A longitudinal study of the predictors of prevalence and severity of symptoms commonly associated with menopause

Objective: To delineate the role of hormone levels, menopause status, exogenous hormone use, and personal characteristics in the changing prevalence and impact of menopause symptoms. Design: Annual longitudinal data were from Michigan Bone Health Study enrollees aged 24 to 44 years at baseline and followed up for a 10-year period beginning in 1992. In self-administered interviews, women reported the presence of and degree of bother (values from 1 = low to 8 = high) for symptoms related to sexuality, vasomotor, sleep/fatigue, negative mood, hair/skin, and urinary problems. Annually, collected sera samples were analyzed for estradiol, follicle-stimulating hormone, and testosterone concentrations. Results: Increasing age consistently predicted the development and bother of the measured symptoms. Transition to postmenopause and higher levels of follicle-stimulating hormone were significantly predictive only of the sexuality and vasomotor constructs, whereas higher estradiol levels were protective against increasing frequency and bother from sexuality and vasomotor constructs. Problems with sleeping, and secondarily, vasomotor symptoms, were the most bothersome constructs. Higher body mass index and current smoking behavior were highly related to increased bother with many symptom constructs, but especially vasomotor symptoms. Exogenous hormone use was associated with more bother from all symptom constructs. Conclusions: Sexuality and vasomotor symptom constructs seem to be more related to menopause than other constructs. The frequency of other constructs in the premenopause and their very strong association with increasing age suggest caution in attributing these factors directly to neuroendocrine events of the menopause transition. The strong associations between smoking and body size with symptoms, particularly vasomotor symptoms, suggest that interventions directed at these personal characteristics might be effective in dampening their impact.