Menopause-like symptoms may become apparent before the menopause transition

The menopause transition is often accompanied by a number of symptoms that can affect a woman’s overall quality of life, including hot flashes, sleep disturbances, and depression. This study suggests that women may already experience some of these symptoms several years before menopause, during the late-reproductive stage. 

By 2025, an estimated 1.1 billion women worldwide will be postmenopausal. Yet, the number of women experiencing menopause-like symptoms will likely be much higher because there is growing evidence to suggest that women in the late-reproductive stage experience multiple symptoms often associated with menopause years before the official menopause transition. This study involving more than 350 Spanish-speaking respondents is the latest to document the effect of various physiologic and psychosocial changes that affect women in the 4 to 10 years preceding the final menstrual period.

A woman’s late-reproductive stage is characterized by low antral follicle counts and subtle changes to menstrual cycle length, duration, and flow. It typically marks the time when fertility begins to decline and hormone patterns begin to change. This study sought to characterize and compare the symptoms Spanish-speaking women around the world report experiencing during the late-reproductive stage and the menopause transition.

This study identified a similar proportion of women in the late-reproductive stage and the menopause transition reporting 8 of 18 common menopause symptoms. Among other findings, women in the late-reproductive stage had lower age-adjusted odds of musculoskeletal pain and lower odds of decreased interest in sex. But both groups reported a similar interference with personal relationships and overall quality of life. Additional analyses are needed to assess how changes associated with reproductive aging affect quality of life.

Abstract

Objectives: The aim of this study was to characterize and compare the symptoms women self-report during the late reproductive stage and the menopausal transition.

Methods: This cross-sectional analysis used data from the Spanish-language Women Living Better survey. Women aged 35 to 55 years completed an 82-item online survey to assess menstrual cycle patterns, changes, and 61 symptoms sometimes associated with menopause. Women's menstrual patterns were classified as late reproductive stage or menopausal transition using the Stages of Reproductive Aging Workshop. Demographic and health-related data were collected, including age, country of residence, race/ethnicity, education, parity, smoking, and alcohol use. Descriptive statistics characterized reported symptoms, and logistic regression models examined associations between reproductive stage and symptoms.

Results: Of 853 respondents, 358 women were included in the sample analyzed. Participants were on average 40 ± 4.1 years old, 46% reported difficulty paying for basics, 34% lived in Spain, and 20% lived in Mexico. A similar proportion of women in the late reproductive stage and menopausal transition reported 8 of 18 symptom groups. Women in the late reproductive stage had a lower age-adjusted odds of musculoskeletal pain (odds ratio, 0.35; 95% CI, 0.19-0.66) and lower odds of decreased interest in sex (odds ratio, 0.49; 95% CI, 0.25-0.92). Both groups of women reported a similar interference with personal relationships.

Conclusions: Late-reproductive-stage women experience multiple symptoms often associated with menopause. A better understanding of symptoms experienced among Spanish-speaking women may lead to more personalized health care and facilitate anticipatory guidance about menopause. Future cross-cultural studies focusing on symptoms during the late reproductive stage are necessary.

Reference

Yamnia I Cortés, Nina Coslov, Marcie K Richardson, Nancy Fugate Woods. Symptom experience during the late reproductive stage versus the menopausal transition in the Spanish-language Women Living Better survey. Menopause 2023 Mar 1;30(3):260-266. doi: 10.1097/GME.0000000000002132. Epub 2023 Jan 10.

Content created April 2023