMS were less prevalent among our postmenopausal women because we enrolled women with a wide age range, as well as those outside the prevalence peak of VMS in early postmenopause. ...
Introduction
The objectives of this study were to evaluate the prevalence and impact of moderate to severe vasomotor symptoms (VMS) on quality of life, sleep, work, and daily activities. We also assessed treatment patterns for VMS, lifestyle changes to mitigate VMS, and attitudes toward available treatments and menopause.
Material and Methods
Women from Denmark, Finland, Norway, and Sweden aged 40–65 years completed an online survey as part of a larger multinational study. The primary outcome, prevalence of moderate to severe VMS, was assessed in postmenopausal women. Secondary outcomes, including the impact of VMS on quality of life (Menopause‐Specific Quality of Life [MENQoL] questionnaire), sleep (Patient‐Reported Outcomes Measurement Information System [PROMIS] Sleep Disturbances‐ Short Form 8b), and work and daily activities (Work Productivity and Activity Impairment [WPAI] questionnaire) were assessed in perimenopausal and postmenopausal women experiencing ≥1 moderate to severe hot flush per day in the prior month. Additionally, survey questions evaluated treatment patterns, lifestyle changes, and opinions toward VMS treatment and menopause in perimenopausal and postmenopausal women.
Results
Among 6383 postmenopausal women (primary analysis population), 739 (11.6%) experienced moderate to severe VMS regardless of whether they were receiving treatment. Among 863 symptomatic perimenopausal and postmenopausal women (secondary analysis population), VMS impaired quality of life and sleep. Work and daily activities were impaired by 24.2% and 30.6%, respectively. Around 35% of women sought advice; however, most women (>60%) reported not taking any treatment for VMS. Among those treating VMS, supplements and nonprescription medications were the most common treatments (19.2%); 12.9% of women reported taking menopausal hormone therapy. Over half of women reported taking over‐the‐counter treatments; 77.8% adopted lifestyle changes to mitigate VMS. One in 4 women (25.6%) expressed concerns about menopausal hormone therapy side effects; 49.5% of women who had used nonmenopausal hormone therapy prescription medication stopped for lack of efficacy. Many women strongly agreed that menopause is a natural part of aging.
Conclusions
Over 10% of postmenopausal Nordic women reported suffering from moderate to severe VMS. VMS impaired the quality of life, sleep, work productivity, and daily activities among perimenopausal and postmenopausal Nordic women, emphasizing the need for effective and well‐tolerated treatments.
... climacteric symptoms and their impact on middle-aged women have been studied extensively [1][2][3][4]. natural menopause, defined as 12 months of amenorrhea resulting from the permanent cessation of ovarian function, typically occurs between the ages of 45 and 55 years, with the average being 51 years [5,6]. Hot flushes, sweating and other frequent menopause-related symptoms, such as depressive symptoms, irritability and sleeping problems, may exist in any phase of the climacterium [7][8][9]. ...
... the intensity (%) of the symptom score of the four typical symptoms associated with reduced estrogen production (sweating, hot flushes, vaginal dryness and sleeping problems) as well as the prevalence (%) of the five most common climacteric symptoms (sweating, hot flushes, sleeping problems, lack of sexual desire and depressive symptoms) increased as women who have never used MHt moved from the age group 42-46 years to the age group 52-56 years; the symptoms selected for the analyses were the same as in our recent studies [1,2] in the same birth cohort of women. this result is consistent with the previous findings [2,4,8,9]. However, the difference in the present study, compared to the previous studies, is that it followed one birth cohort of women who have not used any treatment for their symptoms for 10 years. ...
Abstract
Objective
This study aimed to examine changes over a 10-year period in experiencing climacteric symptoms and their associations with sociodemographic and health-related background factors in a birth cohort of Finnish women who have never used menopausal hormone therapy (MHT).
Methods
This nationwide population-based follow-up study consists of 1491 women who during the follow-up period moved from the age group 42–46 years to the age group 52–56 years. The experience of climacteric symptoms was assessed by 12 symptoms commonly associated with the climacterium. The data were analyzed using statistical techniques.
Results
Both the intensity, expressed as a symptom score of four symptoms associated with a decrease in estrogen production (sweating, hot flushes, vaginal dryness, sleeping problems), and the prevalence of the five most common symptoms (sweating, hot flushes, sleeping problems, lack of sexual desire, depressive symptoms) increased clearly during the follow-up period. The examined sociodemographic and health-related variables did not explain the changes in experiencing the symptoms.
Conclusions
The results of this study can be considered in primary and occupational health care and in gynecological settings when working with symptomatic women or women with hidden climacteric problems and carrying out health promotion and counseling for them.
... Since then, several observational studies have found that regular physical activity and exercise are associated with less VMS among peri-and postmenopausal women and one study found a shorter duration of symptoms. (9,(82)(83)(84)(85)(86)(87) In addition, a higher BMI is also associated with VMS. (28,86,(88)(89)(90)(91) However, other studies did not find an association between VMS and physical activity or exercise. ...
... (9,(82)(83)(84)(85)(86)(87) In addition, a higher BMI is also associated with VMS. (28,86,(88)(89)(90)(91) However, other studies did not find an association between VMS and physical activity or exercise. (92)(93)(94) Theoretically, exercise of longer duration and/or vigorous intensity affects the production of β-endorphin and other endogenous opioids that could potentially reduce VMS. ...
... They were not on treatment for menopausal symptoms except for a few studies that had <10% of the samples on hormone replacement therapy (12)(13)(14)(15)(16). One study reported that in all menopausal groups, women who used HRT did not differ from non-users in having at least one bothersome symptom (17). ...
... In this meta-analysis, the pooled prevalence of premenopausal, perimenopausal, and post-menopausal women was 35.5, 24.18, and 45.49%, respectively. The wide range of prevalence for each of the three menopausal stages was due to the different study settings, where 21 (12, 13, 15, 16, 18-24, 27, 29-31, 36-40) studies were conducted in medical centers, and eight (14,17,25,28,(32)(33)(34)(35) were in the community. Methodological techniques such as sampling methods and tools, together with study implementation may also account for differences in estimated prevalence among studies. ...
Introduction
The menopausal transition represents the passage from reproductive to non-reproductive life and is characterized by a number of menstrual disturbances. We systematically reviewed the evidence on the prevalence of psychosomatic and genitourinary syndrome among menopausal women and compared the risk of symptoms between premenopausal, perimenopausal, and post-menopausal women.
Methods
We performed a systematic search in MEDLINE, CINAHL, and ScienceDirect through March 2021. Case series/reports, conference papers and proceedings, articles available only in abstract form, editorial reviews, letters of communication, commentaries, systematic reviews, and qualitative studies were excluded. Two reviewers independently extracted and assessed the quality of data using the Joanna Briggs Institute Meta-Analysis. The outcomes were assessed with random-effects model using the Review Manager software.
Results
In total, 29 studies had a low risk of bias and were included in the review. Our findings showed that the pooled prevalence of somatic symptoms in post-menopausal women (52.6%) was higher than in the premenopausal and perimenopausal stages (34.6 and 39.5%, respectively). There was a low prevalence of psychological symptoms in premenopausal women (28.4%). The genitourinary syndrome was highest among post-menopausal women (55.1%), followed by perimenopausal (31.9%) and premenopausal (19.2%) women.
Conclusion
Post-menopausal women have a higher risk of experiencing menopausal symptoms particularly genitourinary syndrome than premenopausal and perimenopausal women. It is pertinent for healthcare professionals to evaluate the symptoms in order to provide them with a better quality of life.
Systematic Review Registration
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021235958
... It generally occurs between ages 45 and 55 years (Harlow et al., 2012). The perimenopause and menopause are commonly associated with a wide range of symptoms, with approximately 38-76% of women worldwide reporting symptoms (Moilanen et al., 2010;Zhao et al., 2019). While common symptoms related vasomotor changes (e.g., hot flushes, night sweats), sleep disturbances, weight gain, fatigue and mood changes (Baber, Panay, Fenton, and the IMS writing group, 2016;Sussman et al., 2015), joint aches and musculoskeletal (MSK) pain are also frequently reported (Baber, Panay, Fenton, and the IMS writing group, 2016;Strand et al., 2025), with a prevalence of 52-72% (Blümel et al., 2013;Gibson et al., 2019;Lu et al., 2020). ...
... Además de reducir el riesgo de enfermedades cardiovasculares, prevenir la osteoporosis y bajar el estrés, la ansiedad y la depresión, entre otras (Guerrero-González., et al. 2024). Y muy importante, puede evitar la disminución de las capacidades cognitivas (Barha y Liu-Ambrose, 2020; Moilanen et al., 2010). ...
La menopausia es el cese de la menstruación por un año continuo, debido a la pérdida de la actividad ovárica que cursa con el decremento de los esteroides sexuales ováricos, el cual, aunado a factores socioeconómicos, contribuyen a la manifestación de los síntomas de la menopausia, que incluyen, entre otros: sofocos, sudoración nocturna, cefaleas, enfermedades cardiovasculares, osteoporosis, incontinencia e infecciones urinarias, aumento de peso, disfunción sexual, ansiedad, depresión, irritabilidad, insomnio, fatiga mental, disminución de la memoria y la concentración. La esperanza de vida ha aumentado significativamente. Por ejemplo, mientras que en la década de 1940 las mujeres vivían en promedio 41 años, hoy alcanzan aproximadamente 87 años. Considerando que la edad promedio de entrada a la menopausia es entre los 49 y 51 años, las mujeres pasan entre 36 y 38 años en una etapa no reproductiva, enfrentando desafíos fisiológicos, emocionales, cognitivos y sociales propios de este periodo. Esta prolongada etapa menopáusica y posmenopáusica representa un importante problema de salud pública que requiere una atención integral y cuidadosa. La presente revisión ofrece un resumen de los principales cambios sistémicos y cognitivos que ocurren en las mujeres durante la menopausia, con el propósito de brindar información actualizada sobre un tema que, hasta hace algunas décadas, había sido poco estudiado.
... Pearson's correlation analysis was used; r: correlation coefficient symptoms, that a WHR of ≤ 0.72 affects the increase in genitourinary symptoms, and that women with higher BMI and WHR are more affected by the menopausal complaints they experience. Some studies indicate that there is a positive relationship between obesity and menopausal symptoms (36), and obesity causes an increase in psychological, somatic, and vasomotor symptoms (37), which lead to an increase in heat flashes (17) due to increased weight. The current study results are consistent with the literature. ...
Objective: The study aimed to investigate the relationship between menopause perceptions, feelings felt, body mass index, and waist-hip ratio with menopausal symptoms in Turkish climacteric women. Methods: This descriptive and correlational study was conducted in a Family Health Center. The research sample consisted of 220 women in the climacteric period. Data were collected with the survey form and The Menopause Rating Scale (MRS). Body Mass Index (BMI) and Waist Hip Ratio (WHR) were measured and calculated by the researchers. Results: The women who perceive menopause as a “natural, normal process” had lower somatic, psychological, and general menopausal symptoms, and those who defined it as “the end of sexuality” had higher genitourinary symptoms (p< .01). Women who were adversely affected or felt negative emotions about menopause reported that they experienced all menopausal symptoms more severely (p< .001). Obese women experienced particularly higher levels of somatic and general menopausal symptoms (p< .05-p< .01), while women with WHR< 0.72 experienced a higher level of genitourinary symptoms (p< .05). Conclusion: The results showed that menopause perception, feelings felt, obesity, and WHR have an impact on menopausal symptoms and levels.
... Postmenopausal osteoporosis (PMOP) is the most predominant type of osteoporosis (OP) resulting from oestrogen deficiency, and it is distinguished by reduced bone mineral density (BMD), impaired bone microstructure, heightened bone fragility and increased vulnerability to fractures (Black & Rosen, 2016). PMOP is a significant risk to women's physical and mental wellbeing (Moilanen et al., 2010;Rauma et al., 2014). Early prevention of PMOP is crucial in managing the disease due to its insidious onset. ...
