title: The association of menopause and physical functioning in women at midlife.
abstract: OBJECTIVE
  To determine whether the characteristics of menstrual bleeding and the menopausal transition are associated with physical functioning in women age 40 to 55, after considering ethnicity, ability to pay for basics, body size, and age.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Seven geographically dispersed community samples in the United States.
  
  
  METHODS
  The 14,427 respondents were Caucasians (46.9%), African Americans (28.7%), Chinese (4.0%), Japanese (5.3%), and Hispanics (12.6%) from the Study of Women's Health Across the Nation (SWAN) Cross-sectional Study, a study of the menopausal transition, including surgical menopause.
  
  
  METHODS
  The dependent variable was a three-category variable based on the physical functioning scale of the Medical Outcomes Study. Explanatory variables included menstrual and menopausal status.
  
  
  RESULTS
  Eighty percent (80.8%) of women reported no limitation in physical functioning, whereas 10% of women had some limitation, and 9.2% of women indicated having substantial limitation. Women with substantial limitation in physical functioning had double the prevalence odds ratio (POR = 2.02; 95% confidence interval (CI) = 1.64-2.49) of having surgical menopause and 76% greater odds (POR = 1.76; 95% CI = 1.38-2.24)) of using hormones, compared with women with no limitation. Compared with those without limitation, women with substantial limitation in physical functioning had 56% greater odds (POR = 1.56; 95% CI = 1.23-1.97)) of being naturally postmenopausal and a 41% greater odds (POR = 1.41; 95% CI = 1.17-1.70) of being perimenopausal, relative to being premenopausal and after adjusting for other variables.
  
  
  CONCLUSIONS
  Even at the relatively early age of 40 to 55, approximately 20% of women self-reported limitation in physical functioning. Surgical menopause and the use of hormones were more frequently observed in women with some and substantial physical limitation than in women with no limitation, even after adjusting for economic status, age, body mass index, and race/ethnicity.
authors.affiliation: University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor 48109, USA.
authors.forename: M
authors.initials: M
authors.lastname: Sowers
authors.forename: S
authors.initials: S
authors.lastname: Pope
authors.forename: G
authors.initials: G
authors.lastname: Welch
authors.forename: B
authors.initials: B
authors.lastname: Sternfeld
authors.forename: G
authors.initials: G
authors.lastname: Albrecht
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause / Q000187:drug effects; D008594:Menopause, Premature / Q000187:drug effects; D008875:Middle Aged; D011446:Prospective Studies; D014481:United States