Prevalence of symptoms and associated factors across menopause status in Taiwanese women

Construction and validation of a nomogram for predicting fatigue in climacteric women

OBJECTIVE

The aim was to develop and validate a nomogram for evaluating the risk of fatigue in climacteric women and to assess its clinical application value.

METHODS

Clinical information was collected from 402 climacteric women who visited a tertiary hospital in Shanghai between November 2023 and April 2024. Network analysis methods were utilized to analyze the core symptom (fatigue). The study participants were then randomly divided into training and validation cohorts in a 7:3 ratio. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for fatigue in climacteric women. A nomogram prediction model was established based on these independent risk factors. The predictive performance of the model was evaluated using the concordance index, area under the curve, receiver operating characteristic curve, Hosmer-Lemeshow test, and calibration curve analysis. Additionally, decision curve analysis was performed to assess the model's performance in clinical applications.

RESULTS

Fatigue is identified as the core symptom in climacteric women. Educational level, chronic diseases, and depression status are independent influencing factors for fatigue in menopausal women. The area under the curve for the training cohort and validation cohort are 0.813 (95% CI, 0.743-0.884) and 0.759 (95% CI, 0.637-0.879), respectively, indicating that the model possesses good discriminative ability. The calibration curve shows good consistency between the predicted probabilities and actual probabilities in both the training and validation cohorts. Additionally, the P values for the Hosmer-Lemeshow test in the training and validation sets are 0.233 and 0.197, respectively, indicating good model calibration. Finally, the decision curve analysis curve demonstrates that the model has good clinical utility.

CONCLUSIONS

A simple nomogram based on three independent factors (educational level, chronic diseases, and depression status) can aid in clinically predicting the risk of fatigue in climacteric women.

Traditional Chinese Medicine Herbs for Breast Cancer Prevention and Survival: A Narrative Review of Epidemiological Studies from Taiwan

PURPOSE OF REVIEW

This review aims to describe the association of integrating traditional Chinese medicine (TCM) herbs into conventional medicine (CM) in preventing breast cancer and improving survival rates among breast cancer patients of Taiwan.

RECENT FINDINGS

Of 7 relevant studies, spanning 2014-2023, 4 investigated breast cancer risk in women with menopausal symptoms and other comorbidities. All 4 reported that TCM herbal use was associated with lower risks of developing breast cancer. Three studies investigated survival in newly-diagnosed breast cancer patients receiving CM. All reported that adjunctive TCM users had lower mortality rates than CM-only patients. However, the heterogeneity of study designs, populations, and interventions may limit the generalizability and robustness of the findings. TCM herbs may promote breast cancer prevention and survival when used alongside CM. More rigorous observational research and clinical trials in specific patient populations are needed to guide clinical decision-making.

Role of age, menopausal status, and symptoms in midlife women: Examination of sleep patterns and rest-activity circadian rhythms

BACKGROUND

Midlife women experience menopausal transition at different ages with a variety of symptoms. This study aimed to identify the effects of age, menopausal status, and symptoms in women on their actigraphy-based sleep patterns and circadian rhythms.

METHODS

A total of 87 women aged 45-60 from the community and a gynecology clinic in Taiwan who had their sleep and circadian rhythms recorded with a 7-day actigraphy were analyzed. Multiple linear regression was used to estimate the association of age, menopausal status, and symptoms with sleep parameters and circadian rhythms.

RESULTS

A sleep efficiency below 85 % was observed in 46.0 % of women, and those with severe somatic-vegetative or psychological symptoms tended to have problems with sleep latency (β = 0.22 and β = 0.42, respectively) and efficiency (β = -0.26 and β = -0.36, respectively). Women with more severe urogenital symptoms only experienced significantly longer sleep latency (β = 0.33). There was a weak correlation between circadian rhythms and symptoms. Additionally, perimenopausal (β = 0.30 and β = 0.35, respectively) and late postmenopausal (β = 0.67 and β = 0.59, respectively) women had higher relative amplitude and stability in circadian rhythms than premenopausal women. Age had no significant effect on sleep parameters or circadian rhythms.

