Prevalence of vasomotor, psychological, psychosomatic and sexual symptoms in perimenopausal and recently postmenopausal Greek women: association with demographic, life-style and hormonal factors

Prevalence and Severity of Menopausal Symptoms in Women of Different Ages - China, 2023-2024

What is already known about this topic?

During menopause, women frequently experience a spectrum of physical, mental, and psychological symptoms due to declining ovarian function and fluctuating estrogen levels. There has been a notable absence of systematic, large-scale cross-sectional studies examining menopausal symptoms among Chinese women in recent years.

What is added by this report?

This study examines menopausal symptoms in Chinese women aged 40-60 years, documenting an overall prevalence of 46.3%. The three most commonly reported symptoms are insomnia (50.0%), fatigue (48.2%), and nervousness (46.9%). The prevalence of menopausal symptoms begins to increase in women over age 44, reaching its peak at age 52. Statistically significant differences in symptom severity exist between premenopausal and postmenopausal women within the 45-49 and 50-54 year age groups.

What are the implications for public health practice?

This study represents the first comprehensive large-scale investigation of menopausal symptoms in Chinese women. The findings demonstrate that symptom prevalence varies with age, providing an evidence base for developing targeted health management strategies and interventions specific to different age groups, ultimately enhancing the physical and mental well-being of women experiencing menopause.

Level of Psychological and Somatic Symptoms Predict Perimenopausal Syndrome Severity Better Than Obstetric and Psychiatric History Do Among Korean Women

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.

Association of menopausal symptoms with sociodemographic factors and personality traits

Aim of the study

To investigate the association of personality traits with the severity of vasomotor symptoms (VMS) in a predominantly Greek population.

Material and methods

A questionnaire-based study of women from the Menopause Clinic of a University Hospital in Athens, Greece. Sociodemographic parameters were documented through a structured interview. All women completed the Menopause Rating Scale (MRS) for the assessment of severity of menopausal symptoms, the Hot Flush Beliefs Scale (HFBS) for the assessment of how women were coping with their symptoms and the Big Five Inventory questionnaires for the assessment of personality traits. Associations between baseline parameters and menopausal symptoms were assessed with univariate and multivariate regression analyses.

Results

One hundred women were included. Employed women had lower MRS sub-scores (psychological p< 0.001, somatic p< 0.047, urogenital p< 0.008). Married women scored higher in the psychological and somatic domains. Women of university educational level coped significantly better with hot flushes (β coefficient [SE]: 0.72 [0.25], p< 0.01) and night sweats (0.57 [0.19], p< 0.01) than women of primary education, although the significance of these findings was not replicated when taking into account confounders. Regarding personality traits, women with low openness (-0.33 [0.11], p< 0.01) and empathy (-0.83 [0.37], p = 0.03) and high agreeableness (1.13 [0.21], p< 0.001) had more severe menopausal symptoms. In contrast, women with high agreeableness could better cope with their menopausal symptoms (-0.75 [0.36], p = 0.04). These associations were independent of sociodemographic factors.

Conclusions

Personality traits, especially agreeableness, openness and empathy are associated with menopausal symptoms and functionality in postmenopausal women. These associations might serve as indicators of women at risk of experiencing more severe VMS.

Perimenopausal syndrome and mood disorders in perimenopause: prevalence, severity, relationships, and risk factors

Limited information was focused on perimenopausal syndrome and mood disorders (depression and anxiety) in a specific population: perimenopausal women. We aimed to investigate the prevalence and severity of perimenopausal syndrome and mood disorders, and to analyze their relationships and risk factors in perimenopausal women in Shanghai, China.A cross-sectional study was performed on 1062 women aged 40 to 60 years from 3 communities. The general conditions questionnaire, Kupperman index, self-rating depression scale, and self-rating anxiety scale were used. A multivariable logistic regression analysis was performed to identify risk factors for perimenopausal syndrome and mood disorders.The prevalence of perimenopausal syndrome, depression and anxiety, which were primarily associated with mild symptoms, was 10.92%, 25.99%, and 12.62%, respectively. The differences in the prevalence and severity of perimenopausal syndrome, in the prevalence of depression, and in the severity of anxiety in different age groups were statistically significant (P < 0.001, P = 0.028, P = 0.003, P = 0.002, respectively). The relationships between perimenopausal syndrome and mood disorders were strong and positive (P < 0.001). It was found that age, employment status, personality characteristics, menstruation, and constipation were risk factors for perimenopausal syndrome, but monthly household income was a protective factor. Also, higher income and better medical insurance were beneficial to depression. However, disharmonious family relationships, irregular menstruation, constipation, and severity of perimenopausal syndrome were harmful to depression. For anxiety, attitudes to children status, cesarean section times, and constipation were risk factors.We concluded that perimenopausal syndrome and mood disorders are common in perimenopausal women in Shanghai, whose associations are strong and positive. Many risk factors are associated with and shared between perimenopausal syndrome and mood disorders. Therefore, appropriate management of perimenopause is needed to alleviate the conditions.