Proanthocyanidin‐rich grape seed extract (GSE) has been shown to have the potential to protect bones, although the underlying mechanism remains unknown. The current study aims to explore GSE's preventive and therapeutic impact on bone loss induced by oestrogen deficiency and the underlying mechanism through the gut microbiota (GM) and metabolomic responses. In oestrogen‐deficient ovariectomized (OVX) mice, GSE ameliorated bone loss by inhibiting the expansion of bone marrow adipose tissue (BMAT), restoring BMAT lipolysis and promoting bone formation. GSE regulated OVX‐induced GM dysbiosis by reducing the abundance of opportunistic pathogenic bacteria, such as Alistipes, Turicibacter and Romboutsia, while elevating the abundance of beneficial bacteria, such as Bifidobacterium. The modified GM primarily impacted lipid and amino acid metabolism. Furthermore, the serum metabolites of GSE exhibited a significant enrichment in lipid metabolism. In summary, GSE shows potential as a functional food for preventing oestrogen deficiency‐induced bone loss by modulating GM and metabolite‐mediated lipid metabolism.
... presented with a history of chronic illness. This was in agreement with previous study reported out 666 post-menopausal women (58.9%) of them suffered with chronic diseases (49). The mean duration of menopausal symptoms of enrolled women was (13.25±6.2) months mostly of <7 times/day of hot flushes, though 42.5% of them presented with more than 7 times of hot flushes episodes of duration is often 2 to 3 minutes with a range from a few seconds up to one hour and there is a wide variety in frequency (50). ...
Background: Medicinal herbs as alternative therapies, commonly used to treat menopausal symptoms, and some studies have shown that they can be useful in treating menopausal syndrome, which have been linked to worse self-rated health, and decreased work productivity. Aim of the study: This study compared the effectiveness of EPO and Soybean Oil herbal supplement in a sample of Iraqi postmenopausal women on treatment satisfaction and their quality of life. Patients and methods: This prospective study conducted on 20 post-menopausal women who received 500 mg EPO compared to other 20 received 233 mg soybean oil extract, as a capsule twice a day for 8 weeks. The subjective and clinical assessments of Menopause Symptom Treatment Satisfaction, and Menopause-Specific Quality of Life. Data was collected by the researcher via face-to-face interviews with women at baseline and after 2 months of treatment. Results: In this study, Menopause Symptoms Treatment Satisfaction score was not significant within each group post treatment (P>0.05). While after 2 months of treatment, EPO significantly improved the quality of life by decreasing all MEN-QoL domains more than soybean oil, except for the sexual domain (P<0.01). Conclusions: This study revealed that both EPO and soya bean oil supplements had the beneficial effect in improving the postmenopausal quality of life with less treatment satisfaction.
... In our study, the majority of perimenopausal (84.37%) and postmenopausal (80.75%) women were classified as active and reported a moderate PA level. Our results are in agreement with studies by Bondarev et al. [41] and Moilanen et al. [42] showing that most peri-and postmenopausal women had a moderate level of PA, in contrast to other studies where most women were classified as inactive [43,44]. El Hajj et al. showed in their study that perimenopausal women were more active than postmenopausal women [45], which is also consistent with our findings that perimenopausal participants were more physically active at both moderate and intense PA levels compared to postmenopausal participants. ...
This study aimed to examine the association between physical activity (PA), body composition, and metabolic disorders in a population of Moroccan women classified by menopausal status. This cross-sectional study comprised 373 peri- and postmenopausal women aged 45–64 years old. PA levels were assessed using the short version of the International Physical Activity Questionnaire (IPAQ-SF). Body composition and metabolic disorders were assessed by measurements of anthropometric and biological parameters: weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), WC/HC ratio, percent body fat, systolic and diastolic blood pressure, fasting blood glucose, and serum lipids (total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C). Metabolic syndrome (MetS) was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Pearson correlations were used to test for associations. The mean total PA score of perimenopausal women was 1683.51 ± 805.36 MET-min/week, and of postmenopausal women was 1450.81 ± 780.67 MET-min/week. In all participants, peri- and postmenopausal women, PA was significantly and inversely associated with BMI, weight, percent body fat, HC, WC, and number of MetS components (p < 0.01), and with fasting blood glucose, TC, TG, and LDL-C (p < 0.05). The frequencies of metabolic disorders, obesity, abdominal obesity, type 2 diabetes, dyslipidemia, and MetS were significantly lower at moderate and intense levels of PA (p < 0.05), in also all participants. In middle-aged women, particularly those who are peri-menopausal, PA at moderate and intense levels is associated with more favorable body composition and less frequent metabolic disorders. However, in this particular study, PA does not appear to be associated with blood pressure and HDL-C concentrations. Future studies may be needed to further clarify these findings.
... Many studies have shown a positive relationship between vasomotor symptoms and depressive complaints during the transition to menopause (32,33). However, some other studies suggest that anxiety symptoms are not clearly related to any specific stage of menopause (34). In another study, it was showed that women under the age of 46 who underwent oophorectomy had higher depression scores after surgery (24). ...
Aim: To investigate the effect of of adding oophorectomy on patients who underwent abdominal hysterectomy in the perimenopausal period on menopause, sexual function and mental status.
Materials and Methods: The study was designed prospectively. Women who underwent total abdominal hysterectomy and bilateral salpingectomy (TAH+BS) and total abdominal hysterectomy and bilateral salpingo-ophorectomy (TAH+BSO) in the perimenopausal period for benign indications were included in the study. Three months after surgery, menopausal symptoms (such as vasomotor symptoms, vaginal dryness and/or dyspareunia, memory and sleep problems) were investigated. Beck Anxiety Inventory (BAI) scores were investigated one day before the operation and three months after the operation.
Results: 51 patients with TAH+BS and 55 patients with TAH+BSO included in study. Vasomotor symptoms and postoperative BAI scores were significantly higher in the oophorectomy group (p<0.001 and p=0.009, respectively). Vaginal dryness and/or dyspareunia, which adversely affect sexual function, were significantly higher in the oophorectomy group (p=0.005). Memory and sleep problems were higher in the oophorectomy group (p=0.009 and p<0.001, respectively). Postoperative BAI scores were found to be correlated with postmenopausal symptoms (vasomotor symptoms, vaginal dryness and/or dyspareunia, memory problems, sleeping disorders) in the TAH+BSO group.
Conclusion: Vasomotor symptoms, vaginal dryness and/or dyspareunia, memory and sleeping problems, and anxiety levels were significantly higher in patients who underwent bilateral salpingo-ophorectomy with hysterectomy compared to patients who underwent only hysterectomy and bilateral salpingectomy. It seems useful to inform the patients who are planned for the operation regarding these effects before the decision of oophorectomy.
Keywords: Hysterectomy, oopherectomy, menopause, sexual dysfunction
... 16 However, BMD declines rapidly from late perimenopause to 5-10 years after menopause, resulting in a 10% reduction in bone mass compared with the young-adult mean (equivalent to a decrease of approximately 1.0 T-score unit) with an average loss of 1%-5% BMD per year. [16][17][18][19] Because postmenopausal osteoporosis (PMOP) seriously threatens women's physical and mental health, 17 18 effective prevention of PMOP has important clinical, scientific and social value. Calcium and vitamin D (CaD) comprise the basic prophylactic treatment in the management of postmenopausal osteopenia, which can decrease hip fracture occurrence compared with placebo control in postmenopausal women. ...
Introduction
Postmenopausal osteoporosis, caused by ageing and oestrogen deficiency, seriously threatens women’s physical and mental health. Postmenopausal osteopenia is the transition from healthy bone to osteoporosis, and it may be the key period for preventing bone loss. Moxibustion, a physical therapy of Traditional Chinese Medicine, has potential benefits for osteoporosis treatment and prevention, but it has not been adequately studied. This study aims to explore the clinical effects and safety of moxibustion in delaying bone loss in postmenopausal women.
Methods and analysis
In this parallel-design, randomised, patient-blind and assessor-blind, controlled clinical study, 150 women with osteopenia at low fracture risk will be randomly assigned to a moxibustion treatment (MT) group or a placebo-moxibustion control (PMC) group in a 1:1 ratio. In addition to the fundamental measures (vitamin D3 and calcium) as recommended by the guidelines, participants of the two groups will receive MT or PMC treatment for 42 sessions over 12 months. The primary outcome will be the bone mineral density (BMD) of the lumbar spine at the end of the 12-month treatment, and secondary outcomes will be the BMD of the femoral neck and total hip, T-scores, bone turnover markers, serum calcium levels, serum magnesium levels, serum phosphorus levels, serum parathyroid hormone levels and 25-hydroxyvitamin D levels, intensity of bone pain, quality of life, incidence of osteoporosis and fractures, usage of emergency drugs or surgery, participant self-evaluation of therapeutic effects and the rate of adverse events. All statistical analyses will be performed based on the intention-to-treat and per-protocol principle.
Ethics and dissemination
Ethics approval has been obtained from the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University (permission number: 2021-1243). The results are expected to be published in peer-reviewed journals.
Trial registration number
ChiCTR2100053953.
... Therefore, menopause directly impacts women's health and overall quality of life, with direct consequences occurring within their most intimate region, especially concerning an increased sagging of their external genitalia. [5][6][7] Several therapeutic strategies have been proposed to reverse or minimize these changes, including systemic and topical treatments, surgical procedures, and, recently, non-invasive procedures, to improve the appearance of the skin in the genital region and increase your selfesteem and sexual satisfaction. However, due to the risks and high costs of surgical procedures, and the contraindications associated with hormone replacement therapy, new non-invasive therapeutic options are needed to treat these changes. ...
Objectives
The authors aimed to evaluate clinical and histological changes induced by Fractional Radiofrequency (FRF) and microneedling in vulvar tissue.
Methods
Thirty postmenopausal women were randomly divided into G1 (FRF) and G2 (microneedling) groups. Sub-ablative FRF was executed using disposable fractionated electrodes with an intensity of 8 mJ. Microneedling was performed using a derma roller system. The authors evaluated before and after treatment using the Vaginal Laxity Questionnaire (VLQ), EuroQol Five-Dimensional (EQ-5D) questionnaire, and the Blatt and Kupperman Menopausal Index (BKMI). Additionally, the authors performed biopsies of the labia majora for histological analysis pre- and post-treatment. Data were expressed as mean (± standard deviation). A paired t-test was used for intra-group comparison (pre- and post-treatment), with an independent t-test used to compare intergroup data (both pre- and post-treatment).
Results
In the G1 group, the VLQ values showed differences compared to the pre-treatment values with the data obtained 60 days after the beginning of the sessions (p = 0.01). Similarly, the data changes of the G2 group proved to be significant (p = 0.001) across the same time interval. In comparing the groups, VLQ values were not different (p > 0.05). Regarding histological analysis, FRF demonstrated improvement concerning the number of fibroblasts, blood vessels, and fatty degeneration (p < 0.05) compared to the control. Additionally, FRF and microneedling samples showed higher type III collagen and vimentin expression in the immunohistochemical analysis (p < 0.05).
Conclusions
The therapies were found to be effective in treating the flaccidity of the female external genitalia. Additionally, histological changes were observed after interventions suggesting collagen remodeling.
... Furthermore, the vast majority of these studies are observational and cross-sectional in design and suffer from many limitations common to this type of study, including samples of heterogeneous study in relation to climacteric status. 37,38 The present study showed that the worse individual perception of global health is associated with FSD. Its evaluation was performed by the women's self-perception, not including chronic diseases such as arthrosis, hypertension, and diabetes. ...
Background
It is known that sexual problems increase with age but little is known about the predictors of female sexual dysfunction (FSD) in Brazilian climacteric women.
Aim
To identify predictive factors for FSD in climacteric women.
Methods
This is a cross-sectional population-based study carried out through a household survey.
Outcomes
The measures investigated were sociodemographic characteristics, depressive symptoms, level of physical activity, presence of FSD, self-rated health and sleep satisfaction.
Result
A total of 381 climacteric, sexually active women were included, with a mean age of 55.04 (±7.21) years. The prevalence of FSD was 38.3%. All variables investigated were associated with FSD (P < .05). In the final model, the predictors for FSD were low satisfaction with sleep (OR 4.20; 95% CI 2.32–7.62), advanced age (OR 1.04; 95% CI 1.00–1.08), low education level (OR 0.90; 95% CI 0.85–0.97) and having a partner (OR 0.35; 95% CI 0.16–0.76).
Clinical implication
These aspects deserve attention from the health team to prevent and identify FSD early in life in climacteric women.
Strengths & limitations
This study support existing data about risk factors for FSD in climacteric women. However, it is not possible to attribute causality to any of the correlates identified, which is a limitation of cross-sectional studies.
Conclusion
Dissatisfaction with sleep, senility, insufficient income, low education, not having a partner, complaints of depression, and the worse perception of global health are predictive factors for FSD in climacteric women.
