Linkage of premature and early menopause with psychosocial well-being: a moderated multiple mediation approach

Abstract

Purpose Menopause occurring before the age of 40 is premature and between 40 and 44 years age is early, since the natural age of menopause lies between 45 and 50. The endocrine changes that come with menopause include an erratic decline in estrogen levels which affects the brain. Thus, leading to changes in cognitive function in the longer term due to the menopausal transition. The study aims to explore the effect of premature and early menopause on cognitive health, and psychosocial well-being. The moderated multiple mediation hypothesis of the study is that the effect of premature or early menopause is mediated by depression and insomnia, while all the pathways are moderated by smoking habits. Data and Methods The study utilized Longitudinal Aging Study in India (LASI), 2017–2018, Wave 1 data. The sample of 31,435 women were aged 45 and above and did not undergo hysterectomy. A moderated multiple mediation model was used to understand the association between premature or early menopause (X), insomnia (M1), depression (M2), moderator (W), and cognitive health (Y), while controlling for possible confounders. Results Premature menopause was negatively associated with cognition (β:-0.33; SE:0.12; p < 0.05), whereas positively associated with insomnia (β:0.18; SE:0.03; p < 0.001) and depression (β:0.25; SE:0.04; p < 0.001). There is a moderating effect of smoking or tobacco consumption has a significant moderating effect on the pathways among premature menopause, depression, insomnia and cognition. When the same model was carried out for early menopause (40–44 years), the results were not significant. Conclusions The findings emphasize the fact that smoking is associated with premature menopause, depression and insomnia. Women who experienced premature menopause has lower cognitive scores, depressive symptoms and insomnia symptoms, which were higher among those who consumed tobacco. The study, strongly recommends the dissemination of information on the negative effects of tobacco consumption and making more informed choices to maintain a healthy life. More research into various methods and therapy is needed to determine the relationship between the age of early menopause and their psychosocial well-being.

Exploring the triggers of premature and early menopause in India: a comprehensive analysis based on National Family Health Survey, 2019–2021

“…Overall, this compromises the typical hormonal balance in women, which has an impact on the entire system. When smoking combined with an early menopause, the hormonal imbalances result in sleep problems, depressive symptoms, and eventually impaired cognitive performance 20 , 39 , 40 .…”

“…Menopausal age is associated with a number of factors with includes smoking 13 , 14 , level of education 15 , working status 16 , abortion 17 , body mass index 16 and food habits 18 . Smoking specifically have shown adverse impacts on reproductive health and heavy smokers were observed to reach menopause earlier 19 , 20 , thus making it important to study its association. Tobacco consumption has anti-estrogenic impacts on the female body which can lead to estrogen function resistance 20 .…”

“…Smoking specifically have shown adverse impacts on reproductive health and heavy smokers were observed to reach menopause earlier 19 , 20 , thus making it important to study its association. Tobacco consumption has anti-estrogenic impacts on the female body which can lead to estrogen function resistance 20 . There has not been any consistent association between the onset of menopause and the above stated factors.…”

Drivers of perceived discrimination among older adults in India: an intersectional analysis

“…where i y , is the intercept; a is the effect of X on Y; b is the effect of M on Y; c is moderation effect of M. This is a common method used in many social science research [ 69 , 70 ].…”