Using network analysis to understand the association between menopausal and depressive symptoms: a survey study

Abstract

Background The menopause appears to heighten women's susceptibility to mental health issues, particularly depression. It has been proposed that depressive symptoms occurring throughout the menopause may be linked to specific menopause symptoms. Notably, previous studies have merely examined the severity and prevalence of menopausal and depressive symptoms using summed scores and/or individual item scores, as opposed to understanding how these symptoms interconnect and overlap. The aims of the current study were to: (i) use network analysis to explore the symptom structure and interconnectivity of a broad range of menopausal and depressive symptoms, and (ii) to compare the symptom structure of menopausal and depressive symptoms between the perimenopause and the post-menopause. Methods Online survey data from 858 respondents were analysed. Network analysis was used to explore the symptom structure of menopausal (as measured using the Menopause-specific Quality of Life (MENQOL) questionnaire) and depressive (as measured using the eight-item Patient Health Questionnaire (PHQ-8)) symptoms. Results A network was constructed comprising the 37 variables of interest (MENQOL: 29 symptoms; PHQ-8: 8 symptoms). Decreased stamina, decreased physical strength, feeling depressed, and change in sexual desire were the most central symptoms. The estimated network had a good level of stability (CS-strength = 0.75 and CS-influence = 0.75). The clique percolation analysis revealed 10 communities of symptoms. There were no significant differences in the network structure-distribution of edge weights or global strength between the peri- and post-menopausal groups. Conclusions The findings from this research suggest that addressing decreased stamina could prove instrumental in managing menopausal symptoms. Similarly, psychosocial symptoms were seen to be core symptoms of the menopause experience. Undoubtedly, the menopause is a multifaceted phase that encompasses not only physical changes but also significant psychological challenges, and recognising the holistic nature of the menopause experience is crucial for providing comprehensive care. The findings from the current study also underscore the importance of early intervention, particularly in the perimenopausal stage, where women may face additional barriers in accessing essential support. Early intervention not only aids in alleviating menopausal and depressive symptoms but also contributes to overall well-being during this significant phase of life.