title: Natural history of menopause symptoms in primary care patients: a MetroNet study.
abstract: BACKGROUND
  The association between changes in menopausal status and menopause-related symptom reporting over the course of the menopause transition is not well understood, especially whether there are any racial differences in this association.
  
  
  OBJECTIVE
  To determine (1) the prevalence and the natural history of menopause symptoms among primary care patients approaching, or at menopause; (2) the relationship between self-reported symptoms and menopausal status; and (3) whether this relationship varies in African American and white women.
  
  
  METHODS
  Cross-sectional self-report survey of 342 women aged 40 to 55 years (31.6% African American) were recruited from 8 family practice centers in 2000 and 2001.
  
  
  RESULTS
  Among 251 women without surgical menopause, 133 (53.0%) were premenopausal, 72 (28.7%) were peri-menopausal, and 46 (18.3%) were postmenopausal. The most commonly reported symptoms were joint/muscle pain and headache, which did not vary by menopausal status. As many as 28.6% of the women with regular menstruation reported hot flashes, and 18.8% had night sweats; although both symptoms were strongly associated with changes in menopausal status (P < .01). During the natural menopausal transition, white women had increasing trends of nervousness, memory loss, vaginal dryness, loss of sexual interest, hot flashes, and night sweats while African American women only had increasing trend of painful sex and hot flashes. In multivariate analyses, loss of sexual interest was associated with postmenopause status in white but not in African American women.
  
  
  CONCLUSIONS
  Symptoms are not uncommon among premenopausal women and become more prevalent as the transition through menopause occurs. The prevalence of vasomotor symptoms in premenopausal women may be an under-recognized aspect of the natural history of the menopause transition. African American and white women may present different symptoms through menopause transition.
authors.affiliation: Division of Practice-Based Research, Department of Family Medicine, Wayne State University, Detroit, Michigan 48201-2153, USA.
authors.forename: Jinping
authors.initials: J
authors.lastname: Xu
authors.forename: Monina
authors.initials: M
authors.lastname: Bartoces
authors.forename: Anne Victoria
authors.initials: AV
authors.lastname: Neale
authors.forename: Rhonda K
authors.initials: RK
authors.lastname: Dailey
authors.forename: Justin
authors.initials: J
authors.lastname: Northrup
authors.forename: Kendra L
authors.initials: KL
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001007:Anxiety / Q000453:epidemiology; D018771:Arthralgia / Q000453:epidemiology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology; D006801:Humans; D008569:Memory Disorders / Q000453:epidemiology; D008593:Menopause / Q000208:ethnology; D008875:Middle Aged; D016017:Odds Ratio; D011320:Primary Health Care; D013315:Stress, Psychological / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data