Romano Marquez Reis SC, Martins Pinto J, Aparecida Porcatti de Walsh I, et al. Predictive Factors for the Risk of Sexual Dysfunction in Climacteric Women: Population-based Study. J Sex Med 2022;XX:XXX–XXX.
... Women experience a number of changes and complaints due to declining levels of estrogen; including cycle disorders, vasomotor symptoms (hot flashes and night sweats), vaginal dryness and dyspareunia, urogenital atrophy, tensions, headache, insomnia, lack of energy, fluid retention, back pain, difficulty concentration, confusion, and cognitive decline (3) . In addition, minor mood problems as feeling of anxiety, depression and/or irritability are common during this period. ...
... The study data were collected with a questionnaire form, the 'Menopause Rating Scale (MRS)' and the 'Pittsburgh Sleep Quality Index (PSQI)'. The questionnaire form was developed by the investigators after a review of the relevant literature (Simon and Reape 2009;Moilanen et al. 2010;Smith et al. 2018) and consisted of four sections. The form included 22 questions on the sociodemographic characteristics of the women, the obstetric and menstrual characteristics and general health The Stages of Reproductive Ageing Workshop (STRAW)[18] criteria were used to define menopause in the women (Harlow et al. 2012). ...
The aim of this study was to evaluate the relationship between the menopausal symptoms and sleep quality in women in the climacteric period. This cross-sectional study was conducted on 383 women aged 40–64 years at the Cancer Early Diagnosis Screening and Training Centre. The data were collected with the questionnaire form, Menopause Rating Scale (MRS) and the Pittsburgh Sleep Quality Index (PSQI). The sleep quality was poor in 77.8% of the women in the study. A significant relationship was found between PSQI scores and the somatic and psychological subscale scores of the MRS in the presence of other variables that could affect sleep according to multiple linear regression analysis (p
... During menopause, women come across significant changes that include psychological, emotional, and physical health. Surgical menopause is an invasive emergency procedure in which the female gonads are removed (Oophorectomy) (2). In these artificially induced conditions, the mortality rate is much higher (16.8%) than natural menopause (13.2%) (3). ...
Introduction: Hysterectomy among premenopausal women is a matter of concern as it exposes women to anxiety and depression. There are a wide variety of conventional treatments for these patients to reduce menopausal anxiety and depression such as Cognitive Behaviour Therapy (CBT). Methods: A randomized controlled trial was carried out on 230 females aged 25-55 years undergoing hysterectomy. After collecting complete history, the participants were allocated randomly into two groups. Participants were allocated to the experimental (115) and control (115) group in the ratio of 1:1. The anxiety and depression were descriptively measured using Beck's Anxiety and Depression inventory. Later, CBT, including six procedures, were carried out for the experimental group in six sessions, for the period of seven months. Results: In the pretest, the experimental group anxiety scores were 5.22% (low), 39.13% (moderate), and 55.65% (high); while 4.35% (low), 43.48% (moderate), and 52.17% (high) for the control. Depression scores in the experimental group showed none within the normal score, 3.48% for borderline, 15.65% for mild, 73.91% for moderate, and 6.96% for severe levels; while 4.35% for borderline, 18.26% mild, 72.17% moderate, and 5.22% for severe levels. Conclusion: The CBT is effective in reducing anxiety and depression among women with surgical menopause. CBT was found to the improved psychological profile of these patients.
... Although previous studies reported that physical exercise could improve psychological health in menopausal women, 29,30 the evidence regarding its influence on specific symptoms is scarce or contradictory. 19,[31][32][33] It is estimated that 80% of perimenopausal women suffer VMS (eg, palpitations or hot flashes) which negatively affect their quality of life. 34 Of note, VMS involve other alterations, such as sleep problems, negative mood, or stress, 35 which can all together compromise the self-perception of health. ...
Objective:
To investigate the influence of a supervised multicomponent exercise training program on menopause-related symptoms, particularly vasomotor symptoms (VMS), in middle-aged women.
Methods:
A total of 112 middle-aged women (mean age 52 ± 4 y old, age range 45-60 y) from the FLAMENCO project (exercise [n = 59] and counseling [n = 53] groups) participated in this randomized controlled trial (per-protocol basis). The exercise group followed a multicomponent exercise program composed of 60-minute sessions 3 days per week for 16 weeks. The 15-item Cervantes Menopause and Health Subscale was used to assess the frequency of menopause-related symptoms.
Results:
After adjusting for body mass index and Mediterranean diet adherence, the subscales measuring menopause-related symptoms and VMSs decreased 4.6 more in the exercise group compared to the counseling group (between-group differences [B]: 95% CI: -8.8 to -0.2; P = 0.040). The exercise group also showed significant improvements in the subscales of couple relationships (between-group differences [B]: -1.87: 95% CI: -3.29 to -0.45; P = 0.010), psychological state (between-group differences [B]: -2.3: 95% CI: -5 to -0.2; P = 0.035), and VMSs (between-group differences [B]: -4.5: 95% CI: -8.8 to -0.2; p = 0.040) in the Cervantes Menopause and Health Subscale compared with the counseling group.
Conclusions:
A 16-week multicomponent physical exercise program showed a positive effect on menopause-related symptoms especially in couple relationships, psychological state, and VMS, among 45 to 60 year old women.
... Participants reported their menopausal symptoms by selecting from the following options: sweating, hot flashes, sleep disturbance and insomnia, headache, joint ache, fatigue, changes in mood or melancholia, vaginal symptoms, urinary symptoms, sexual reluctance, and other possible symptoms. 30,31 For the analysis, symptoms were re-coded as vasomotor (sweating, hot flashes), somatic and pain (headache, joint ache), psychological (sleep disturbance and insomnia, fatigue, depression), and urogenital (vaginal symptoms, urinary symptoms, sexual reluctance) symptoms. ...
Objective:
This study investigated whether (1) cognitive functions change after the transition from the perimenopausal to the postmenopausal stage, (2) cognitive functions and walking are associated in middle-aged women, and (3) cognitive functions assessed in perimenopause are associated with walking after reaching the postmenopause or vice versa.
Methods:
In total, 342 women, categorized as early (n = 158) or late perimenopausal (n = 184), were included in the study and followed up until postmenopausal. Psychomotor speed, executive functions related to set-shifting and updating, working memory, and visual memory were assessed. Walking was assessed with walking speed, walking distance, and dual-task cost in walking speed. Data was analyzed using the paired-samples t test, Wilcoxon signed rank test, multiple linear regression analysis, and structural equation modeling.
Results:
We found small but significant improvements in psychomotor speed (P = 0.01) and working memory (P < 0.001) among early perimenopausal and in psychomotor speed (P = 0.001), set-shifting (P = 0.02), visual memory (P = 0.002), and working memory (P < 0.001) among late perimenopausal women after the transition from peri- to postmenopause. Walking speed (β = 0.264, P = 0.001) and dual-task cost (β = 0.160, P = 0.03) were associated with updating, and walking distance was associated with updating and set-shifting (β = 0.198, P = 0.02, β=-0.178 P = 0.04 respectively) among the late perimenopausal women. We found no longitudinal associations between cognitive functions and walking.
Conclusion:
Cognitive performance remained unchanged or improved after reaching postmenopause. Cognitive functions and walking were associated during the late perimenopause, but the association depended on the cognitive process and nature of the physical task. Cognitive performance was not associated with walking after reaching postmenopause or vice versa.
... Menopause is a physiological process that marks the end of the reproductive phase of a woman's life [1]. This process entails a constellation of symptoms (e.g., hot flashes, sleep disturbances, and decreased physical strength) attributed to hormonal changes, which may vary considerably in terms of incidence and intensity across individuals [2]. On average, the menopausal transition begins between the ages of 48 and 55 years and typically lasts for four to eight years [3]. ...
(1) Background: The increasing presence of employed women undergoing menopause has stimulated a growing corpus of research highlighting the complex relationship between menopause and work. Nevertheless, little is known regarding the mechanism by which menopause affects work ability and work-related well-being. In order to fill this gap in the literature, the present study examines whether and how menopausal symptoms affect the relationship between job demands, work ability, and exhaustion. (2) Method: In total, 1069 menopausal women, employed as administrative officers in a public organization, filled out a self-report questionnaire. A moderated mediation analysis was carried out using the latent moderated structural (LMS) equation. (3) Findings: The findings of this analysis indicate that the indirect effect of work ability on the relationship between job demands and exhaustion is influenced by the exacerbating effect of menopausal symptoms on the relationship between job demands and work ability. Moreover, the conditional effect confirmed that women with high menopausal symptoms receive more exposure to the negative effects of job demands on work ability compared to women with low menopausal symptoms. (4) Conclusion: The present findings may help in addressing interventions to prevent negative outcomes for menopausal women and their organizations.
... Similar results were presented by Bińkowska et al. [5] as well as Wyderka and Zdziennicki [37]. Beck et al. also observed that among British women hot flashes were the most commonly mentioned menopausal symptoms together with fatigue, night sweats and sleeplessness [38], which dominate the list of the most common menopausal ailments [39][40][41][42]. ...
Current reports indicate that there is a relationship between women's socio-economic status (SES) and their level of knowledge on the menopausal transition. The aim of the study was to assess the level of knowledge in pre-menopausal women on the most frequent symptoms accompanying the menopausal transition as well as conventional and nonconventional therapies of alleviating symptoms in relation to women's SES. The study was conducted among 114 women with the mean age of about 44 (± 2.51) years. A self-prepared questionnaire was used to investigate their SES and level of knowledge on the most common menopausal symptoms and methods of alleviating them. Most of the women (66.7%) were familiar with the most frequent menopausal symptoms. The women associated menopause with hot flashes (41.2%), mood swings (27.2%) and depression (15.8%). The majority of the women (84.2%) were familiar with hormone replacement therapy (HRT) and 43% of them were familiar with alternative therapies (AT). Better-educated women were more likely to take AT in the future while less-educated women intended to take HRT. Place of residence and income did not differentiate whether women intended to use HRT or AT during the menopausal transition. There was no difference in the level of women's knowledge on HRT in relation to SES. There was an association between the level of knowledge on AT and education as well as place of residence. Better-educated women from medium and large urban centres tended to know unconventional methods of alleviating climacteric symptoms. Education was the most significant predictor of self-assessed level of knowledge on the menopausal transition.
... Menopause is a natural biological process related to the end of a woman´s reproductive life and is associated with physical symptoms such as vascular dysfunction (hot flashes, palpitations, and night sweats), psychological symptoms including mood changes, irritability, anxiety, or depression, and metabolic effects such as weight gain and slowed metabolism [1]. After the reproductive or premenopausal period, women usually experience menopausal transition between the ages of 45 and 55. ...
Background
This study was designed to evaluate the beneficial effects of a botanical extract combination containing soy isoflavone extract (100mg), Aframomum melegueta seed dry extract (50 mg), and Punica granatum skin dry extract (100mg) on health-related Quality of Life in healthy Spanish menopausal women with hot flashes, anxiety, and depressive symptoms using the validated Cervantes Scale.
Methods and results
Fifty-seven outpatient women (45–65 years) with menstrual problems associated with climacteric syndrome were enrolled from April 2018 to April 2019 in the context of a prospective, placebo-controlled, double-blind study. Women were randomized to receive treatment with either the botanical combination (250 mg daily divided into two doses) or placebo for eight weeks. At the beginning and end of the study, health-related Quality of Life was assessed using the Cervantes Scale. Subjects treated with the botanical extract, compared to subjects in the placebo group, showed a significant improvement in the Global health-related Quality of Life score (38% [11.3–50.0]% vs. 18.8% [0–37.7]%; P = 0.04) on the Cervantes Scale and, specifically, in the menopause and health domain (13.6% [0–45.4]% vs. 40.7% [20.6–61.0]%; P = 0.05). By contrast, there were no significant changes in the psychic, sexuality, and couple relationship related domains of the Cervantes Scale. Patients who concluded the study did not report substantial side effects.
Conclusion
Short-term intake of the botanical combination improved the Global Quality of Life of climateric women, according to the Cervantes Scale. Since this is a pilot trial, results should be analysed with caution.
Trial registration
NCT04381026; ClinicalTrial.gov (retrospectively registered).