CONCLUSIONS

Premenopausal women had the most unstable day-to-day rhythms compared to their peri- and postmenopausal counterparts. Women with higher somatic-vegetative, psychological, and urogenital symptoms showed greater sleep problems. Psychological symptoms (e.g., depression, irritability, anxiety, exhaustion) were the strongest predictors for all sleep parameters. The mechanisms underlying these associations warrant investigation.

Menopausal symptoms in midlife Singaporean women: Prevalence rates and associated factors from the Integrated Women's Health Programme (IWHP)

OBJECTIVE

Menopausal symptoms can substantially impact quality of life. We studied somatic, psychological, and urogenital symptoms and their associated factors.

DESIGN

Cross-sectional study of healthy midlife Singaporean women from three major Asian ethnic groups.

METHODS

In 2014-16, women aged 45 to 69 attending well-woman clinics at the National University Hospital Singapore completed the Menopause Rating Scale (MRS). Sociodemographic, reproductive, medical, anthropometric, body composition, and physical performance characteristics were assessed using validated questionnaires and strict protocols. We analysed sub-scales and total scores by median split, and adjusted odds ratios using multivariable logistic regression.

RESULTS

Of the 1054 eligible women, 62.6 % reported at least one moderate to extremely severe symptom. The top five menopausal symptoms were joint and muscle discomfort, sleep problems, vaginal dryness, physical and mental exhaustion, and hot flushes. Higher total scores on the MRS were associated with moderate disability (adjusted odds ratio: 9.80, 95 % confidence interval: 2.88-33.34), poorer self-rated health status (2.18, 1.60-2.97), menstrual irregularity at 25 years (1.63, 1.07-2.49), and slower chair stands (1.49, 1.09-2.03). Age ≥65 (0.54, 0.30-0.94) and a lower level of education (0.45, 0.26-0.76) had significant inverse associations with total MRS score.

CONCLUSIONS

Menopausal symptoms were associated with disability, poorer health status, and weaker lower-body muscle strength. These data add to the limited Asian evidence and raise the profile of this important area of health.

Exploration of the association between menopausal symptoms, gastrointestinal symptoms, and perceived stress: survey-based analysis

OBJECTIVE

The study aimed to evaluate the relationship between menopausal symptoms, gastrointestinal symptoms, and experienced stress in women from premenopause to postmenopause.

METHODS

We conducted a cross-sectional study using an anonymous survey that included questions on demographics, health (gynecological, gastrointestinal), and lifestyle (physical activity, sleep, etc) factors, the Perceived Stress Scale (PSS), and the Menopause-Specific Quality of Life Questionnaire (MENQOL).

RESULTS

Data of 693 participants aged 50.1 ± 3.2 years were analyzed. We found that the MENQOL total score increased depending on the stages of reproductive aging ( P < 0.001) and positively correlated with PSS scores ( r = 0.47, P < 0.001). Age, reproductive stage, body mass index (BMI), PSS score, diagnosis of depression or anxiety disorder, physical activity, and frequency of defecation appeared to have significant association with the total MENQOL score ( P < 0.05). The analysis within separate MENQOL domains revealed that PSS score and diagnosis of depression or anxiety disorder were associated with higher scores in all MENQOL domains ( P < 0.05) except sexual. Physical activity and the values of the Bristol stool form scale were related to the vasomotor items ( P < 0.05). The frequency of defecation was an independent contributor to the psychosocial and sexual domains ( P < 0.05). BMI, physical activity, and frequency of defecation were associated with physical symptoms ( P < 0.05).

CONCLUSIONS

Perceived stress and some gastrointestinal symptoms in women were associated with menopausal symptoms. Reproductive stages, physical activity, BMI, and previously diagnosed depression or anxiety disorder were related to the intensity of menopausal symptoms. However, further research is needed to confirm the relationship between stress, gastrointestinal, and menopausal symptoms.

