A cross-cultural comparison of climacteric symptoms, self-esteem, and perceived social support between Mosuo women and Han Chinese women

A communicative model of premenstrual syndrome with social determinants of health: a path analysis

INTRODUCTION

Premenstrual syndrome (PMS) is characterized by the periodic emergence of physical, psychological, or behavioral symptoms that manifest following ovulation and subside with the commencement of menstruation. These symptoms may be intense enough to interfere with personal relationships, social engagements, or work performance. This study was undertaken to examine the relationship between social determinants of health (SDH) and premenstrual syndrome, taking into account the influence of social factors on health and disease, as well as the existing gap in knowledge regarding the impact of SDH on PMS, following the World Health Organization (WHO) model.

METHOD

A cross-sectional study was carried out involving 600 women who visited health centers in Tehran in 2024. The questionnaires utilized comprised demographic and obstetric forms, Perceived Social Support, Physical Activity, Socioeconomic Status, Intimate Partner Violence, and the Premenstrual Symptoms Screening Tool. Data analysis employed SPSS-27, while the relationship model was assessed through path analysis in LISREL-8.8.

RESULTS

Path analysis revealed the direct impact of two intermediate factors on PMS: social support (B=-0.29) and physical activity (B=-0.35). Among the structural variables, socioeconomic status (B=-0.22) and age (B = 0.07) indirectly affected PMS. The model fit indices indicated a good fit (Chi-Square = 22.53, GFI = 0.99, RMSEA = 0.045, NFI = 0.95, NNFI = 0.94, CFI = 0.97, IFI = 0.97).

CONCLUSION

According to the path analysis PMS is prevalent in Iranian women which indicates the necessity of screening for this disorder. In order to alleviate PMS, healthcare providers should pay attention to this condition's risk and protective factors.

Psychological and cultural correlates of illness conception and menopausal symptoms: a cross-sectional and longitudinal comparative study of Mosuo, Yi, and Han women

Objective

This study explores the differences in menopausal symptoms, illness conception, and health-seeking behaviors among Mosuo, Yi, and Han women in China, analyzes the key factors behind these differences, and conducts a longitudinal comparison.

Methods

This study collected data from Mosuo, Yi, and Han women in Yongning Township, Ninglang County, Yunnan Province, through a questionnaire survey. The instruments included the Kupperman Menopause Index (KMI), Depression-Anxiety-Stress Scale (DASS), Self-Rating Scale of Illness Conception and Health Seeking Behavior (SSICHSB) and General Self-Efficacy Scale (GSES). First, descriptive statistical analysis was conducted on the demographic characteristics and various indicators of the sample. Chi-square tests and one-way ANOVA were used to examine the differences in KMI and SSICHSB among the different ethnic groups. The KMI was used to assess menopausal symptoms, and multiple linear regression analysis was employed to identify the main factors influencing menopausal symptoms. A longitudinal comparison of data from 2012 and 2020 was performed to analyze the dynamic changes in KMI and SSICHSB of Mosuo and Han women.

Results

The regression analysis identified stress, anxiety, and dysmenorrhea experience as risk factors, while self-efficacy served as a protective factor influencing menopausal symptoms. Both the menopausal symptoms and the scores for concerns and fears about illness among Mosuo women significantly decreased in 2020 compared to 2012 (p = 0.040, p = 0.010).

Conclusion

The results provide an important basis for the development of culturally sensitive health interventions. Future public health strategies should consider cultural, social, and physiological factors to provide more effective health support and interventions for women from different ethnic groups.

Chronic stress, social support, and symptoms at midlife. Is there a buffering effect?

OBJECTIVES

This study was designed to examine associations among measures of stress, social support, and symptoms at midlife. Specifically, the study examined whether support buffered against the negative effects of stress on severity of symptoms grouped via factor analyses into emotional instability, vaso-somatic symptoms, mood disturbances, and aches and pains.

METHODS

We used cross-sectional data from n = 119 women aged 40-55 in Nagaland, India. Midlife symptoms were measured with the help of questionnaires, and factor analysis was used to identify latent factors. Stress and social support were measured by Perceived Stress Scale and Multidimensional Scale of Perceived Social Support, respectively. Chronic stress was measured by fingernail cortisol.

RESULTS

After adjusting for menopausal status, tobacco use, body mass index, and socioeconomic status, cortisol level was positively associated with emotional instability (p < 0.01), vaso-somatic symptom score (p < 0.05), and total symptoms at midlife (p < 0.05). Familial support was negatively associated with emotional instability (p < 0.05) and total symptoms at midlife (p < 0.05). However, no significant associations were observed with spousal or friend support. Although no significant interactions between stress, social support, and symptoms at midlife were observed, spousal support when stratified as high and low support using the means, perceived stress and vaso-somatic symptoms indicated an interaction.

