Symptom experience during the late reproductive stage and the menopausal transition: observations from the Women Living Better survey

Abstract

Objective: The aim of this study was to examine the occurrence of a variety of symptoms, their frequency, bother, burden, and interference in the lives of women in the late reproductive stage (LRS) and compare their experiences to that of women in the menopausal transition (MT) stage. Methods: Women ages 35 to 55 years responded to an 82-question online survey offered by Women Living Better. Participants reported current menstrual patterns, recent changes and symptom frequency, bother, and interference. Women's cycles were classified as LRS or MT using Stages of Reproductive Aging Workshop +10 criteria. Results: Of 2,406 respondents, 946 met criteria for LRS and 583 for MT. Participants included 30% from outside the United States, 31% from diverse racial/ethnic groups, and 18% reported having difficulty paying for basics. A similar proportion of women in the LRS and MT+ groups reported each of the symptoms: there was a less than 10% difference for 54 of the 61 symptoms. Of mean bother ratings for all symptoms, only hot flashes differed significantly between the LRS and MT groups. LRS women experienced similar levels of symptom-related interference with personal relationships and daily living to those in the MT stage but did not anticipate these symptoms occurring until they were 50 years old. Conclusions: Women in the LRS experience symptoms strikingly similar to those often associated with the MT. Women do not expect these changes until the age of 50 years or later and are surprised by such symptoms before cycle irregularity. Research about the epidemiology and management of LRS symptoms, anticipatory guidance for women, and education for clinicians who care for them warrant increased attention.

Nutritional Risk Factors Associated with Vasomotor Symptoms in Women Aged 40–65 Years

“…In this study, several women in the late reproductive stage also reported the presence of VMS; 15.2% had hot flashes and 11.1% had either night sweats or palpitations. Previous studies have reported night sweats in 40.0% and hot flashes in 29.0% of late reproductive women aged 35-55 years [37]. It is important to note that VMS can begin at earlier stages, such as the late reproductive stage, although in a low proportion due to estrogen reduction through constant aging and death of follicles [38].…”

Women’s Voices: The Lived Experience of the Path to Menopause

“…In a 2020 WLB survey aimed at creating a better understanding of women's experience during the menopausal transition, participants were queried about 61 symptoms gathered from a variety of sources, that are sometimes associated with the menopause transition. Only two symptoms, vaginal pain in the absence of sex (3%) and more interest in sex (9%) were reported by fewer than 10% of women, all others were reported by more than 10% of people surveyed [1]. Most people associate the menopausal…”

“…When asked to think back to when they were 30 about at what age they assumed changes associated with the menopause transition would begin, 59% of women anticipated changes at 50 or later and another 28% said 45-49 years old. Only 13% assumed changes would begin before age 44 [1]. Because they haven't been given anticipatory guidance to expect changes in their late 30s or early 40s as ovarian follicles significantly decline and reproductive hormone patterns change, when the first changes occur, most don't know what is happening to them or within their bodies.…”

“…-Elaine 1 All names have been disguised to preserve privacy. Quotes were sourced from submissions to the Women Living Better website and posts from The Menopause Chicks and the Perimenopause Hub Facebook Groups with permission from moderators.…”

“…The menopause symptoms that I experienced were ridiculous, and I was incensed that there had been no pre-warning about these... the fact that I was learning about them first after suffering for a year (and having them impact my relationship and my self-esteem) so greatly, was inexcusable. -Carlotta Not only do women believe menopause-related changes will begin at 50 or later [1], but they assume they will skip a period before symptoms occur. In fact, early changes in experience often come before a skipped period or cycles that are dramatically different in length, but most people don't know this.…”