Identifying the different subtypes in menopausal symptoms among middle-aged women in China: a latent class analysis

Abstract

Objective: Many studies have focused on the severity and prevalence of menopausal symptoms among middle-aged women, which are limited by heterogeneity and diversity of subtypes. Subtyping facilitates the adaptation to prevention and clinical intervention strategies that target women. To determine the existence of significant subgroups of women with similar menopausal symptoms, a person-centered approach was used to identify potential profiles of women during the menopausal transition. In addition, we aimed to examine the association between latent subtypes and individual factors. Methods: This cross-sectional study included 797 middle-aged women, aged 40 to 60 years, who were recruited from Shandong Province, China, between December 2017 and August 2018. We identified the subtypes in menopausal symptoms by performing a latent class analysis according to the self-reported Menopause Rating Scale and evaluated the robustness of our identified subtypes using a sensitivity analysis. Multinomial logistic regression was performed to explore the association between emergent latent subtypes and sociodemographic, clinical, and psychosocial characteristics. Results: The mean age of participants was 49.83 ± 5.05 years. (1) Four potential classes were identified in middle-aged women: “severe symptoms” (14.9%), “dominant sleep-emotion symptoms” (31.4%), “physical/mental exhaustion symptoms” (32.5%), and “no symptoms” (21.2%). The four classes were also verified using a sensitivity analysis according to age and menopause status subgroups, which revealed the robust subtypes of menopausal symptoms. (2) The odds ratio of neuroticism, chronic diseases, and gynecological diseases were significantly higher for the “severe symptoms,” “dominant sleep-emotion symptoms,” and “physical/mental exhaustion symptoms” classes, compared to the “no symptoms” class, while the odds ratio of mindfulness and social support were lower. Conclusions: A person-centered approach for middle-aged women could address the unmet need to understand the heterogeneity of menopausal symptoms. Subtyping facilitates the identification of the potential causes of menopausal symptoms and the development of personalized interventions. Video Summary: http://links.lww.com/MENO/A830.

Symptom patterns and health service use of women in early adulthood: a latent class analysis from the Australian Longitudinal Study on Women’s Health

“…To our knowledge, this is first study that has looked at patterns of a broad range of recurring symptoms in women in early adulthood. Although not directly comparable due to differences in the characteristics of study populations, symptom lists and timeframes over which symptoms are reported, our finding of a latent class with minimal symptoms and a latent class with many symptoms is consistent with studies of symptom patterns in populations of both men and women across broad age groups [ 5 , 39 ], women in mid-life [ 7 , 13 ], and cancer patients [ 40 ].…”

“…Latent class analysis of somatic symptoms in a Danish population found that women had a higher probability than men of being in classes with many symptoms compared with the class characterised by no symptoms [ 5 ]. Latent class analysis has been used to identify symptom patterns in women; however, these studies have either focussed on narrow groups of symptoms (e.g., menopausal [ 6 , 7 ], mood [ 8 ], menstrual and mood [ 9 ]), symptom patterns among women with specific conditions (e.g., dysmenorrhea [ 10 ], irritable bowel syndrome [ 11 ]) or women in midlife (i.e., during menopause transition) [ 12 – 14 ].…”

Perimenopause and/or menopause help-seeking among women from ethnic minorities: a qualitative study of primary care practitioners experiences

“…Literature shows that ethnic minority women may present with symptoms of menopause that are different, or described differently, to their white peers 1,2,3,4,5 . Our study has shown a communication gap in the consultation, rising from lack of awareness of peri/menopausal symptomatology in some ethnic minority women which does not allow them to advocate for their health, compounded by a lack of knowledge or confidence in some primary care clinicians to interpret and connect symptom presentation with a holistic menopause care lens.…”

“…The menopause is a natural stage in a woman's life, and each woman's experience is individual and unique. Research from the USA shows that different ethnic groups may have different experiences from their white peers, such as entering the peri/menopause at earlier ages 1 , having longer transition periods 2 , and emphasising different symptom experiences 3,4,5 . Acculturation and the stresses of poverty and structural racism appear to play a complex role in menopausal symptomatology, with recommendations to clinicians that ethnicity should be taken into account when interpreting symptom presentation 6,7,8,9 .…”

“…Research from the US shows that women from different ethnic groups may have different experiences from their White peers, such as entering the perimenopause and/or menopause at earlier ages, 1 having longer transition periods, 2 and an emphasis on different symptoms. 3 – 5 Acculturation and the stresses of poverty and structural racism appear to play a complex role in menopausal symptomatology, with recommendations to clinicians that ethnicity should be taken into account when interpreting symptom presentation. 6 – 9 Despite evidence of high menopausal symptom burden among women from ethnic minorities from studies outside the UK, evidence of help-seeking and hormone replacement therapy (HRT) treatment are less common when compared with White women.…”