CONCLUSION

Cortisol level and support from family were independently associated with symptoms at midlife. The study highlights the importance of family ties and support for navigating the stressors of everyday life among women in Nagaland.

The Effect of Resilience and Family Support Match on Psychological Distress among Women in the Menopausal Transition Based on Polynomial Regression and Response Surface Analysis

Menopausal transition (MT) is a natural process in women from reproductive decline to aging. During this period, women present with an increased prevalence of psychological distress. The aim of this study was to investigate how resilience and family support interact to influence psychological distress among women during MT. A convenience sampling method was used to recruit 858 women during MT from Shandong Province. All participants completed the 10-item Connor-Davidson Resilience Scale, the family care degree questionnaire, and the Kessler Psychological Distress Scale. Data were analyzed by using SPSS 24.0. Response surface analysis was used for polynomial regression and response surface analysis. The results of response surface analysis show that in the case of agreement between resilience and family support, the joint effect manifested as a negative curve (inverted U shape) related to the psychological distress of women during MT. In the case of disagreement, the joint effect manifested as a negative curve (inverted U shaped) related to psychological distress. Specifically, with increased variance in the degree of resilience and family support, women experienced less psychological distress. Both resilience and family support play an important role in protecting women from psychological distress, either alone or in combination. Future intervention studies targeting women during MT should consider the coordinated actions of resilience and family support.

Associations of sleep quality, anxiety symptoms and social support with subjective well-being among Chinese perimenopausal women

BACKGROUND

Few studies have explored the internal pathway of the association between sleep quality and subjective well-being among perimenopausal women.

METHODS

A survey was performed of 1063 perimenopausal women aged 40 to 60 years who participated in a regular health examination conducted at the First Hospital of Jilin University, China. Participants were asked to complete a study questionnaire. The Pittsburgh Sleep Quality Index, Zung Self-rating Anxiety Scale, Perceived Social Support Scale and Subjective Well-being Scale for Chinese Citizens were used to assess sleep quality, anxiety symptoms, social support and subjective well-being, respectively. The data were analyzed using t-tests, analysis of variance, Pearson correlation analysis, multiple linear regression analysis and the PROCESS macro.

RESULTS

The mean total subjective well-being score was 90.14 ± 12.80. The correlation analyzes showed that sleep quality (r = -0.341, P < 0.001) and anxiety symptoms (r = -0.490, P < 0.001) were negatively correlated with subjective well-being. Social support was positively correlated with subjective well-being (r = 0.480, P < 0.001). The effect of sleep quality on subjective well-being was partially mediated by anxiety symptoms (Effect = -0.462, 95% CI = [-0.577, -0.363]). In addition, social support moderated the association between anxiety symptoms and subjective well-being (Index = -0.006, 95% CI = [-0.012, -0.001]).

LIMITATIONS

This was a cross-sectional study.

CONCLUSIONS

The effect of sleep quality on subjective well-being was partially mediated by anxiety symptoms, and social support moderated the association between anxiety symptoms and subjective well-being among perimenopausal women.

Correlates of palpitations during menopause: A scoping review

OBJECTIVE

Palpitations during peri- and post-menopause are common. It is unclear what variables are related to palpitations in peri- and post-menopausal women. The purpose of this scoping review was to summarize potential correlates of palpitations in women transitioning through menopause.

METHODS

The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Authors included English-language, full-length, peer-reviewed, cross-sectional research articles on palpitations in menopausal women published through December 18, 2021, from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO searches. Following de-duplication, screening of titles and abstracts, and review of full-texts, independent reviewers extracted data on variables studied in relationship to palpitations from 84 articles and resolved discrepancies. Authors extracted data on (1) demographic, clinical, biomarker, and symptom/quality of life variables and (2) data analysis method (bivariate, multivariate). Authors classified each variable as a likely, unlikely, or unclear correlate of palpitations.

RESULTS

Articles were diverse in region of origin, sample sizes, and variables assessed in relationship to palpitations. Evidence for any one variable was sparse. Likely correlates of palpitations included race/ethnicity, lower physical activity, worse vasomotor symptoms (VMSs), worse sleep, and worse quality of life. Unlikely correlates included age, employment, education, marital status, socioeconomic status, comorbidities, body mass index, and sexual difficulties. Unclear correlates due to equivocal evidence were menopausal status, smoking, and depression. Unclear correlates due to insufficient evidence (less than three articles) included all of the assessed biomarkers, anxiety, and stress.

CONCLUSION

Likely correlates were identified including race/ethnicity, physical activity, VMS, sleep, and quality of life. However, additional research is needed to better understand potential correlates of palpitations.

