title: The menopausal transition was associated in a prospective study with decreased health functioning in women who report menopausal symptoms.
abstract: OBJECTIVE
  To examine change in health functioning as women progress through the menopausal transition.
  
  
  METHODS
  Prospective study of 2,489 women followed through four phases of the Whitehall II study. Health functioning was assessed with the eight subscales of the SF-36.
  
  
  RESULTS
  Compared with peri- and postmenopausal women who did not experience menopausal symptoms, women who reported vasomotor symptoms or menopausal depression experienced large and significant declines on most scales of the SF-36. Women who reported the greatest symptom severity experienced the largest declines in functioning. For example, decline in physical functioning for perimenopausal women experiencing severe vasomotor symptoms was 3.3 (standard error SE=1.1) greater than those who experienced no vasomotor symptoms. Decline in role limitation-emotional for perimenopausal women experiencing severe menopause-associated depression was 18.4 (SE=2.3), compared with those who did not experience these symptoms. Vasomotor symptom reporting was predicted by low socioeconomic position, high body mass index, and limiting long-term illness at baseline. Menopause-associated depression was additionally predicted by smoking and depression.
  
  
  CONCLUSIONS
  The menopausal transition is associated with decreased health functioning in women who report menopausal symptoms. Menopausal symptoms are strongly related to all aspects of health functioning assessed by the SF-36. Socioeconomic and behavioral risk factors for menopausal symptoms and associated declines in health functioning have been identified.
authors.affiliation: International Centre for Health and Society, Department of Epidemiology and Public Health, Royal Free and University College London Medical School, 1-19 Torrington Place, London WC1 6BT, UK. M.Kumari@ucl.ac.uk
authors.forename: Meena
authors.initials: M
authors.lastname: Kumari
authors.forename: Mai
authors.initials: M
authors.lastname: Stafford
authors.forename: Michael
authors.initials: M
authors.lastname: Marmot
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003863:Depression / Q000503:physiopathology; D005260:Female; D006304:Health Status; D020249:Hormone Replacement Therapy; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D011446:Prospective Studies; D012907:Smoking / Q000503:physiopathology; D012923:Social Class; D013315:Stress, Psychological / Q000503:physiopathology; D014666:Vasomotor System / Q000502:physiology; D016387:Women's Health