... Menopause dikaitkan dengan berbagai macam fisik dan gejala psikologis. Gejala khas pada saat menopause yang berlangsung 4-5 tahun adalah hot flushes, keringat malam, kekeringan vagina dan gangguan tidur (Moilanen et al., 2010). MO memiliki khasiat antioksidan dan memiliki potensi terapeutik untuk pencegahan komplikasi selama menopause (Kushwaha et al., 2014). ...
Moringa oleifera (MO) merupakan salah satu tumbuhan nutrasetikal karena selain memiliki nilai nutrisi juga berfungsi dalam penyembuhan penyakit. Bila dibandingakan dengan Zingiberaceae, polularitas MO jauh tertinggal, oleh karena itu diperlukan kajian mendalam mengenai manfaat MO sehingga potensi pemanfaatannya bisa dikembangkan. Kajian ini bertujuan membahas secara konfrehensif mengenai pemanfaatan MO sebagai bahan pangan dan obat yang didasarkan pada studi literature. Literature diperoleh secara online di Google scholar dengan menggunakan kata kunci Moringa oleifera, uses MO, dan bioactivities MO. MO memiliki berbagai efek terapi sebagai antimikroba, antikanker, hepetoprotektif, anti diabetes mellitus, dan antioksidan, menghambat menopause. MO kaya nutrisi mengandung berbagai senyawa penting terutama di daun dan dapat digunakan untuk mengatasi malnutrisi. Kandungan gizi MO sebanyak 7 kali lebih banyak vitamin C dari jeruk, 10 kali lebih banyak vitamin A dari pada wortel, 17 kali lebih banyak kalsium daripada susu, 9 kali lebih banyak protein daripada yoghurt, 15 kali lebih banyak pisang dan 25 kali lebih banyak zat besi daripada bayam. MO merupakan salah satu alternatif bahan pangan yang sangat potensial untuk mengatasi malnutrisi sekaligus memiliki efek pharmaceutikal.
... Previous studies supported the importance and benefit of physical activity on mood improvement and weight Page 6 of 8 Fouad et al. Bull Natl Res Cent (2021) 45:59 control, no impact on vasomotor symptoms and urogenital symptoms (Mansikkamaki et al. 2015;Tseng et al. 2012;Moilanen et al. 2010). ...
Background
Nutrition and good health are two dependent parallel axes; female’s health at different ages in general and at the time of menopause in particular has received a lot of attention last several years. The objective of this experimental study was to evaluate the effect of consuming food supplement versus lifestyle modification in the dietary habit on menopausal symptoms in perimenopausal Egyptians females.
Results
Forty seven females in the perimenopausal stage of life with mean age 46.04 ± 5.88 years participated on the food supplement consumption group, they consumed 75 g per day of a rusk (prepared from corn flour, wheat flour 72%, full cream milk powder, flaxseed oil, wheat germ, clove and cinnamon powder) for 2 months. They were compared with the control group (forty nine females with mean age 46.91 ± 5.39 years) who changed their foods habits to a healthy life style. Menopause rating scale and the biochemical analysis were comparable on day 1 and on day 60. The total menopause rating scale and its three subscales (psychological, urogenital and somatic), waist circumference, serum follicle stimulating hormone and estradiol in the corn rusk supplement group showed a statistically significant improvement. No significant difference was noted in the control group apart of the psychological subscale and waist circumference.
Conclusions
Corn Rusk enriched with clove and cinnamon as a food supplement snake is promising to relief menopausal symptoms and should be considered on the diet of menopausal females.
... Menopause dikaitkan dengan berbagai macam fisik dan gejala psikologis. Gejala khas pada saat menopause yang berlangsung 4-5 tahun adalah hot flushes, keringat malam, kekeringan vagina dan gangguan tidur (Moilanen et al., 2010). MO memiliki khasiat antioksidan dan memiliki potensi terapeutik untuk pencegahan komplikasi selama menopause (Kushwaha et al., 2014). ...
ABSTRAK Moringa oleifera (MO) merupakan salah satu tumbuhan nutrasetikal karena selain memiliki nilai nutrisi juga berfungsi dalam penyembuhan penyakit. Bila dibandingakan dengan Zingiberaceae, polularitas MO jauh tertinggal, oleh karena itu diperlukan kajian mendalam mengenai manfaat MO sehingga potensi pemanfaatannya bisa dikembangkan. Kajian ini bertujuan membahas secara konfrehensif mengenai pemanfaatan MO sebagai bahan pangan dan obat yang didasarkan pada studi literature. Literature diperoleh secara online di Google scholar dengan menggunakan kata kunci Moringa oleifera, uses MO, dan bioactivities MO. MO memiliki berbagai efek terapi sebagai antimikroba, antikanker, hepetoprotektif, anti diabetes mellitus, dan antioksidan, menghambat menopause. MO kaya nutrisi mengandung berbagai senyawa penting terutama di daun dan dapat digunakan untuk mengatasi malnutrisi. Kandungan gizi MO sebanyak 7 kali lebih banyak vitamin C dari jeruk, 10 kali lebih banyak vitamin A dari pada wortel, 17 kali lebih banyak kalsium daripada susu, 9 kali lebih banyak protein daripada yoghurt, 15 kali lebih banyak pisang dan 25 kali lebih banyak zat besi daripada bayam. MO merupakan salah satu alternatif bahan pangan yang sangat potensial untuk mengatasi malnutrisi sekaligus memiliki efek pharmaceutikal. ABSTRACT Moringa oleifera (MO) is one of the nutritious plants that also functions in healing diseases. Compared with Zingiberaceae, MO popularity is left behind. Therefore, an in-depth study of the benefits of MO is needed to elaborate on its potential use. This study aims to comprehensively explore MO as food and medicine resources based on literature studies. Literature is obtained online at Google scholar using the keywords Moringa oleifera, MO uses, and bioactivity. MO has various therapeutic
... Prior work has shown that women with higher PTSD symptom levels are at increased risk of obesity and more likely to have accelerated weight gain (30) as well as less likely to be physically active (41,42) or have a healthy diet (43). These factors have also previously been associated with more menopausal symptoms (44)(45)(46)(47), potentially increasing likelihood of initiating MHT. However, we did not find that further adjusting for health-related behaviors and BMI made notable change to the PTSD-MHT association magnitude, and our results therefore do not provide strong support for this pathway. ...
Background
Posttraumatic stress disorder (PTSD) is associated with higher risk of certain chronic diseases, including ovarian cancer, but underlying mechanisms remain unclear. Although prior work has linked menopausal hormone therapy (MHT) use with elevated ovarian cancer risk, little research considers PTSD to likelihood of MHT use. We examined whether PTSD was prospectively associated with greater likelihood of initiating MHT use over 26 years.
Methods
Using data from the Nurses' Health Study II, with trauma and PTSD (symptoms and onset date) assessed by screener in 2008 and MHT assessed via biennial survey (from 1989), we performed Cox proportional regression models with women contributing person-years from age 36 years. Relevant covariates were assessed at biennial surveys. We considered potential effect modification by race/ethnicity, age at baseline, and period (1989–2002 vs. 2003–2015).
Results
Over follow-up, 22,352 of 43,025 women reported initiating MHT use. For example, compared with women with no trauma, the HR for initiating MHT was 1.18 for those with trauma/1–3 PTSD symptoms [95% confidence interval (CI), 1.13–1.22] and 1.31 for those with trauma/4–7 PTSD symptoms (95% CI, 1.25–1.36; P trend < 0.001), adjusting for sociodemographic factors. Associations were maintained when adjusting for reproductive factors and health conditions. We found evidence of effect modification by age at baseline.
Conclusions
Trauma and number of PTSD symptoms were associated with greater likelihood of initiating MHT use in a dose–response manner.
Impact
MHT may be a pathway linking PTSD to altered chronic disease risk. It is important to understand why women with PTSD initiate MHT use.
... 4 However, geographical location, ethnicity, education and lifestyle may influence the prevalence of menopausal symptoms. 5 Thus, identifying the factors associated with menopausal symptoms, especially those which are modifiable, may be important to reduce the risk of future chronic illness among postmenopausal women. Smoking has been proved to be linked to depressive mood during the menopausal transition. ...
Objective
To investigate the dependency of menopausal symptoms on age and/or menopausal status and association with social and environmental factors.
Methods
The cross-sectional study was conducted on 4595 women (40–83 years) coming from 31 provinces during two years to our “Menopause Clinic”, the first official center in China. Menopausal symptoms were assessed: negative mood, cognitive symptoms, sleep disorder, vasomotor symptoms (VMS), urogenital symptoms, autonomic nervous disorder, limb pain/paresthesia. Social and environmental factors were collected; simple and unconditional logistic regression with adjustments by all analyzed factors were used to assess associations.
Results
Urogenital symptoms were the most common and VMS the least common complaints. All symptoms, except cognitive and urogenital symptoms, worsened age-dependently up to 60 years but improved beyond this age. Most symptoms also were associated with menopause, except negative mood and autonomic nervous disorders. Soya-rich diet decreased all symptoms, but only if consumed daily. Exercise was beneficial for some symptoms. Hormone replacement therapy (HRT) was most effective but only with regular use. Increased alcohol consumption aggravated VMS. Higher education was associated with less symptoms; no relationship was found for smoking, gravidity, parity, and menarche.
Conclusion
All symptoms, except cognitive and urogenital symptoms, worsened age-dependently up to 60 years but improved beyond this age; most were also associated with menopause. For the first time in a large study population, it was observed that soy-rich diet is protective but only with daily consumption. Exercising can protect against some of the symptoms. HRT decreased all symptoms, but regular use is necessary. Women with higher education reported less symptoms, but after adjustments no other relationships were observed (ChiCTR2000035047).
... Data from preceding research recommended that <50% of women aged 45-64 years agonize from the perimenopausal syndrome. 24 We set parameters confidence intervals at 95%, incidence at 49.6% and precision at 7.44%. Thus, the projected sample size was 173. ...
Introduction: Perimenopause is the period indicated immediately before and after the 1 st year of menopause where the estrogenic activity is abridged, leading to neurotic and psychotic changes. Purpose: To assess the prevalence of perimenopausal depression among women of the age group 40 to 54 years. Method: A descriptive cross-sectional study was conducted in women of age group 40 to 54 years residing at ward no. 11 and 12 of Butwal Sub-Metropolitan City of Rupandehi district. One hundred seventy-three samples were selected using a non-probability purposive sampling technique. A pretested semi-structured interview schedule was used for data collection and data were analyzed by using descriptive and inferential statistics, i.e. frequency, percentage, mean and χ 2 test. Results: The study finding revealed that the mean age of the respondents was 46 years. The overall prevalence of perimenopausal depression was more than half (56.6%). The majority (16.2%), 15%, 14.4% and minority (11%) of the respondents had mild, moderate, severe and very severe depression respectively. The respondent's level of perimenopausal depression was statistically significant with the
Bu çalışmada 18 yaş ve üstü kadınlarda menopoz bilgisini ölçen Menopoz Bilgisi Ölçeği geliştirilmesi amaçlanmaktadır. Çalışmamız 18 yaş ve üstü 397 kadın ile yapılmıştır. Ölçek geçerlilik ve güvenirlik analizleri kapsamında kapsam geçerliliği, açımlayıcı faktör analizi, iç tutarlılık güvenirlik analizleri yapılmıştır. Ölçek yapısını belirlemek için temel bileşenler analizi ve varimax rotasyon tekniği kullanılmıştır. Güvenirlik analizinde iç tutarlılık (Cronbach alfa katsayısı) yöntemi, madde toplam korelasyon analizi ve test tekrar test yöntemi kullanılmıştır. Veri setinin faktör analizi için uygunluk analizi KMO katsayısı 0,931 Bartlett’s Testi için p
Bu çalışma postmenopozal dönemde kadınlara verilen menopoz semptomlarını yönetme eğitiminin menopoz semptomları ve yaşam kalitesi düzeyine etkisini belirlemek amacıyla yapılmıştır. Mayıs Temmuz 2023 tarihleri arasında gerçekleştirilen çalışma, anket formlarının çevrimiçi platformlar aracılığıyla yayınlanması ve eğitimlerin video konferans yöntemiyle gerçekleştirilmesi yoluyla 106 (53 Deney, 53 Kontrol) kadınla, randomize kontrollü olarak yürütülmüştür. Araştırmanın verileri Kişisel Bilgi Formu, Menopoza Özgü Yaşam Kalitesi Ölçeği ve Menopoz Semptomları Değerlendirme Ölçeği ile toplanmıştır. Çalışmada deney grubuna 4 haftalık menopoz semptomlarını yönetme eğitimi videokonferans yöntemi kullanılarak bireysel olarak gerçekleştirildi. Araştırmanın verileri uygun istatistiksel yöntemler kullanılarak analiz edildi. Çalışmada eğitim sonrası gruplar arasında Menopoz Semptomları Değerlendirme Ölçeği (MSDÖ) ile Menopoza Özgü Yaşam Kalitesi Ölçeği (MÖYKÖ) toplam ve alt boyutları puan ortalamaları karşılaştırılmış ve gruplar arasındaki farkın deney grubu lehine istatistiksel olarak anlamlı olduğu bulunmuştur (p
Menopause occurs around midlife and is an inevitable component of women's aging. The study aimed to investigate the associations between the lifetime prevalence of menopausal symptoms and health-related characteristics among Israeli postmenopausal women aged 55-75 years. Additionally, this study aimed to estimate the use of hormone replacement therapy (HRT) and women's attitudes toward this treatment. Data for this study were extracted from a cross-sectional national telephone survey conducted in Israel between 2018 and 2020. For the current study, only postmenopausal women aged 55-75 years were included. Multivariate analyses were used to identify demographic and health-related characteristics associated with menopausal symptoms. The study included 688 participants. Most (68.8%) reported one or more menopausal symptoms, specifically vasomotor symptoms (50.4%). According to the multivariate logistic regression analysis, menopausal symptoms were associated with moderate-high anxiety and/or depression symptoms (OR = 2.01, 95% CI 1.12-3.58) and with osteoporosis (OR = 1.78, 95% CI 1.08-2.92). Although most (78.3%) symptomatic women were bothered by their symptoms, 29.1% received any treatment for symptom relief and only 12.6% reported current or past use of HRT. The findings show that menopausal symptoms were associated with a higher prevalence of anxiety and/or depression symptoms and osteoporosis in the years following menopause. Most symptomatic women did not receive any treatment and the majority were against HRT. Knowledge and awareness about menopause and treatment options should be increased among Israeli women. Additionally, the promotion of positive attitudes toward menopause and HRT use among women and healthcare providers is strongly recommended.