Review of menopausal palpitations measures

Palpitations are reported commonly by women around the time of menopause as skipped, missed, irregular, and/or exaggerated heartbeats or heart pounding. However, much less is known about palpitations than other menopausal symptoms such as vasomotor symptoms. The objective of this review was to integrate evidence on menopausal palpitations measures. Keyword searching was done in PubMed, CINAHL, and PsycINFO for English-language, descriptive articles containing data on menopause and palpitations and meeting other pre-specified inclusion criteria. Of 670 articles, 110 met inclusion criteria and were included in the review. Results showed that 11 different measures were used across articles, with variability within and between measures. Inconsistencies in the wording of measurement items, recall periods, and response options were observed even when standardized measures were used. Most measures were limited to assessing symptom presence and severity. Findings suggest that efforts should be undertaken to (1) standardize conceptual and operational definitions of menopausal palpitations and (2) develop a patient-friendly, conceptually clear, psychometrically sound measure of menopausal palpitations.

Psychosocial factors promoting resilience during the menopausal transition

Despite significant biological, psychological, and social challenges in the perimenopause, most women report an overall positive well-being and appear to be resilient to potentially negative effects of this life phase. The objective of this study was to detect psychosocial variables which contribute to resilience in a sample of perimenopausal women. A total of 135 healthy perimenopausal women aged 40-56 years completed a battery of validated psychosocial questionnaires including variables related to resilience, well-being, and mental health. First, using exploratory factor analysis, we examined which of the assessed variables related to resilience can be assigned to a common factor. Second, linear regression analyses were performed to investigate whether a common resilience factor predicts well-being and mental health in the examined sample of women. Optimism (LOT-R-O), emotional stability (BFI-K-N), emotion regulation (ERQ), self-compassion (SCS-D), and self-esteem (RSES) in perimenopausal women can be allocated to a single resilience-associated factor. Regression analyses revealed that this factor is related to higher life satisfaction (SWLS; β = .39, p < .001, adj. R² = .20), lower perceived stress (PSS-10; β = - .55, p < .001, adj. R² = .30), lower psychological distress (BSI-18; β = - .49, p < .001, adj. R² = .22), better general psychological health (GHQ-12; β = - .49, p < .001, adj. R² = .22), milder menopausal complaints (MRS II; β = - .41, p < .001, adj. R² = .18), and lower depressive symptoms (ADS-L; β = - .32, p < .001, adj. R² = .26). The α levels were adjusted for multiple testing. Our findings confirm that several psychosocial variables (optimism, emotional stability, emotion regulation, self-compassion, and self-esteem) can be allocated to one common resilience-associated factor. This resilience factor is strongly related to women's well-being as well as mental health in perimenopause.

The Influence of Factors Such as Parenting Stress and Social Support on the State Anxiety in Parents of Special Needs Children During the COVID-19 Epidemic

OBJECTIVES

The study aims to investigate the state anxiety of parents of special needs children during the 2019 coronavirus disease (COVID-19) epidemic and the influence of parental stress, social support, and other related variables on the anxiety of parents.

METHODS

Bespoke questionnaires of children's and parent's mental and behavioral problems during the epidemic were used in the study. We also used the State Anxiety Inventory (S-AI), the Parenting Stress Index-Short Form-15 (PSI-SF-15), the NEO Five-Factor Inventory (NEO-FFI), and the Multidimensional Scale of Perceived Social Support (MSPSS). The data used in the study were pooled from an online survey of parents of special needs children and analyzed by one-way analysis of variance (ANOVA) and multiple linear regression.

RESULTS

Overall, 1,451 individuals were included, of which 402 were fathers (27.71%) and 1,049 were mothers (72.29%). ANOVA results showed that educational background, family monthly income, and type of their child's disability made parents' state anxiety significantly different. The results of multiple linear regression showed that during the epidemic, social support negatively predicted parents' state anxiety (B = -0.15, p < 0.001), whereas parenting stress (B = 0.07, p = 0.001) and parental mental and behavioral problems (B = 0.37, p < 0.001) positively predicted parents' state anxiety.

CONCLUSIONS

During the outbreak of COVID-19, parents of special needs children suffered mental and behavioral problems, together with parenting stress and social support, which influenced their state anxiety. These findings can be used to develop relevant psychological interventions to improve the mental health of vulnerable groups during a pandemic like COVID-19.

Menopausal symptoms in different substages of perimenopause and their relationships with social support and resilience

OBJECTIVE

This study is designed to measure the prevalence and severity of menopausal symptoms at different substages of perimenopause, as well as the relationships of these symptoms with social support and resilience in perimenopausal women.

METHODS

A convenience sample of 732 perimenopausal women was recruited from 3 communities of Jinan City, Shandong Province, China, between March 2015 and March 2017. The participants completed the Menopause Rating Scale, the 10-item Connor-Davidson Resilience Scale, the Perceived Social Support Scale, and a questionnaire regarding sociodemographic information.

