title: Menopause and determinants of quality of life in women at midlife and beyond: the study of health in pomerania (SHIP).
abstract: OBJECTIVE
  Determinants of quality of life (QoL) in pre- and postmenopausal women including nonhormonal modulators of QoL in adult women are not well understood; there is an ongoing controversy about the impact of menopause on health-related QoL. We investigated the extent to which diverse mental and physical symptoms are associated with (a) menopausal status; (b) sociodemographic, psychosocial, and lifestyle factors; and (c) menopausal hormone therapy (MHT) in adult women after the German reunification in a region of the former German Democratic Republic.
  
  
  METHODS
  The Study of Health in Pomerania is a cross-sectional, population-based survey. Computer-based structured interviews and self-administered questionnaires were used to capture QoL (Zerssen Symptom List) and sociodemographic parameters, psychosocial, and lifestyle indicators (age, socioeconomic status, abuse, social support, nutrition, body mass index, self-rated health, chronic diseases, and use of MHT) in 1,119 pre- and postmenopausal women with an intact uterus.
  
  
  RESULTS
  Analyses suggest that menopausal status was not associated with QoL. MHT was associated with physical, mental, and gastrointestinal symptoms. Age was a significant predictor for cardiopulmonary symptoms and sensory impairment. The relationship between age and both physical and mental complaints was inverse as was the relationship between age and both mood and gastrointestinal symptoms. Age, socioeconomic status, physical and sexual abuse, perceived social support, nutrition, body mass index, self-rated health, chronic diseases, and MHT modulated QoL.
  
  
  CONCLUSIONS
  Our findings do not support the hypothesis that QoL is reduced after menopause. Differences between pre- and postmenopausal women can be explained by sociodemographic, psychosocial, and lifestyle factors.
authors.affiliation: Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Clinical Research Center of Women's Health, Berlin, Germany. sabine.schwarz@charite.de
authors.forename: Sabine
authors.initials: S
authors.lastname: Schwarz
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Dietrich
authors.initials: D
authors.lastname: Alte
authors.forename: Christian
authors.initials: C
authors.lastname: Schwahn
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Grabe
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.forename: Martina
authors.initials: M
authors.lastname: Dören
mesh_terms: D000339:Affect; D000368:Aged; D015992:Body Mass Index; D002908:Chronic Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000453:epidemiology; D017698:Postmenopause / Q000523:psychology*; D017697:Premenopause / Q000523:psychology*; D011788:Quality of Life; D012923:Social Class; D011795:Surveys and Questionnaires