During menopause, women experience numerous symptoms of a psychological, somatic, vasomotor, and/or sexual nature. Women may experience none, some, or all of these types of symptoms to varying degrees, often having a significant negative impact on their overall quality of life. Data suggest that women who participate in regular exercise experience less menopausal symptoms than those who do not; hence, exercise may present a safe and accessible therapy for the symptoms of menopause. However, there are also many studies in the literature that show little or no effect of exercise alleviating these symptoms. We present the existing data and highlight the need for well-designed, appropriately powered studies in the future.KeywordsMenopauseExercisePhysical activitySomatic symptomsVasomotor symptomsPsychological symptomsInflammation
Objective:
Menopause symptoms can vary in type, duration, and severity. The purpose of this study was to investigate the key factors predicting severe symptoms among Korean perimenopausal women with various demographic data, obstetric and psychiatric histories, and menopausal symptoms screening scale scores.
Methods:
Data were collected from 1,060 women, and 4 latent classes were identified using latent profile analysis, with 6 major categories of menopausal complaints. Among the 4 classes, we selectively used data from the "all unimpaired" and "all impaired" groups. Menopause rating scale (MRS), sociodemographic, obstetric, and psychiatric factors were assessed, and hierarchical logistic regression analyses were conducted with the "all impaired" group as a dependent variable.
Results:
Marital status and scores on the psychological and somatic subscales of the MRS were statistically related to being in the "all impaired" group. Otherwise, family history of menopausal symptoms, menarche age, and history of other psychiatric disorders were not statistically significant predictors of being in the "all impaired" group.
Conclusion:
The psychological and somatic subscales of the MRS predict the severity of perimenopausal syndrome better than obstetric and psychiatric history do among Korean perimenopausal women. Psychological and somatic symptoms as well as genitourinary symptoms in menopausal patients should be closely evaluated.
Objective
To chart peer-reviewed literature regarding the psychological and social health outcomes of physical activity (PA) around menopause in a systematic manner.
Methods
Nine electronic databases and 10 core journals were searched using specific search strings to identify eligible articles. Manual checking of reference lists was also performed. The selection process was guided by the stages in PRISMA-ScR.
Results
Eighty peer-reviewed articles representing 67 studies from 25 countries were included. All articles were published between 1994 and 2021. For all studies, surveys were the primary method of measuring psychological and social health outcomes, in cross-sectional studies (36 papers), intervention studies (33), longitudinal cohort studies (10) and one paper reporting a mixed-method study. The dataset comprised a total of 103,826 women, with an average age of 52.6 and a variety of menopausal states. Most of the studies involved primarily Caucasian, relatively healthy, married and employed participants. Nineteen psychological and social health outcomes were assessed, including psychological menopause symptoms (N = 34), quality of life (N = 33), depression (N = 30), anxiety (N = 11), mental wellbeing (N = 21), perceived stress (N = 9), satisfaction with life (N = 7) and self-esteem (N = 5).
Conclusions
Collectively, the findings of these studies indicate a relatively evident positive impact of PA on the respective health outcomes, with only a few studies reporting no association. It is also noteworthy that most studies did not report any difference related to menopausal status. Future studies would benefit from, inter alia, a qualitative approach to lived experiences of psychological and social health outcomes of PA during the menopausal transition.
Background
Vasomotor symptoms (VMS) are common around menopause. Menopausal hormone therapy is the most effective treatment for VMS. Physical exercise has been proposed as an alternative treatment since physically active women have previously been found to experience fewer VMS than inactive women. In our randomised controlled trial on resistance training to treat VMS, sympoms were reduced by 50% in the intervention group compared with the control group.
Objectives
To propose a mechanism to explain how resistance training reduced VMS and to assess if luteinizing hormone (LH) and follicle stimulating hormone (FSH) were affected in accordance with the proposed mechanism.
Trial design and methods
A substudy of a randomized controlled trial on 65 postmenopausal women with VMS and low physical activity who were randomised to 15 weeks of resistance training three times per week (n = 33) or to a control group (n = 32). To be regarded compliant to the intervention we predecided a mean of two training sessions per week. The daily number of VMS were registered before and during the 15 weeks. Blood samples were drawn for analysis of LH and FSH at baseline and after 15 weeks.
Results
LH decreased significantly in the compliant intervention group compared with the control group (-4.0±10.6 versus 2.9±9.0, p = 0.028 with Mann-Whitney U test). FSH also decreased in the compliant intervention group compared with the control group, however not enough to reach statistical significance (-3.5±16.3 versus 3.2±18.2, p = 0.063 with Mann-Whitney U test). As previously published the number of hot flushes decreased significantly more in the intervention group than in the control group but there was no association between change in LH or FSH and in number of VMS.
Conclusions
We propose that endogenous opiods such as β-endorphin or dynorphin produced during resistance training decreased VMS by stimulating KNDγ-neurons to release neurokinin B to the hypothalamic thermoregulatory centre. Through effects on KNDγ-neurons, β-endorphin could also inhibit GnRH and thereby decrease the production of LH and FSH. The significanty decreased LH in the compliant intervention group compared with the control group was in accordance with the proposed mechanism.
During the perimenopausal and early postmenopausal periods, women experience several systemic and psychological changes. They mainly concern the genitourinary, central nervous, musculoskeletal, and cardiovascular systems. Changes related to the aging process of the skin also play an important role. The aim of the study was to evaluate the influence of age, selected anthropometric data (such as body weight, body height, body mass index (BMI) and external dimensions of the pelvis), and the parameters included in the questionnaires on the bioelectric activity of the pelvic floor muscles (PFM). Postmenopausal women achieved higher levels of resting and functional surface activity of pelvic floor muscle electromyography (sEMG PFM), indicating that PFM function improves over the years following menopause. Women who report significant symptoms of urinary incontinence had a lower PFM resting tone. This may prove significant functions of PFM, mainly during resting activity. However, this results requires further verification based on a larger study group and usage of specialized methods of assessing the degree and type of urinary incontinence.
During the menopause transition, many women will report various physical and psychological symptoms that adversely affect quality of life. Psychological symptoms include sadness, irritability, tearfulness, decreased memory and concentration, depression, and anxiety. Many women may not recognize these psychological symptoms as being related to menopause. Healthcare providers are uniquely positioned to offer education and anticipatory guidance on what to expect well in advance of the menopause transition. The wide variety of treatment options including pharmacologic and nonpharmacologic interventions should be tailored to the woman and to her treatment preferences.
The article is devoted to the possibilities of correction of neuropsychiatric disorders in perimenopause, a condition associated with the cessation of menstruation in a woman and a decrease in the level of ovarian steroid hormones (estrogen and progesterone) due to the loss of the ovarian follicular mass. It is known that biological and endocrine changes during this period are often accompanied by autonomic symptoms. In perimenopause, women may experience symptoms such as hot flashes and night sweats, insomnia, vaginal dryness, mood disorders, etc. Although most symptoms are not life-threatening, they can have a negative impact on the quality of life, physical and mental health of perimenopausal women. During menopause, women are at higher risk of developing depression, stress, anxiety and emotional disorders. In addition, during perimenopause, women experience not only depressive symptoms but also cognitive impairment, which may be related to changes in hormonal background. Drugs that are used in the treatment of mood disorders affect different neurotransmitters, in particular serotonin, norepinephrine and gamma-aminobutyric acid (GABA). One of the benzodiazepine derivatives is Tofisopam, first developed in Hungary and marketed in a number of European countries under the name Grandaxin. It is indicated for the treatment of neurotic and somatic disorders associated with tension, anxiety, autonomic disorders, lack of energy and motivation, apathy, fatigue, depressed mood and alcohol withdrawal syndrome, including during perimenopause. Tofisopam has good anxiolytic activity with no observable sedative, anticonvulsant, amnestic or muscle relaxant effects.
Lifestyle factors can impact the gynaecological well-being of a woman throughout her life, affecting parameters such as the age of the menarche and symptoms of dysmenorrhoea. Periconceptual lifestyle behaviours play a role in the likelihood of conception, having a healthy pregnancy and the risk of miscarriage and pregnancy complications, such as gestational diabetes. During pregnancy, lifestyle behaviours, including diet and caffeine and alcohol intake, will affect the future health of offspring. At the time of the menopause, many women are modifying their lifestyle to manage adverse symptoms they may experience.
This chapter will explore the role that lifestyle plays in determining gynaecological health and well-being. It is essential that all women are provided with evidence-based knowledge and advice, so they are empowered to make lifestyle changes, which could improve their health and quality of life.
Objective
Lifestyle modification is consistently recommended for healthy living during menopause; nonetheless, there is paucity of data on menopausal experiences and lifestyle practices of women in rural communities of Nigeria. This study assessed the lifestyle practices of menopausal women, their experiences of menopause-related symptoms and the influence of lifestyle practices on their experiences of menopause-related symptoms.
Method
A descriptive cross-sectional design was used in this study. Systematic random sampling was used to select 271 menopausal women at household level in rural communities of Ado-Ekiti Local Government Area in Ekiti State, Nigeria. A self-developed structured questionnaire was used to assess lifestyle practices while modified menopause rating scale was used to assess menopausal-related symptoms of the women. Data were analysed using descriptive and inferential statistics in SPSS version 22 at 0.05 level of significance.
Results
Findings revealed that 58.3% had poor lifestyle, while 41.0% and 0.7% had moderate and good lifestyle, respectively. Findings showed that 66.4% of the women experienced moderate menopause-related symptoms, while 15.5% and 0.4% of the women had severe and very severe menopause-related symptoms respectively. Result of the multiple regression indicated that Exercise (β = 0.22, t = 3.63, p = .01), Nutrition (β = 0.13, t = 2.23, p = .02) and Substance use (β = 0.04, t = 2.25, p = .02) were major predictors of menopause-related symptoms.
Conclusion
The study concluded that positive lifestyle modification could help reduce menopausal-related symptoms.
Background
The prevalence and intensity of menopausal symptoms differ depending on ethnicity, culture, and country. Epidemiological data from China are scarce.
Objective
To compare the prevalence and severity of menopausal symptoms in peri- and postmenopausal Chinese women.