Cognitive Problems in Perimenopause: A Review of Recent Evidence

PURPOSE OF REVIEW

To review recent research regarding cognitive problems during perimenopause, including which menopause-related symptoms, demographic variables, stress exposures, and neural biomarkers are associated with cognitive problems and which interventions demonstrate efficacy at improving cognitive performance.

RECENT FINDINGS

Cognitive problems are common during perimenopause and have a significant impact on a substantial proportion of women. Evidence continues to indicate that verbal learning and verbal memory are the cognitive functions that are most negatively affected during perimenopause, and new research suggests that perimenopause may also be associated with deficits in processing speed, attention, and working memory. Recent research suggests that the cognitive profiles of women transitioning through perimenopause are heterogenous - with some showing strengths and others demonstrating weaknesses in particular cognitive domains. Depression, sleep problems, and vasomotor symptoms in perimenopause may be associated with cognitive difficulties. Recent neuroimaging studies are identifying changes in activity patterns within brain regions that correlate with cognitive performance in perimenopause, but future causal studies are needed to understand the neural mechanisms of cognitive problems during this time. Although clinical treatment studies for cognitive concerns have historically focused on postmenopause, some small trials in perimenopausal samples have been conducted recently but are frequently underpowered. Current guidelines from the North American Menopause Society do not support the use of hormone therapy at any age for cognitive problems. Animal research demonstrates that estradiol and levonorgestrel combined may alleviate working memory problems. Much progress has been made in understanding how perimenopause impacts cognition, and more research is needed to better identify who is at highest risk and how to meaningfully prevent and alleviate cognitive problems during this reproductive stage. Larger-scale randomized intervention trials specifically during perimenopause are urgently needed to address cognitive concerns in this population of women. More consistent reproductive staging, inclusion of covariates, and analyses examining perimenopause specifically would improve study quality and the ability to draw clear conclusions from this research.

Influencing factors on women's attitudes toward hormone therapy acceptance for menopause treatment: a systematic review

IMPORTANCE

There is a paucity of data on recent attitudes and perceptions toward hormone therapy use, especially subsequent reanalysis and follow-up of Women's Health Initiative data.

OBJECTIVE

The aim of this systematic review was to assess the factors influencing women's attitudes and perceptions toward hormone therapy use for menopausal symptoms.

EVIDENCE REVIEW

We conducted a comprehensive search of several medical databases including PubMed, Web of Science, Google Scholar, and Scopus. Quality assessment was performed using the Strengthening the Reporting of Observational Studies in Epidemiology Statement for cross-sectional studies. A search was conducted for cross-sectional articles published from January 2012 to March 2023 in English medical databases (PubMed, Web of Science, Scopus, and Google Scholar). Search keywords included "hormone therapy," "acceptance," "menopause," "attitudes," "influence," "factor," "estrogen," "perimenopause," "postmenopause," and "climacteric." Studies evaluating factors that influenced women's attitudes toward hormone therapy were identified.

FINDINGS

A total of 1,280 articles were initially identified. Twenty-one articles were ultimately included in the review after screening studies based on inclusion and exclusion criteria. The studies were conducted between 2012 and 2023 and included a total of 40,226 participants. The most common positive factor included awareness of the existence and efficacy of hormone therapy. The most common negative factors included concern for general adverse effects and negative perception of hormone therapy from family and friends. The factors assessed in this review on women's attitudes toward hormone therapy acceptance for menopause treatment were categorized into three main themes: (1) demographic factors, (2) environmental/contextual factors, and (3) health care-related factors.

CONCLUSIONS AND RELEVANCE

Hormone therapy can be a safe and effective tool to improve the quality of life in perimenopausal and postmenopausal women with vasomotor and genitourinary symptoms. However, there are many complex factors that shape women's perceptions of the efficacy, safety, and accessibility of hormone therapy. Healthcare providers should seek to understand these factors to better discuss the benefits and risks with women and assist with decision making based on cultural, personal, and environmental factors.

