“…7 Aside from hormonal changes, age, 3,5,8 socioeconomic status, 3,9 altitude of residency, 3 ethnicity, and cultural aspects 10,11 may also correlate with more intense menopausal symptoms and hence impaired QoL. On the other hand, lifestyle factors such as cigarette smoking, 12 alcohol consumption, 13 sedentary lifestyle, obesity, 13,14 and mental illnesses, especially mood disorders such as anxiety and depression 3 are also important.…”