Methods
This was a prospective two year cohort study that included all eligible women from 31 Chinese provinces attending our ‘Menopause Clinic’, the first official specialized center in China. Structured questionnaires containing seven domains with 41 items in total were used to assess the following menopausal symptoms using descriptive analysis: negative mood, cognitive symptoms, sleep disorder, vasomotor symptoms (VMS), urogenital symptoms, autonomic nervous disorder, and limb pain/paresthesia.
Results
A total of 4063 women with a mean age of 50.53 ± 6.57 (n = 2107 perimenopausal and 1956 postmenopausal) participated. All menopausal symptoms were more severe in postmenopausal women (p<.05). Independent of menopausal status, urogenital symptoms, often combined with sexual problems, were the most common complaints (in prevalence and severity), followed by sleep disorder, cognitive symptoms (especially hypomnesia), negative mood, autonomic nervous disorder, limb pain/paresthesia and, as the rarest complaint, VMS.
Conclusions
Urogenital symptoms among midlife Chinese women are common, frequently also in combination with sexual dysfunction, although many do not often complain about these in the first place. Postmenopausal women presented more prevalent and severe menopausal symptoms. In contrast to Western countries, VMS are rare among our population. A multidisciplinary approach and use of hormonal and non-hormonal therapies should be considered for these women.
The period of the menopausal transition from 40–45 years to menopause – is the crucial period of a woman’s life, in which, against the background of increasing estrogen deficiency, in addition to the appearance of vasomotor, psychological, and urogenital symptoms, complications and exacerbations of accumulated extagenital diseases occur. The loss of the natural balance of sex hormones leads to hyperplastic processes in hormone-dependent tissues, which leads to cancer risks. In solving this problem, menopausal hormone therapy (MHT) can play a crucial role, but this will become possible if, when choosing drugs for MHT, preference will be given to the safest dosage forms that provide the whole spectrum of compensatory reactions, including the prevention of dramatic situations of this age.
Although most women report vasomotor symptoms (hot flashes, night sweats) during midlife, their etiology and risk factors are incompletely understood. Body fat is positively associated with vasomotor symptoms cross-sectionally, but the longitudinal relation between changes in body fat and vasomotor symptoms is uncharacterized. The study aim was to examine whether gains in body fat were related to vasomotor symptom reporting over time. Measures of bioelectrical impedance for body fat, reproductive hormones, and reported vasomotor symptoms were assessed annually over 4 years from 2002 to 2006 among 1,659 women aged 47-59 years participating in the Study of Women's Health Across the Nation. Body fat change was examined in relation to vasomotor symptoms by using generalized estimating equations. Body fat gains were associated with greater odds of reporting hot flashes in models adjusted for age, site, race/ethnicity, education, smoking, parity, anxiety, and menopausal status (relative to stable body fat, gain: odds ratio = 1.23, 95% confidence interval: 1.02, 1.48; P = 0.03; loss: odds ratio = 1.07, 95% confidence interval: 0.89, 1.29; P = 0.45). Findings persisted controlling for estradiol, the free estradiol index, or follicle-stimulating hormone concentrations. The relations between body fat changes and night sweats were not statistically significant. Body fat gains are associated with greater hot flash reporting during the menopausal transition.
A number of studies have suggested that ethnic background influences a woman's perception of her symptoms. The Study of Women's Health Across the Nation (SWAN) is a multiethnic, longitudinal, cohort study of US women that includes non-Hispanic Caucasian, African-American, Chinese, Japanese and Hispanic women. The initial strategy for this seven-site study involved community-based recruitment of non-Hispanic Caucasians at each site, plus one minority ethnic group. Since ethnicity varies with many other factors, measures of education, acculturation, social status, psychological wellbeing and financial strain were all taken into account in interpreting symptom onset, frequency and severity of the common menopausal symptoms. Biological and physical measures were also assessed and related to symptoms. Most symptoms varied by ethnicity. Vasomotor symptoms were more prevalent in African-American and Hispanic women and were also more common in women with greater BMI, challenging the widely held belief that obesity is protective against vasomotor symptoms. Vaginal dryness was present in 30-40% of SWAN participants at baseline, and was most prevalent in Hispanic women. Among Hispanic women, symptoms varied by country of origin. Acculturation appears to play a complex role in menopausal symptomatology. We conclude that ethnicity should be taken into account when interpreting menopausal symptom presentation in women.
The mechanisms causing postmenopausal vasomotor symptoms are unknown, but changes in hypothalamic beta-endorphins have been suggested to be involved. beta-endorphin production may be increased by regular physical exercise.
To assess if physically active women suffered from vasomotor symptoms to a lower extent than sedentary women.
All women (n = 1323) in the ages ranging from 55-56 years in the community of Linköping Sweden, were included. In a questionnaire these women were asked about their physical exercise habits and their complaints from vasomotor symptoms. Only those 793 women who had reached a natural menopause were grouped into sedentary, moderately or highly active women, based on a physical activity score.
Only 5% of highly physically active women experienced severe hot flushes as compared with 14-16% of women who had little or no weekly exercise (P < 0.05; relative risk 0.26; CI 95%: 0.10-0.71). This was not explained by differences in body mass index, smoking habits or use of hormone replacement therapy. Women who used hormone replacement therapy were more physically active than non-users (P < 0.05).
Fewer physically active women had severe vasomotor symptoms compared with sedentary women. This may be due to a selection bias but also to the fact that physical exercise on a regular basis affects neurotransmitters which regulate central thermoregulation.
A community-based survey was conducted during 1995-1997 of factors related to menopausal and other symptoms in a multi-racial/ethnic sample of 16,065 women aged 40-55 years. Each of seven sites comprising the Study of Women's Health across the Nation (SWAN) surveyed one of four minority populations and a Caucasian population. The largest adjusted prevalence odds ratios for all symptoms, particularly hot flashes or night sweats (odds ratios = 2.06-4.32), were for women who were peri- or postmenopausal. Most symptoms were reported least frequently by Japanese and Chinese (odds ratios = 0.47-0.67 compared with Caucasian) women. African-American women reported vasomotor symptoms and vaginal dryness more (odds ratios = 1.17-1.63) but urine leakage and difficulty sleeping less (odds ratios = 0.64-0.72) than Caucasians. Hispanic women reported urine leakage, vaginal dryness, heart pounding, and forgetfulness more (odds ratios = 1.22-1.85). Hot flashes or night sweats, urine leakage, and stiffness or soreness were associated with a high body mass index (odds ratios = 1.15-2.18 for women with a body mass index > or =27 vs. 19-26.9 kg/m2). Most symptoms were reported most frequently among women who had difficulty paying for basics (odds ratios = 1.15-2.05), who smoked (odds ratios = 1.21-1.78), and who rated themselves less physically active than other women their age (odds ratios = 1.24-2.33). These results suggest that lifestyle, menstrual status, race/ethnicity, and socioeconomic status affect symptoms in this age group.
Results of recent trials highlight the risks of hormone therapy, increasing the importance of identifying preventive lifestyle factors related to menopausal symptoms. The authors examined the relation of such factors to vasomotor symptoms in the multiethnic sample of 3,302 women, aged 42-52 years at baseline (1995-1997), in the Study of Women's Health Across the Nation (SWAN). All lifestyle factors and symptoms were self-reported. Serum hormone and gonadotropin concentrations were measured once in days 2-7 of the menstrual cycle. After adjustment for covariates using multiple logistic regression, significantly more African-American and Hispanic and fewer Chinese and Japanese than Caucasian women reported vasomotor symptoms. Fewer women with postgraduate education reported vasomotor symptoms. Passive exposure to smoke, but not active smoking, higher body mass index, premenstrual symptoms, perceived stress, and age were also significantly associated with vasomotor symptoms, although a dose-response relation with hours of smoke exposure was not observed. No dietary nutrients were significantly associated with vasomotor symptoms. These cross-sectional findings require further longitudinal exploration to identify lifestyle changes for women that may help prevent vasomotor symptoms.
To determine the association of modifiable factors, such as smoking, body mass index, and alcohol use, with hot flashes, and to ascertain whether the association with hot flashes varies by menopausal stage.
A written survey completed by perimenopausal and postmenopausal women enrolling in a randomized, controlled trial of a menopause risk management program in 1999. Survey items included questions on demographics, health status, and health behaviors.
A Massachusetts-based health maintenance organization.
Female members, age 40 to 65, excluding women with chronic conditions precluding study participation, were randomly selected from an automated medical record system.
The majority of the 287 postmenopausal and 468 perimenopausal women participating in the study were white, college educated, and nonsmoking. Approximately 30% of both groups reported experiencing hot flashes. Separate multivariable logistic regression models were developed for perimenopausal and postmenopausal women to identify correlates of reporting any versus no hot flashes. After controlling for age, race, oral contraceptive use, hormone replacement therapy use, and depression, correlates of hot flashes in perimenopausal women were body mass index >/=25 kg/m(2) (odds ration [OR], 2.00; 95% confidence interval [CI], 1.28 to 3.12) and alcohol use of 1 to 5 drinks per week (OR, 0.52; 95% CI, 0.31 to 0.86). The only significant correlate of hot flashes in the postmenopausal population was high dietary fat intake (OR, 0.35; 95% CI, 0.15 to 0.81).
Although study respondents were from similiar sociodemographic groups and received their health care in the same health maintenance organization, modifiable factors associated with hot flashes were different for perimenopausal and postmenopausal women.
The purpose of this randomized clinical trial study was to determine the effectiveness of a 24-week, home-based, moderate-intensity, walking intervention in improving symptoms (vasomotor, uro-genital/sexual, sleep, psychological, cognitive, physical) experienced by midlife women. One hundred and seventy-three Caucasian and African American women aged 45 to 65 who were not on hormone therapy, had no major signs or symptoms of cardiovascular disease, and were sedentary in their leisure activity were randomly assigned to the moderate-intensity walking group or the nonexercise control group. The exercise prescription was walking at a frequency of 4 times a week for a duration of 20 to 30 minutes. The symptom impact inventory included the frequency, intensity, and bothersomeness of 33 symptoms collected at baseline and 24 weeks. Adherence was measured with a heart rate monitor and exercise log. Average adherence to frequency of walking was 71.6% of the expected walks. After 24 weeks, there were no differences between the walking and control group on change in symptoms. However, multiple regression revealed that frequency of adherence to walking along with change in physical symptoms and menopausal status were significant predictors of change in sleep symptoms. While walking did not improve most symptoms experienced by midlife women, frequency of walking may improve sleep.
The main objective of the study was to examine the relationship between physical activity and Body Mass Index (BMI) on menopausal symptoms in Australian midlife women. This study is a secondary data analysis of the Queensland Midlife Women Health Study (2001), which included a randomized, population-based postal survey with a questionnaire. Selected women completed a questionnaire, which included measurement of sociodemographic factors (age, employment and education attainment), general health, use of hormone replacement therapy, smoking, exercise pattern and BMI. The measures that are reported in this paper include menopausal symptoms, BMI and exercise. After adjusting for confounding variables, significant multivariate difference was still found for most menopausal symptoms, including a significant relationship between somatic symptoms, psychological symptoms, depression and anxiety. No significant relationship was seen, however, between vasomotor symptoms, sexual function and exercise. In conclusion, the study showed that exercise was effective in relieving somatic and psychological symptoms, including depression and anxiety. These findings are promising news for women who are interested in using non-pharmacological interventions for relieving menopausal symptoms.
It has long been hypothesized that increased adiposity would be associated with decreased vasomotor symptoms during menopause because of conversion of androgens to estrogens in body fat. However, recent thermoregulatory models have postulated that increased adipose tissue would be associated with a greater likelihood of vasomotor symptoms. The authors evaluated these hypotheses in the Study of Women's Health Across the Nation, a multiethnic, community-based observational study of US women transitioning through menopause. The sample included 1,776 women aged 47-59 years with an intact uterus and at least one ovary who completed bioelectrical impedance analysis for assessment of body composition at the sixth annual study visit (2002-2004). Assessments also included reported vasomotor symptoms (hot flashes, night sweats) and serum levels of follicle-stimulating hormone, estradiol, and sex hormone-binding globulin-adjusted estradiol (free estradiol index). Results indicated that a higher percentage of body fat was associated with increased odds of reporting vasomotor symptoms (per standard deviation increase in percent body fat, odds ratio = 1.27, 95% confidence interval: 1.14, 1.42) in age- and site-adjusted models. Associations persisted in fully adjusted models and were not reduced when models included reproductive hormones. These findings support a thermoregulatory model of vasomotor symptoms.