The severity of menopause and associated factors among middle-aged women residing in Arba Minch, DHSS, Ethiopia, 2022

BACKGROUND

Menopause is a common practice in women, and it is recognized as a complete pause of menses for more than twelve months. A decrease in sex hormone levels particularly estrogen in the blood is associated with different types of menopausal symptoms. Those symptoms include different psychological, vasomotor, physical, and sexual symptoms. They are among the major public health problems of middle-aged women. Particularly severe forms of menopausal symptoms are bothersome for middle-aged women. However, little is known about the severity status and associated factors of menopausal symptoms among middle-aged women in the study area.

OBJECTIVE

The main aim of the present study was to assess the severity of menopausal symptoms and associated factors among middle-aged women residing in Arba Minch DHSS.

METHODS AND MATERIALS

Community-based crossectional study was employed. A single population proportion formula was used to determine the sample size. A total of 423 study participants were recruited to conduct the study. A simple random sampling technique was used to employ study participants. Proportional sample size allocation formula was used to allocate study participants in each Kebele of Arba Minch DHSS (demographic and health surveillance site). A menopausal rating scale was used to assess the severity status of Menopausal symptoms. The collected data were analyzed by using SPSS version 20. A descriptive analysis was made to describe the Sociodemographic characteristics of the study participants. Moreover, binary and ordinal logistic regressions were used to identify the factors associated with the severity of menopausal symptoms among middle-aged women. On binary logistic regression variables with p-value < 0.25 were eligible for ordinal logistic regression. Variables with a p-value < 0.05 were considered statistically significant.

RESULT

The present study revealed that the prevalence of menopausal symptoms was 88.7%. According to the Menopausal rating scale, 91.7% of the study participants were Asymptomatic, 6.6% of them were mild in severity, 1.4% of them were moderate and the remaining 0.23% individuals were severe menopausal symptoms. The most severe menopausal symptom was the sexual problem. The factors that have a significant association with the severity of menopausal symptoms were Age with [AOR = 1.46(95%CI: 1.27-1.64)] and history of chronic disease with [AOR = 2.56(95%CI: 1.78-3.4)] and p < 0.001.

CONCLUSION AND RECOMMENDATION

Generally, menopausal symptoms among middle-aged women were common. Asymptomatic and mild forms are the dominant severity forms of menopausal symptoms. Age and history of chronic diseases have statistically significant associations with the severity of menopausal symptoms. The ministry of health, researchers, and different stakeholders are recommended to be concerned about this neglected issue.

"They see me as mentally ill": the stigmatization experiences of Chinese menopausal women in the family

BACKGROUND

Menopausal women are regarded as "abnormal people" in China and are often discriminated against and ostracized, especially in the privacy of their homes. However, research on the stigmatization of menopausal women in China is limited. The aim of this study is to explore and describe the stigmatization experiences of Chinese menopausal women in the family and their feelings about these experiences.

METHODS

A phenomenological qualitative research design involving in-depth semi-structured interviews was selected. Our data analysis adopted Colaizzi's methodology.

RESULTS

Fourteen menopausal women participated in this study. Four themes and 12 subthemes emerged: (1) violent treatment (verbal and physical violence); (2) lack of attention and companionship (lack of understanding of physical and psychological suffering, neglect of the value of labour and difficulty finding someone to talk to and accompany them); (3) coping struggles (keeping quiet, fighting back, changing inappropriate perceptions and developing a menopausal transition management plan); and (4) despair (deep-rooted perceptions, restrictions on travel and consumption, and unknown "healing" times).

CONCLUSION

Our results suggest that Chinese menopausal women suffer physically and mentally within their families. The stigma of menopause is both a symptom of the broad societal lack of knowledge regarding menopause and a reflection of the patriarchal oppression of women in a specific cultural context. Accordingly, this study can help menopausal women and society in general better understand the former's stigmatization experiences and amplify their inner voices. Moreover, it can serve as a reference for the formulation of menopause-related health policies in China and for advocating and promoting humanistic care for menopausal women.