Prevalence and severity of menopause symptoms and associated factors across menopause status in Korean women

OBJECTIVE

The present study investigated the prevalence and severity of menopause symptoms experienced by Korean women aged 44 to 56 years and their associated factors.

METHODS

A cross-sectional study was performed on 2,201 women aged 44 to 56 years in health checkup centers between November 2012 and March 2013. The 29-item Menopause-Specific Quality of Life Questionnaire was used to assess vasomotor, psychosocial, physical, and sexual symptoms related to menopause. The guidelines for the classification of reproductive aging stages proposed at the Stages of Reproductive Aging Workshop were used. Multivariable linear regression analyses were performed to identify factors associated with severity of menopause symptoms.

RESULTS

Among participants, 42.6% were premenopausal, 36.7% were perimenopausal, and 20.7% were postmenopausal. Although physical symptoms were the most severe menopause symptoms experienced by premenopausal and perimenopausal women, postmenopausal women reported sexual symptoms as the most bothersome. The mean scores for each domain increased from the premenopausal period through the postmenopausal period (P for trend < 0.001). The regression model revealed that age (for vasomotor and sexual symptoms) and obesity (for vasomotor and physical symptoms) were significantly associated with severity of menopause symptoms (P < 0.05). Physically active women had fewer severe physical symptoms related to menopause than inactive women.

CONCLUSIONS

Postmenopausal women experience the most severe symptoms. Obesity and physical activity are the main modifiable factors associated with symptom severity. Further studies are needed to examine the effects of physical activity promotion and weight control interventions on preventing menopause symptoms in Korean women.

Greater monoamine oxidase a binding in perimenopausal age as measured with carbon 11-labeled harmine positron emission tomography

IMPORTANCE

Perimenopause is a period of high risk for mood disorders, and it has been proposed that perimenopause is also a window of risk for processes linked to later dementia. However, in human perimenopause, the neurobiological changes implicated in the genesis of mood disorders or dementia have not been identified. Monoamine oxidase A (MAO-A) is an important brain enzyme that creates oxidative stress, influences apoptosis, and metabolizes monoamines. After declines in estrogen level, MAO-A density may be elevated for a month or longer, and repeated declines in estrogen level occur with greater magnitude during perimenopause.

OBJECTIVE

To investigate whether MAO-A total distribution volume (VT), an index of MAO-A density, is elevated in women of perimenopausal age (41-51 years).

DESIGN, SETTING, AND PARTICIPANTS

In a cross-sectional study at a tertiary care psychiatric hospital, 58 women underwent carbon 11-labeled harmine positron emission tomography. These included 19 young women of reproductive age (mean [SD], 28.26 [5.05] years), 27 women of perimenopausal age (mean [SD] age, 45.21 [3.41] years; including 14 women with change in menstrual cycle length with a mean [SD] age of 45.50 [4.00] years and 13 women with no change in menstrual cycle length with a mean [SD] age of 44.92 [2.81] years), and 12 women in menopause (mean [SD] age, 56.25 [3.19] years).

MAIN OUTCOMES AND MEASURES

Values of MAO-A VT in the prefrontal cortex, anterior cingulate cortex, dorsal striatum, ventral striatum, thalamus, hippocampus, and midbrain.

RESULTS

On average, MAO-A VT in perimenopausal age was elevated by 34% compared with reproductive age and by 16% compared with menopause (multivariate analysis of variance, group effect, F16,94 = 3.03; P < .001). Within the perimenopausal age group, meeting Stages of Reproductive Aging Workshop criteria for perimenopause, which is mainly based on menstrual cycle length, was not associated with MAO-A VT (F8,18 = 0.548; P = .81) but tendency to cry was positively correlated with MAO-A VT in the prefrontal cortex (r = 0.54; P = .008).

CONCLUSIONS AND RELEVANCE

To our knowledge, this is the first report of a change in a central biomarker during perimenopausal age that is also present during major depressive episodes and high-risk states for major depressive episodes. The functions of MAO-A influence oxidative stress and apoptosis, 2 processes implicated as excessive in both mood disorders and dementia. Hence, greater MAO-A VT during perimenopause may represent a new target for assessing novel interventions to prevent mood disorders and reduce longer-term risk of neurodegenerative disease.