RESULTS

Of all perimenopausal women surveyed, 76.4% reported menopausal symptoms. The prevalence and severity of menopausal symptoms differed significantly by different substages of perimenopause (all P < 0.001); the severity of menopausal symptoms was the least during the early menopausal transition substage and the most during the early postmenopausal substage. Multivariable-adjusted linear regression showed that family support (β = -0.169 to -0.240, P < 0.001) and resilience (β = -0.140 to -0.202, P < 0.001) were negatively associated with the total and subscale scores of the Menopause Rating Scale, and higher family support and resilience had fewer menopausal symptoms.

CONCLUSIONS

The present findings suggest that menopausal symptoms vary across different substages of perimenopause. Furthermore, higher family support and resilience were significantly associated with fewer menopausal symptoms, which might be helpful for medical staff to identify these symptoms and seek appropriate preventive intervention.

The experiences and needs of Asian women experiencing menopausal symptoms: a meta-synthesis

OBJECTIVE

The aim of the study was to explore the experiences and needs of Asian women who were experiencing or had experienced menopause and to determine possible differences in experiences due to acculturation by comparing Asian women living in Asia and those living in Western countries.

METHODS

Six electronic databases were systematically searched: PubMed, CINAHL, Embase, Scopus, PsycINFO, and ProQuest. The search resulted in 17 qualitative studies that met the inclusion and exclusion criteria. Quality appraisal was conducted using the Critical Appraisal Skills Programme Checklist. All 17 studies were analyzed using meta-summaries and, then, using meta-synthesis.

RESULTS

Five themes were identified from the 17 included studies (United States, n = 5; Asia, n = 12): (1) perceptions and attitudes toward menopause (n = 14), (2) physical and emotional experiences during menopause (n = 16), (3) changes in life and relationships (n = 11), (4) needs and coping strategies (n = 13), and (5) unique Asian experiences in Western societies (n = 5). Asian women generally had neutral or positive attitudes toward menopause, but their negative physical, emotional, and psychosocial experiences highlighted their unmet needs and unpreparedness for this phase of life. Diverse self-management strategies were adopted, but there was a high demand for more trustworthy informational resources. Asian women in Western societies were not highly acculturated and retained traditional practices.

CONCLUSIONS

Although cultural influences serve as a protective factor against menopausal symptoms, the traditional and conservative nature of the Asian society poses as a help-seeking barrier. Therefore, to ensure the healthy well-being of postmenopausal women, the implementation of culturally appropriate mitigation and management strategies is necessary.

"Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder

Background

Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions.

Methods

Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework.

Results

Themes identified included ‘Constructions of mood change: menopause or bipolar disorder?’,‘ Life events, bipolar disorder and menopause coming together’; ‘Treatment choices for mood change during menopause’.

Conclusions

The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices.

Electronic supplementary material

The online version of this article (10.1186/s12905-017-0467-y) contains supplementary material, which is available to authorized users.

Prevalence of climacteric symptoms comparing perimenopausal and postmenopausal Chinese women

INTRODUCTION

The climacteric symptoms during peri- and postmenopause have not been extensively studied in China. To further understanding of the characteristics of Chinese women during their menopausal transition, the aim of the study was to compare the prevalence and severity of climacteric symptoms of peri- and postmenopausal Chinese women.

METHODS

The retrospective descriptive study was carried out in perimenopausal and postmenopausal women from 20 provinces of China who visited Beijing Obstetrics & Gynecology hospital during 2008-2015. A total of 1225 women aged 34-76 years without hormone replacement therapy were analyzed. Menopausal status was defined by the "2011 Stages of Reproductive Aging Workshop criteria". The following climacteric symptoms were assessed: fatigue, insomnia, irritability, depression, palpitations, muscle and joint pain, dizziness, vaginal dryness, headache, urinary incontinence, hot flash, sweat, pain during intercourse, and formication.

RESULTS

The most frequent five symptoms were fatigue (75.84%), insomnia (69.39%), irritability (67.02%), palpitations (62.78%), and depression (61.88%). The prevalence of 14 symptoms was significantly higher in the postmenopause compared with the perimenopause status group (all p < .05).The severity of fatigue, insomnia, irritability, palpitation, vaginal dryness, muscle, and joint pain and pain during intercourse was significantly different between the perimenopausal and postmenopausal groups.

CONCLUSIONS

The most frequent five symptoms among the investigated 1225 Chinese women were fatigue, insomnia, irritability, palpitations, depression, nearly the same in perimenopausal and postmenopausal women. The prevalence and the severity of most of the symptoms were significantly different between the two groups.