The structure of menopausal syndrome: Using network analysis to understand unique symptomatic relationships

OBJECTIVE

To explore the network structure underlying the symptoms of menopausal syndrome and to identify the central and bridge symptoms of menopause among middle-aged women.

METHODS

This is a cross-sectional survey study conducted in the Chinese community with a total of 1829 women aged 40-65 years. The Menopause Rating Scale (MRS) was used to assess the menopausal syndrome, including somato-vegetative, psychological, and urogenital subdomains. The network analysis was performed to determine the central and bridge symptoms of menopause.

RESULTS

In the network of menopausal symptoms, anxiety, vaginal dryness, depressive mood, and irritability were the most central symptoms. Depressive mood, anxiety, and vaginal dryness were also detected as the bridge symptoms. The estimated network between the symptoms had good stability (CS-strength = 0.75 and CS-edge = 0.75).

CONCLUSION

The present network analysis provided unique insights into the inner structure of menopausal symptoms. Psychological symptoms should be considered as the core symptoms in developing relevant interventions to improve the health and well-being of middle-aged women.

Lactic Acid Bacteria: A Promising Tool for Menopausal Health Management in Women

Menopause is a period during which women undergo dramatic hormonal changes. These changes lead to physical and mental discomfort, are greatly afflictive, and critically affect women's lives. However, the current safe and effective management measures for women undergoing menopause are insufficient. Several probiotic functions of lactic acid bacteria (LAB) have been recognized, including alleviation of lactose intolerance, protection of digestive tract health, activation of the immune system, protection against infections, improvement of nutrient uptake, and improvement of the microbiota. In this review, we highlight the currently available knowledge of the potential protective effects of LAB on preventing or mitigating menopausal symptoms, particularly in terms of maintaining balance in the vaginal microbiota, reducing bone loss, and regulating the nervous system and lipid metabolism. Given the increasing number of women entering menopause and the emphasis on the management of menopausal symptoms, LAB are likely to soon become an indispensable part of clinical/daily care for menopausal women. Herein, we do not intend to provide a comprehensive analysis of each menopausal disorder or to specifically judge the reliability and safety of complementary therapies; rather, we aim to highlight the potential roles of LAB in individualized treatment strategies for the clinical management of menopause.

Prevalence, severity, and associated factors in women in East Asia with moderate-to-severe vasomotor symptoms associated with menopause

OBJECTIVE

To understand prevalence, severity, impact, and treatment of vasomotor symptoms associated with menopause, using cross-sectional survey data.

METHODS

This online, two-part survey was conducted in East Asia among women 40-65 years recruited from established online panels (Edelman, Beijing; Hankook Research, Seoul; Rakuten Insight, Taipei) using stratified sampling. Part I collected demographics/disease characteristics, including menopausal status and vasomotor symptom severity. Women with moderate-to-severe vasomotor symptoms completed Part II, including clinical characteristics, health-related quality of life, and healthcare-seeking behavior. Primary endpoints included vasomotor symptom prevalence and severity and proportions of women eligible and willing to take hormone therapy. Results are presented for each of the three online panels separately and as a pooled total. All analyses are descriptive with no formal hypothesis testing across groups.

RESULTS

Numbers of peri- versus postmenopausal women completing Part I were Edelman, 1,588 (55.1% vs 44.9%); Hankook Research, 1,000 (43.6% vs 56.4%); Rakuten Insight, 773 (61.7% vs 38.3%). Vasomotor symptom prevalence was =80% in each region; overall moderate-to-severe vasomotor symptom prevalence was 55%; >50% of women were untreated. Most of those treated used non-prescription treatments. Menopausal hormone therapy use was reported by 11.6% of peri- and 7.2% of postmenopausal women. In peri- and postmenopausal women with moderate-to-severe vasomotor symptoms, 8.6% and 3.4%, respectively, were hormone therapy-willing, 19.3% and 16.8% hormone therapy-contraindicated, 25.4% and 23.0% hormone therapy-cautious, and 10.2% and 8.3% hormone therapy-averse. Women experienced significant burden on health-related quality of life and substantial impairment of work productivity and daily activities.

