In addition to the general health and well-being of older working women, we also examined menstrual status and women’s experience of menopause-related symptoms. Women were asked a series of questions about their menstrual status and from these responses, women were categorised into three menstrual categories (pre-menopausal, peri-menopausal and natural post-menopausal) according to the STRAW +10 Staging System (Harlow et al., 2012; Soules et al., 2001). This system categorises women into menstrual stages depending on when they had their last period and the variability of their menstrual cycle.
27% (n=227) of women gave answers that classified them as pre-menopausal; that is they reported no variability in their menstrual cycle.
25.1% (n=208) of women gave answers that classified them as peri-menopausal, that is they reported variability in their menstrual cycle (skipped cycles and cycle length changes).
47.5% (n=393) of women gave answers that classified them as being post-menopausal, through biological processes. Women who reported that they had their last period more than one year ago were classified as natural post-menopausal.
In addition to assessing the general health of older working women, another health outcome scale (the MENSI) was included in order to assess women’s experience of menopause-related symptoms.
- Menopause symptoms (The MENSI – The Menopause Symptom Index; Sarrel et al., 1990): a 19-item scale that assesses women’s experience, in terms of frequency and bothersomeness of 19 menopause-related symptoms.
- In order to assess the frequency of symptoms, women were asked whether they often experienced 19 menopause-related symptoms, such as “In the last month, did you experience hot or warm flushes?” and “In the last month, did you experience sleep disturbance?” They responded on a scale of 0 (no), 1 (yes, occasionally) and 2 (yes, on a regular basis).
- In order to assess symptom bothersomeness, women were asked whether each symptom was “a real problem for you?” They responded on a scale of 0 (no) and 1 (yes).
Figure 1 presents the percentage of women who reported having experienced menopause-related symptoms occasionally or on a regular basis in the last month, by menstrual status. Only the ten most frequently experienced symptoms listed in the Menopause Symptom Index (MENSI, Sarrel et al., 1990) are included.
Figure 1 – Percentage of participants who had experienced menopause-related symptoms occasionally or on a regular basis in the last month, by menstrual status^
Click image to enlarge.
^ Menstrual status categorised according to STRAW +10 Staging System.
As can be seen in Figure 1, the most frequently experienced symptoms among peri-menopausal women were: sleep disturbance, headaches, weakness or fatigue, loss of sexual desire, anxiety, memory loss, pain in bone joints, and hot flushes (more than half of all peri-menopausal women experienced these symptoms at least occasionally or on a regular basis in the last month). The most frequently experienced symptoms among post-menopausal women were: sleep disturbance, pain in bone joints, weakness or fatigue, loss of sexual desire, anxiety and headaches (more than half of all post-menopausal women experienced these symptoms at least occasionally or on a regular basis in the last month).
For seven out of the ten most frequently reported symptoms, the highest rates (most frequent experience of menopause symptoms) were observed among peri-menopausal women. However, there is a close similarity between the percentage of women in the peri-menopausal group and the post-menopausal group for many of the symptoms.
Hot flushes, the symptom most commonly associated with menopause, was experienced regularly by just over half of peri-menopausal women and 45% of post-menopausal women. Hot flushes occur when oestrogen levels are fluctuating (i.e. when women are within two years of last menstrual flow) and usually decrease during post-menopause (Stearns et al., 2002).
While all of these symptoms are typically associated with the bodily and hormonal changes that occur during and after the menopause transition, many of the symptoms are also generally age-related. For example, symptoms such as pain in bone joints, weakness, fatigue and memory loss are also typically associated with increasing age (Luszcz & Bryan, 1998). This must be taken into consideration when examining the frequency of experience of symptoms commonly associated with menopause.