Perceived change in quality of life during the menopause

Abstract

The directly attributable effect of menopausal transition on women's quality of life (QoL) remains unclear. This study investigates the relationship between perceived change in QoL and menopausal transition status, socio-economic circumstances, lifestyle factors, and life stress. Prospective data were collected from a cohort of 1525 British women followed up since their birth in 1946 and annually from 47 to 54 years. Following factor analysis, the 10 survey items for perceived change were combined into three QoL domains: physical health (physical health, energy level, and body weight), psychosomatic status (nervous and emotional state, self-confidence, work life, ability to make decisions, and ability to concentrate), and personal life (family life and time for self, hobbies, and interests). In the fully adjusted model, the most important risk factor for decline in all three domains was work or family related stress (p<0.001). Menopausal transition status was significantly associated with change in physical health (p<0.001) and psychosomatic (p<0.001) domains, but not personal life. Women who were perimenopausal for at least a year perceived decline in physical (p=0.009) and psychosomatic (p=0.05) domains compared with premenopausal women, while those on hormone replacement therapy (HRT) for at least a year reported relative improvement (physical p=0.02, psychosomatic p=0.06). Apart from work and family-related stress, physical inactivity was associated with a relative decline (p=0.03) in the physical health domain, and nulliparity with a relative decline in the personal life domain (p=0.006). Both psychosomatic and personal life domains declined significantly with age (p<0.0001 and p=0.003, respectively). Women with four or more children reported a relative improvement in the psychosomatic (p=0.05) domain. In terms of the three QoL domains, women's experience of the menopausal transition appears complex, potentially involving a range of other factors and influences in their lives, and is by no means overwhelmingly negative.