CONCLUSIONS

Vasomotor symptoms associated with menopause affected =80% of women aged 40 to 65 years. A substantial proportion of women are unsuitable for, or choose not to take, menopausal hormone therapy, resulting in an unmet need for nonhormonal treatment options.

The impact of age group in breast cancer survival outcome according to neoadjuvant treatment response: A matched case-control study

This study aimed to investigate the effectiveness of neoadjuvant chemotherapy in patients with breast cancer in different age groups and evaluate the impact of age group on survival outcome according to different treatment responses. Data were retrospectively collected from the cancer registry database of Kaohsiung Medical University Hospital in Taiwan under an approved protocol. Overall, 96 elder patients (aged >50 years) and 96 younger controls (aged ≤50 years) who received neoadjuvant chemotherapy and breast surgical treatment were examined after 1:1 matching. Logistic regression analysis was used to investigate the effectiveness of treatment response in patients of different age groups. Additionally, the Kaplan-Meier estimator and log-rank test were performed to evaluate the effect of age group and treatment response on disease-free and overall survival (OS). Although no direct significant association was found between age group and treatment response, several significant results were found in treatment response stratification analysis. Among 16 pathological complete response (pCR) patients, elder patients showed significantly greater 5-year disease-free survival (DFS) than younger patients (DFS rate, 85.7% vs. 0%, p = 0.041). However, in 176 non-pCR patients, elder patients showed poor DFS compared to younger patients (DFS rate, 16.6% vs. 32.3%; log-rank test, p = 0.031). With limited sample size and study design, our study results demonstrate that patients aged >50 years who achieved pCR after neoadjuvant chemotherapy could obtain better survival outcome than younger patients. However, the younger patients showed no survival benefits regardless of pCR status.

Influencing factors on women's attitudes toward menopause: a systematic review

IMPORTANCE

Menopause is a natural stage of the reproductive life of a woman. This natural event might affect activities of daily living and cause problems for women. Positive attitudes toward menopause can improve women's quality of life and reduce the severity of menopausal symptoms.

OBJECTIVE

The aim of this systematic review was to assess the factors influencing women's attitudes toward menopause.

EVIDENCE REVIEW

This systematic review was conducted based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline in medical databases including PubMed, Web of Science, Scopus and Google Scholar, as well as Magiran, and SID until October 2020.

FINDINGS

A total of 7,512 articles were identified. Eight articles were included in the review after excluding the duplicates and screening the articles based on the inclusion and exclusion criteria. The majority of the studies used the Attitude Toward Menopause Scale to assess the attitudes toward menopause. This variable differed between the studies conducted in different regions and countries. Furthermore, postmenopausal women had more positive attitudes toward menopause compared with peri- or premenopausal women. Other influencing factors of attitudes toward menopause included age, menopausal symptoms, psychological and socioeconomical status, and profession and ethnicity.

CONCLUSION AND RELEVANCE

The findings showed that menopausal stage, menopausal symptoms, and psychological and socioeconomic status can influence the attitude of women toward menopause. Therefore, these factors should be considered in interventions that aim to improve women's attitudes toward menopause.

A decision tree analysis on multiple factors related to menopausal symptoms

OBJECTIVES

The purpose of this study was to examine the specific characteristics that were directly linked to menopausal symptoms of midlife women from four major racial/ethnic groups in the United States using a decision tree analysis.

METHODS

This was a secondary analysis of the data from 1,027 midlife women from 2 larger Internet-based studies. The parent studies used the Midlife Women's Symptom Index with multiple questions on background characteristics and health and menopausal status. The data were analyzed using ANOVA and decision tree analyses.

RESULTS

Across all the racial/ethnic groups, menopausal stage and country of birth were significantly related to the total number and total severity scores of menopausal symptoms (P < 0.001). In each racial/ethnic group, different combined characteristics of the participants were closely linked to the total number and total severity scores of menopausal symptoms (P < 0.05). For instance, in African Americans, the total severity scores of menopausal symptoms increased among those who were postmenopausal (P < 0.001), US born (P < 0.001), and with low family income (P = 0.030).

