Details of Publication 395 for Project A239:

Berecki J, Begum N & Dobson A. Symptoms reported by women in mid-life: menopausal transition or ageing? Menopause, 2009; 16(5): 1021-1029

Objective: The aim of this study was to determine which symptoms commonly reported by women at mid-life are associated with menopausal transition, after adjusting for ageing, life events, sociodemographics and lifestyle factors.Design: Middle-aged women participating in the Australian Longitudinal Study on Women's Health between 1996 (Survey 1, ages 45 to 50) and 2007 (Survey 5) were included in the analyses if natural menopausal status could be determined at any survey (n=8649 out of 13716 participants). Natural menopausal status was determined from reported menstruation patterns. A survival function describing age at menopause was computed. Logistic regression models for repeated measures wereused to estimate the association between menopausal stage and symptom prevalence.Results: There were 6814 (79%) women who reached natural menopause before 2007. The median age at menopause was 52 years. Compared to the premenopausal phase, the menopause was associated with hot flushes (odds ratio= 8.6 [95% CI= 7.5 to 9.9]), night sweats (5.5 [4.8 to 6.3]), and to a lesser extent with stiff or painful joints (1.6 [1.4 to 1.8]), difficulty sleeping (1.4 [1.2 to 1.6]), and poor/fair self-rated health (1.6 [1.3 to 1.9]), after controlling for confounders. Prevalence of some symptoms was still raised more than 7 years after menopause. Headaches/migraines were negatively, and urinary incontinence positively associated with ageing.Conclusions: Treatment such as hormone replacement therapy should be targeted at vasomotor symptoms which are most strongly associated with menopause rather than at less specific symptoms related to ageing per se.