Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Feb 8:344:e402.
doi: 10.1136/bmj.e402.

Health symptoms during midlife in relation to menopausal transition: British prospective cohort study

Gita D Mishra  1 , Diana Kuh
Affiliations

Health symptoms during midlife in relation to menopausal transition: British prospective cohort study

Gita D Mishra et al. BMJ. .

Abstract

Objective: To characterise symptoms experienced by women during the transition into natural menopause, to classify women into distinct symptom profiles or trajectories, and to relate these profiles to sociodemographic factors and health behaviours.

Design: Nationally representative cohort study.

Setting: England, Scotland, and Wales.

Participants: 695 women followed-up since birth in 1946 and annually from age 47 to 54 who experienced natural menopause and reported on 20 common health symptoms.

Main outcome measure: Longitudinal profiles for reported bothersome symptoms.

Results: Of 20 individual symptoms, 18 formed into four stable symptom groups: psychological, somatic, vasomotor, and sexual discomfort. Using latent class analyses, all except the somatic group of symptoms showed a clear relation with the timing of menopause for some women. A small proportion of women (10%, n=63) had a severe psychological symptom profile that peaked at or in the year after menopause. For vasomotor symptoms, 14% of women (n=83) had the early severe profile that also peaked around early postmenopause and then declined noticeably; 11% (n=67) had the late severe profile of bothersome symptoms that increased rapidly in perimenopause and remained high for four years or more after menopause. Women were less likely to have a profile for severe vasomotor symptoms if they were from a non-manual social class (odds ratio 0.79, 95% confidence interval 0.57 to 1.01) or had degree level qualifications (0.37, 0.18 to 0.77). The 14% of women (n=85) who had the late severe profile for sexual discomfort showed a similar increase in symptoms until menopause, with symptoms persisting after menopause. Married women were more likely to have the late severe or late moderate profile than women of other marital status (2.40, 1.30 to 4.41). Four profiles each were identified for somatic symptoms (mild, moderate, severe, and very severe), although these did not vary by chronological age or age at menopause.

Conclusion: Profiles for psychological, vasomotor, and sexual discomfort symptoms relative to age at menopause could help health professionals to tailor their advice for women with natural menopause.

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

None
Fig 1 Profiles of psychological symptoms across midlife and according to age relative to menopause
None
Fig 2 Profiles of somatic symptoms across midlife and according to age relative to menopause
None
Fig 3 Profiles of vasomotor symptoms across midlife and according to age relative to menopause
None
Fig 4 Profiles of sexual discomfort symptoms across midlife and according to age relative to menopause
See this image and copyright information in PMC

Comment in

References

    1. Freeman EW, Sherif K. Prevalence of hot flushes and night sweats around the world: a systematic review. Climacteric 2007;10:197-214. - PubMed
    1. Gold EB, Colvin A, Avis N, Bromberger J, Greendale GA, Powell L, et al. Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: study of women’s health across the nation. Am J Public Health 2006;96:1226-35. - PMC - PubMed
    1. NIH. NIH state-of-the science conference statement on management of menopause related symptoms. NIH Consensus and State-of-the-Science Statements, 2005. - PubMed
    1. Col NF, Guthrie JR, Politi M, Dennerstein L. Duration of vasomotor symptoms in middle-aged women: a longitudinal study. Menopause 2009;16:453-7. - PubMed
    1. Hardy R, Kuh D. Change in psychological and vasomotor symptom reporting during the menopause. Soc Sci Med 2002;55:1975-88. - PubMed

Publication types