The aim of the study was to determine the effect of postmenopausal hormone therapy on women's symptom reporting and quality of life in a randomized trial.
1823 women participated in the Estonian Postmenopausal Hormone Therapy (EPHT) Trial between 1999 and 2004. Women were randomized to open-label continuous combined hormone therapy or no treatment, or to blind hormone therapy or placebo. The average follow-up period was 3.6 years. Prevalence of symptoms and quality of life according to EQ-5D were assessed by annually mailed questionnaires.
In the hormone therapy arms, less women reported hot flushes (OR 0.20; 95% CI: 0.14-0.28), sweating (OR 0.56; 95% CI: 0.44-0.72), and sleeping problems (OR 0.66; 95% CI: 0.52-0.84), but more women reported episodes of vaginal bleeding (OR 19.65; 95% CI: 12.15-31.79). There was no difference between the trial arms in the prevalence of other symptoms over time. Quality of life did not depend on hormone therapy use.
Postmenopausal hormone therapy decreased vasomotor symptoms and sleeping problems, but increased episodes of vaginal bleeding, and had no effect on quality of life.
ISRCTN35338757.
This article examines published evidence from longitudinal studies of the menopausal transition that address the following questions: (1) Which symptoms do women report during the perimenopause, and how prevalent are these symptoms as women traverse the menopausal transition? (2) How severe are symptoms and for how long do they persist? (3) To what do women attribute their symptoms, and do their attributions match findings from epidemiologic studies of community-based populations? (4) How significant are these symptoms in women’s lives? Data from published longitudinal studies were examined for evidence bearing on each of these questions. Only vasomotor symptoms, vaginal dryness, and sleep disturbance symptoms varied in prevalence significantly across menopausal transition stages and the postmenopause in ≥1 population studied. A minority of women report severe symptoms. Given the limited follow-up data available, it is unclear how long symptoms persist after the menopause. Women attribute their symptoms to a variety of factors (biological and psychosocial), and their attributions correspond well to those correlates identified in epidemiologic studies of community-based populations. The significance of symptoms for women’s lives remains uncertain. The impact of symptoms during the perimenopause on well-being, role performance, adaptation to demands of daily living, and quality of life warrants additional study. The appraisal of the consequences of perimenopausal symptoms by women from different ethnic groups will be enhanced significantly as a result of the Study of Women’s Health Across the Nation (SWAN) and other investigations in progress.
OBJECTIVE: To assess whether lifestyle factors, specifically smoking and body mass index (BMI), are associated with the occurrence of any, moderate to severe, or daily hot flashes. METHODS: A cross-sectional study was conducted among women aged 40–60 years residing in the Baltimore metropolitan area who reported their history of hot flashes through a mailed survey. Logistic regression was used to assess the associations between smoking and BMI with any, moderate to severe, and daily hot flashes. RESULTS: Of the 1087 women included in the study, 56% reported having hot flashes. Compared with never-smokers, current smokers were at an increased risk for both moderate to severe hot flashes (adjusted odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.3, 2.9) and daily hot flashes (adjusted OR = 2.2, 95% CI 1.4, 3.7). Among current smokers, risk for hot flashes increased with greater amount smoked. High BMI (more than 30 kg/m2) was associated with an increased risk for moderate to severe hot flashes compared with low BMI (less than 24.9 kg/m2) (adjusted OR = 2.1, 95% CI 1.5, 3.0). An increased risk for any or daily hot flashes with high BMI was present only among premenopausal or perimenopausal women. CONCLUSION: Potentially modifiable factors, such as current smoking and high BMI, may predispose a woman to more severe or frequent hot flashes. This information may be valuable for identifying women at risk for hot flashes and for developing appropriate prevention strategies that may include lifestyle modifications.
Fortunately, it is extremely rare for one woman to experience all of the symptoms of the menopause; however, it is estimated that 75% of postmenopausal women do experience some acute symptoms, often starting before menstruation ends. This review offers an overview of the acute symptoms of the menopause and the treatments that are available.
Issues relating to the design of scales and their psychometric properties are discussed in the context of constructing a standard measure of core climacteric symptoms. Seven factor analytic studies of climacteric symptoms are examined to determine whether or not there is sufficient consensus across studies to permit agreement on the symptom content and the structure of such a scale. It is argued that these factor analytic studies do indeed contain sufficient consensus on the basis of which a standard climacteric scale can be constructed. Such a scale is described.
The aim of this study was to determine the prevalence and distribution of menopausal symptoms among women in Ibadan in the 4-week period preceding the survey and factors associated with these symptoms.
A descriptive cross-sectional, community-based study was carried out on Nigerian women aged 40 to 60 years, using the multistage sampling technique. Quantitative data were collected on sociodemographic, obstetric, and gynecological variables as well as symptom experience in the preceding 4 weeks using a structured questionnaire that included a standardized Menopause Rating Scale (MRS). Eleven symptom groups were scored for each respondent on a scale of 0-4, with increasing severity for each score and a maximal total score of 44. The MRS is made of three subscales (somatovegetative, psychological, and urogenital) with maximal scores of 16, 16, and 12, respectively. Scores for each subscale and the overall total score were calculated for each respondent, and these served as the main outcome measures. The higher the composite score, the greater the severity of menopausal symptoms.
In all, 1,189 women with a mean age of 48.1 +/- 5.9 years were interviewed. Prevalence of any menopausal symptom was 84.5% during the 4-week period studied. Joint and muscular discomfort was the most common reported symptom among all women in this study (59.0%), followed by physical and mental exhaustion (43.0%), sexual problems (40.4%), and hot flashes (39.0%). Factors predicting the total score on the MRS were age of respondent (P = 0.01; 95% CI, 0.02-0.17), menopause status (P = 0.001; 95% CI, 0.33-1.24), and occupational group (P = 0.02; 95% CI, 0.10-1.42). Age of respondent and menopause status also predicted scores on the somatovegetative and urogenital subscales, but not on the psychological subscale. Occupation was the only predictor on the psychological subscale (P = 0.002; 95% CI, 0.16-0.75).
Prevalence of menopausal symptoms was high among women in this study. Although any woman could face challenges associated with menopausal symptoms, those who were older, perimenopausal, and postmenopausal and who had routine or manual occupations had the highest total MRS scores. All women, especially those in these categories, should receive health information and guidance on possible lifestyle adjustments to ease the disruptions that menopausal symptoms can cause.
Vasomotor symptoms adversely affect the quality of life and functional status of most women during the menopausal transition, but little is known about how long these symptoms last. The most effective treatment, hormone therapy (HT), carries risks and benefits that depend on the timing and duration of use. In this study we sought to estimate the duration of vasomotor symptoms in a longitudinal study.
We reanalyzed primary data from 438 women in the longitudinal cohort of the population-based Melbourne Women's Midlife Health Project. Two hundred and five women who had completed 13 years of follow-up were included in the analyses. The onset and cessation of vasomotor symptoms were reported, stratifying analyses according to ever use of HT. Symptom duration was calculated as the time between the first and last bothersome hot flush reported.
The mean (SD) duration of bothersome menopausal symptoms for women who completed 13 years of follow-up and who never used HT was estimated to be 5.2 (3.8) years (median, 4 years). If women who used HT were included, the mean (SD) duration was 5.5 (4.0) years (median, 4 years). The estimated duration of symptoms varied according to the duration of longitudinal follow-up, with a mean estimate of 3.4 years (median, 3 years) when only 8 years of follow-up data were analyzed. The only factor associated with duration of hot flushes was regular exercise-more exercise was associated with shorter symptom duration.
The average duration of vasomotor symptoms in this sample is more than 5 years, substantially longer than had been previously reported.
To investigate the variability and determinants of menopause age in two European cohort studies, the European Respiratory Health Survey and the Swiss Air Pollution and Lung Disease in Adults Cohort.
Age at menopause was estimated in 5,288 women, aged 30 to 60 years, randomly selected in nine European countries between 1998 and 2002. Determinants of natural and surgically induced menopause were investigated by Cox regression and heterogeneity by meta-analysis. Follicle-stimulating hormone and luteinizing hormone levels were assessed in a subsample.
A quarter of the women were postmenopausal by age 50.8 years. Median age of natural menopause was 54 years. Hormone levels were within expected ranges for premenopausal and postmenopausal women. Surgically induced menopause was highly prevalent (22%-47%), associated with earlier timing of menopause. Determinants of earlier menopause were current smoking (hazard ratio [HR], 1.59; 95% CI, 1.27-1.98), body mass index greater than 30 kg/m (HR, 1.32; 95%, CI, 1.02-1.70), and low physical activity (HR, 1.37; 95%, CI, 1.12-1.67). The determinant for later menopause was multiparity (HR, 0.74; 95% CI, 0.62-0.89). Predictors were similar for naturally and surgically induced menopause. Oral contraceptive use yielded heterogeneous effects on timing of menopause. Later birth was associated with later menopause (HR, 0.934; 95% CI, 0.91-0.96). This evidence of a secular trend is heterogeneous across countries.
Age at menopause varies across Europe, shifting toward higher ages. This secular trend seems paradoxical because several adult determinants, that is, overweight, smoking, sedentarity, and nulliparity, associated with early menopause are on the rise in Europe. The heterogeneity of the secular trend suggests additional country-specific factors not included in the study, such as improved childhood nutrition and health, that have an influence on reproductive aging.
Literature on women's experiences with climacterium is mostly based on patients or on North American women. In this study, the experiences and opinions of Finnish women were investigated.
In 1989, a questionnaire was sent to a representative sample of 45-64-year-old Finnish women (n = 2000); 1713 (86%) responded, of which 1308 were postmenopausal.
Most women (87%) reported their health to be good or rather good. Symptoms were commonly experienced, but each symptom usually by a minority of women. Most subjective health problems were not related to climacterium as such, but were problems also encountered otherwise or related to aging. Some symptoms decreased with increased age, others increased or stayed the same. Comparing the symptoms reported in the past two weeks and women's own judgements suggests that hot flashes and irritability were specific to climacterium. Most women had a neutral or positive opinion of climacterium in general.
Our study challenges the view that climacterium is a time of big subjective health problems.
To identify symptoms that change in prevalence and severity during midlife and evaluate their relationships to menopausal status, hormonal levels, and other factors.
In a longitudinal, population-based study of 438 Australian-born women observed for 7 years with an 89% retention rate, 172 advanced from premenopause to perimenopause or postmenopause. Annual measures included a 33-item symptom check list; psychosocial, lifestyle, and health-related factors; menstrual status; hormone usage; and blood levels of follicle-stimulating hormone and estradiol (E2).
Increasing from early to late perimenopause were the number of women who reported five or more symptoms (+14%), hot flushes (+27%), night sweats (+17%) and vaginal dryness (+17%) (all P <.05). Breast soreness-tenderness decreased with the menopausal transition (-21%). Trouble sleeping increased by +6%. The major change in prevalence was from early to late perimenopause, except for insomnia, which showed a gradual increase. Those variables most related to onset of hot flushes were number of symptoms at early perimenopause (P <.05), having an unskilled or no occupation (P <.05), more than 10 pack-years of smoking (P <.01), and decreased E2 (P <.01). The onset of night sweats increased with the change in E2 (P <.05). The onset of vaginal dryness decreased with more years of education (P <.05). Trouble sleeping was predicted by prior lower well-being (P <.01), belief at baseline that women with many interests hardly notice menopause (P <.01), and hot flushes (P <.01).
Although middle-aged women are highly symptomatic, the symptoms that appear to be specifically related to hormonal changes of menopausal transition are vasomotor symptoms, vaginal dryness, and breast tenderness. Insomnia reflected bothersome hot flushes and psychosocial factors.