CONCLUSIONS

Specific risk groups by the combined characteristics need to be considered in future practice with midlife women.

Using a short questionnaire of the perimenopausal fatigue scale to evaluate perimenopausal women prone to fatigue syndrome

OBJECTIVE

Fatigue, a painful and unpleasant subjective experience, is common in perimenopausal women. Therefore, an effective tool to evaluate the fatigue-precipitating factor is important for perimenopausal women prone to fatigue syndrome.

MATERIALS AND METHODS

This study was surveyed by short-term perimenopausal fatigue scale. The enrollment period was from November 2019 to January 2020. The subjects were perimenopausal women prone to perimenopausal fatigue. The differences between the fatigue-precipitating factors and the degrees of fatigue and disturbance were determined by one-way ANOVA and t test.

RESULTS

A total of 220 perimenopausal women with mean age of 51.3 years were included. Among these, 64.1% did not have a habit of regular exercise and 55.5% had chronic diseases. Fatigue syndrome was found in 64.1% of subjects, who were mainly presented by shoulder and neck pain and sleep problems. There were significant differences between "perimenopausal fatigue" and "duration" (p < 0.001); "with and without regular exercise" (p = 0.05); and "with and without chronic diseases" (p = 0.03).

CONCLUSIONS

Our study showed the perimenopausal fatigue syndrome is more frequently found in perimenopausal women who have a co-morbidity (chronic illness) and do not have a habit of regular exercise. An early identification and prompt intervention may help perimenopausal women to deal with their fatigue syndrome. The short questionnaire perimenopausal fatigue scale seems to be useful for screening perimenopausal women prone to fatigue syndrome.

The Perimenopausal Fatigue Self-Management Scale Is Suitable for Evaluating Perimenopausal Taiwanese Women's Vulnerability to Fatigue Syndrome

The purpose of this study was to test the feasibility of utilizing the established perimenopausal fatigue self-management scale (P-MFSMS) to evaluate perimenopausal Taiwanese women's vulnerability to fatigue syndrome. A cross-sectional study design was adopted to survey 220 perimenopausal Taiwanese women with a mean age of 51.8 ± 4.64 years and a mean body mass index of 23.07 ± 3.04 kg/m2, 75.9% of whom were married, 52.3% had a college education or above, 80.4% had salaries, 81.3% had small families, and 96.4% were not using hormone therapy. The P-MFSMS consists of 25 questions based on six categories: (1) strive to maintain work energy and efficiency; (2) seek self-help from medical resources (doctor shopping); (3) strive to maintain the normal operation of the family (seeking help and support from family or significant other); (4) make time for activities or exercise in busy life; (5) slow down or adjust lifestyle; (6) frustration. For all of these six categories, the minimum loading of each question on the factor was calculated to be over 0.50, with a Cronbach's α of 0.78 and a corrected total-item correlation of >0.50. The goodness of fit of the model was determined to be acceptable, with a chi-square/df value of <3.0 (χ2 = 503.45 and df = 260), a root mean square error of approximation (RMSEA) value of 0.065 (<0.08), as well as a Kaiser-Meyer-Olkin (KMO) value of 0.892. The Tucker-Lewis index (TLI = 0.91), Comparative Fit index (CFI = 0.92), and Incremental Fit index (IFI = 0.92) were all >0.90. There was no statistically significant difference in the difficulty between perimenopausal and postmenopausal women utilizing differential item function (DIF) analysis. Taken together, the 25-question P-MFSMS may be a potentially valid and reliable instrument for suitably evaluating perimenopausal Taiwanese women's vulnerability to fatigue syndrome. Future studies will be conducted to test the effectiveness of the P-MFSMS for evaluating perimenopausal Taiwanese women's vulnerability to fatigue syndrome in clinical practice.