Hot flashes are a primary reason that midlife women seek medical care, but there is little information about the onset or the predictors of hot flashes in the years before the menopause. This study examines women's experience of hot flashes in the late reproductive years, comparing African American and Caucasian women, and identifies hormonal, behavioral, and environmental risk factors for hot flashes associated with ovarian aging. Data are from a population-based prospective cohort study of ovarian aging in women who were ages 35--47, in general good health, and had regular menstrual cycles at study enrollment. Hot flashes were assessed by subject report in a structured interview at the first follow-up period and correlated highly with previous prospective daily ratings of hot flashes (p = 0.0001). Blood samples were obtained in the first 6 days of the menstrual cycle in two consecutive cycles at enrollment and two consecutive cycles at follow-up. Predictor variables include hormone measures, structured interview, and standard questionnaire data. Thirty-one percent of the sample (n = 375) reported hot flashes (mean age 41 years). In bivariate analysis, more African American than Caucasian women reported hot flashes (38% vs. 25%, p = 0.01). Significant predictors of hot flashes in the final multivariable logistic regression model were higher follicle-stimulating hormone (FSH) levels (odds ratio [OR] 3.19), anxiety (OR 1.06), baseline menopausal symptoms (OR 4.91), alcohol use (OR 1.09), body mass index (BMI) (OR 1.04), and parity (OR 1.20). Race did not predict hot flashes after adjusting for these variables. Hot flashes commonly occur before observable menstrual irregularities in the perimenopause and are associated with both hormonal and behavioral factors. The association of hot flashes with increased body mass (BMI) challenges the current "thin" hypothesis and raises important questions about the role of BMI in hormone dynamics in the late reproductive years.
To assess whether lifestyle factors, specifically smoking and body mass index (BMI), are associated with the occurrence of any, moderate to severe, or daily hot flashes.
A cross-sectional study was conducted among women aged 40-60 years residing in the Baltimore metropolitan area who reported their history of hot flashes through a mailed survey. Logistic regression was used to assess the associations between smoking and BMI with any, moderate to severe, and daily hot flashes.
Of the 1,087 women included in the study, 56% reported having hot flashes. Compared with never-smokers, current smokers were at an increased risk for both moderate to severe hot flashes (adjusted odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.3, 2.9) and daily hot flashes (adjusted OR = 2.2, 95% CI 1.4, 3.7). Among current smokers, risk for hot flashes increased with greater amount smoked. High BMI (more than 30 kg/m(2)) was associated with an increased risk for moderate to severe hot flashes compared with low BMI (less than 24.9 kg/m(2)) (adjusted OR = 2.1, 95% CI 1.5, 3.0). An increased risk for any or daily hot flashes with high BMI was present only among premenopausal or perimenopausal women.
Potentially modifiable factors, such as current smoking and high BMI, may predispose a woman to more severe or frequent hot flashes. This information may be valuable for identifying women at risk for hot flashes and for developing appropriate prevention strategies that may include lifestyle modifications.
The purpose of this study was to analyze the influence of sociodemographic characteristics and environmental factors on self-reported menopause-related symptoms among middle-aged Swedish women.
Women who were born in the years 1935 to 1945 and who were living in the Lund area of southern Sweden were investigated. Each woman completed a generic questionnaire and underwent a personal interview that pertained to sociodemographic characteristics, lifestyle, and current health-related problems. With these background factors, the frequency and intensity of hot flushes and vaginal dryness were determined; risk factor analysis was evaluated with the use of the multiple regression models.
There were 6917 participants, with a response rate of 64%. A lower risk for hot flushes was related to older age, high education, and vigorous physical exercise. The major risk factors for vasomotor complaints were current weight gain, part-time employment, oophorectomy, unhealthy lifestyle, and concomitant health problems. Light smoking, late age of menopause, higher education, and excessive weight reduced the risk of vaginal dryness. However, older age, marriage, and chronic diseases negatively affected vaginal complaints. The background factors had less impact on symptoms in women who used hormone replacement therapy.
Sociodemographic characteristics, lifestyle, and concomitant health problems appear to be important modifiable determinants for menopause-related symptoms.
To evaluate the effect of moderate-intensity exercise on the occurrence and severity of menopause symptoms.
A yearlong, randomized, clinical trial, conducted in Seattle, WA, with 173 overweight, postmenopausal women not taking hormone therapy in the previous 6 months. The intervention was a moderate-intensity exercise intervention (n = 87) versus stretching control group (n = 86). Using logistic regression, odds ratios comparing exercise with controls were calculated at 3, 6, 9, and 12 months for menopause symptoms and their severity.
There was a significant increase in hot flash severity and decreased risk of memory problems in exercisers versus controls over 12 months, although the numbers affected were small. No other significant changes in symptoms were observed.
Exercise does not seem to decrease the risk of having menopause symptoms in overweight, postmenopausal women not taking hormone therapy and may increase the severity of some symptoms in a small number of women.
To delineate the role of hormone levels, menopause status, exogenous hormone use, and personal characteristics in the changing prevalence and impact of menopause symptoms.
Annual longitudinal data were from Michigan Bone Health Study enrollees aged 24 to 44 years at baseline and followed up for a 10-year period beginning in 1992. In self-administered interviews, women reported the presence of and degree of bother (values from 1 = low to 8 = high) for symptoms related to sexuality, vasomotor, sleep/fatigue, negative mood, hair/skin, and urinary problems. Annually, collected sera samples were analyzed for estradiol, follicle-stimulating hormone, and testosterone concentrations.
Increasing age consistently predicted the development and bother of the measured symptoms. Transition to postmenopause and higher levels of follicle-stimulating hormone were significantly predictive only of the sexuality and vasomotor constructs, whereas higher estradiol levels were protective against increasing frequency and bother from sexuality and vasomotor constructs. Problems with sleeping, and secondarily, vasomotor symptoms, were the most bothersome constructs. Higher body mass index and current smoking behavior were highly related to increased bother with many symptom constructs, but especially vasomotor symptoms. Exogenous hormone use was associated with more bother from all symptom constructs.
Sexuality and vasomotor symptom constructs seem to be more related to menopause than other constructs. The frequency of other constructs in the pre-menopause and their very strong association with increasing age suggest caution in attributing these factors directly to neuroendocrine events of the menopause transition. The strong associations between smoking and body size with symptoms, particularly vasomotor symptoms, suggest that interventions directed at these personal characteristics might be effective in dampening their impact.
To estimate the association of anxiety with menopausal hot flashes in the early transition to menopause.
A randomly identified, population-based cohort of midlife women followed up for 6 years to assess reproductive hormones and other physical, emotional, and behavioral factors. At enrollment, the women were premenopausal, aged 35 to 47 years, and had regular menstrual cycles in the normal range. Enrollment was stratified to obtain equal numbers of African American (n = 219) and white (n = 217) women.
At the 6-year endpoint, 32% of the women were in the early transition stage and 20% reached the late menopausal transition or were postmenopausal. Reports of hot flashes increased with the transition stages, which were determined by bleeding patterns. At endpoint, hot flashes were reported by 37% of the premenopausal women, 48% of those in the early transition, 63% of women in the late transition, and 79% of the postmenopausal women. Anxiety scores were significantly associated with the occurrence of hot flashes and were also significantly associated with the severity and frequency of hot flashes (each outcome at P < 0.001). Compared with women in the normal anxiety range, women with moderate anxiety were nearly three times more likely to report hot flashes and women with high anxiety were nearly five times more likely to report hot flashes. Anxiety remained strongly associated with hot flashes after adjusting for menopause stage, depressive symptoms, smoking, body mass index, estradiol, race, age, and time. In a predictive model, anxiety levels at the previous assessment period and the change in anxiety from the previous assessment period significantly predicted hot flashes (P < 0.001).
Anxiety is strongly associated with menopausal hot flashes after adjusting for other variables including menopause stage, smoking, and estradiol levels. Anxiety preceded hot flashes in this cohort. Additional studies are needed to examine the duration of menopausal hot flashes and to determine whether treatments that target anxiety effectively reduce menopausal hot flashes.
To investigate factors associated with the presence, severity, and frequency of hot flushes.
A 9-year prospective study of 438 Australian-born women, aged 45 to 55 years and menstruating at baseline. Annual fasting blood collection, physical measurements, and interviews including questions about bothersome hot flushes in previous 2 weeks were performed. A "hot flush index" score was calculated from the product of the severity and frequency data. Data were analyzed using random-effects time-series regression models.
A total of 381 women supplied complete data over the follow-up years. A total of 350 women experienced the menopause transition, of whom 60 (17%) never reported bothersome hot flushes. At baseline, women who reported hot flushes were significantly more likely to have higher negative moods, not be in full- or part-time paid work, smoke, and not report exercising every day. Over the 9-year period of the study, variables significantly associated with reporting bothersome hot flushes were relatively young age (P < 0.001), low exercise levels (P < 0.05), low estradiol levels (P < 0.001), high follicle-stimulating hormone (FSH) levels (P < 0.001), smoking (P < 0.01), being in the late menopause transition (P < 0.001), or being postmenopausal (P < 0.001). In women reporting hot flushes, the hot flush index score increased as their FSH levels increased (P < 0.01), as they entered the late stage of the menopause transition (P < 0.001), and as they became postmenopausal (P < 0.05), and decreased with as their age (P < 0.001) and exercise level (P < 0.05) increased. Between-women analyses found that the hot flush index score was greater in women with higher average FSH levels over time (P < 0.05).
Menopause status, FSH and estradiol levels, age, exercise level, and smoking status all contributed to the experience of bothersome hot flushes.
This article examines published evidence from longitudinal studies of the menopausal transition that address the following questions: (1) Which symptoms do women report during the perimenopause, and how prevalent are these symptoms as women traverse the menopausal transition? (2) How severe are symptoms and for how long do they persist? (3) To what do women attribute their symptoms, and do their attributions match findings from epidemiologic studies of community-based populations? (4) How significant are these symptoms in women's lives? Data from published longitudinal studies were examined for evidence bearing on each of these questions. Only vasomotor symptoms, vaginal dryness, and sleep disturbance symptoms varied in prevalence significantly across menopausal transition stages and postmenopause in >1 population studied. A minority of women report severe symptoms. Given the limited follow-up data available, it is unclear how long symptoms persist after menopause. Women attribute their symptoms to a variety of biologic and psychosocial factors, and their attributions correspond well to those correlates identified in epidemiologic studies of community-based populations. The significance of symptoms for women's lives remains uncertain. The impact of symptoms during the perimenopause on well-being, role performance, adaptation to demands of daily living, and quality of life warrants additional study. The appraisal of the consequences of perimenopausal symptoms by women from different ethnic groups will be enhanced significantly as a result of the Study of Women's Health Across the Nation (SWAN) and other studies in progress.
Hot flashes commonly affect women during menopause and are among the primary menopausal complaints for which women seek medical treatment. Recent evidence of the potential risks posed by hormone therapies has led to interest in nonhormonal interventions, including physical activity. Studies evaluating the therapeutic effects of physical activity for relief of hot flashes have been limited by small sample size, problems with hot flash classification, and assumptions regarding the timing of risk and effect. The current study evaluated the association between physical activity prior to the time of the last menstrual period (LMP) and hot flashes in a large sample maintaining an appropriate sequence of physical activity and menopausal symptoms.
This study included 512 perimenopausal and postmenopausal women who participated in a population-based study of midlife health in the Baltimore metropolitan area. Questionnaires assessed self-reported physical activity levels at various ages as well as frequency and severity of hot flashes. Multiple logistic regression was used to evaluate the association between physical activity prior to LMP and each of the hot flash outcomes.
Highly active women between the ages of 35 and 40 were significantly more likely to report moderate to severe hot flashes (OR = 1.70, p = 0.01) and daily hot flashes (OR = 1.79, p < 0.01) than minimally active women in unadjusted models. Adjustment for age and smoking status did not substantially alter these results.
Frequent physical activity in midlife may be associated with risk of greater severity and frequency of menopausal hot flashes.
Many women experience health problems when going through menopause, and these health problems may result in a substantial reduction in quality of life. There are some indications that physical activity may play a role in ameliorating menopausal symptoms, but there is conflicting evidence about this. To assess the relationship between changes in physical activity and self-reported vasomotor, somatic, and psychological symptoms.
Data from the third (2001) and fourth (2004) surveys of the Australian Longitudinal Study on Women's Health were used. Data from 3,330 middle-aged women were included in the analyses. In linear regression models, the relationships between changes in physical activity of at least moderate intensity and total menopausal, vasomotor, somatic, and psychological symptoms were determined.
Physical activity was not associated with total menopausal symptoms, vasomotor or psychological symptoms. A weak association with somatic symptoms (B = -0.003; 95% CI: -0.005 to -0.001) was found. Weight gain was associated with increased total, vasomotor, and somatic symptoms. Weight loss was associated with a reduction in total and vasomotor symptoms.
Changes in physical activity were not related to vasomotor or psychological symptoms and only marginally to somatic symptoms. Changes in weight showed a stronger relationship with menopausal symptoms. The relationship between weight change and menopausal symptoms merits further exploration.
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