Change in health-related quality of life over the menopausal transition in a multiethnic cohort of middle-aged women: Study of Women's Health Across the Nation.
OBJECTIVE
The aim of this study was to examine changes in health-related quality of life (HRQL) during the menopausal transition, controlling for chronological aging, symptoms, and other covariates.


METHODS
This was a prospective, longitudinal study of women aged 42 to 52 years at baseline recruited at seven US sites (N = 3,302) in the multiethnic Study of Women's Health Across the Nation. Women eligible for the cohort had an intact uterus, had at least one ovary, were not currently using exogenous hormones, were either premenopausal or early perimenopausal, and were self-identified as one of the study's designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. HRQL was assessed with five subscales from the Medical Outcomes Study Short-Form Health Survey, with reduced functioning defined as being in the lowest 25% on a subscale. Covariates included symptoms, medical conditions, sociodemographics variables, physical activity, and psychological factors.


RESULTS
With adjustment for baseline age, chronological aging, and relevant covariates, the odds of reduced role-physical functioning were significantly greater at late perimenopause (odds ratio, 1.46; 95% CI, 1.08-1.99) and postmenopause (odds ratio, 1.49; 95% CI, 1.09-2.04) compared with premenopause. Menopause status was unrelated to bodily pain, vitality, role-emotional, or social functioning. Hormone therapy users were more likely to report reduced functioning. Other variables significantly related to HRQL across all domains included vasomotor symptoms, urine leakage, poor sleep, arthritis, depressed mood, perceived stress, and stressful life events.


CONCLUSIONS
The menopausal transition showed little impact on HRQL when adjusted for symptoms, medical conditions, and stress.
Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1063, USA. navis@wfubmc.edu
Nancy E
NE
Avis
Alicia
A
Colvin
Joyce T
JT
Bromberger
Rachel
R
Hess
Karen A
KA
Matthews
Marcia
M
Ory
Miriam
M
Schocken
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000375:Aging / Q000502:physiology / Q000523:psychology; D001294:Attitude to Health / Q000208:ethnology*; D015914:Estrogen Replacement Therapy / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008593:Menopause / Q000187:drug effects / Q000208:ethnology* / Q000502:physiology; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012380:Role; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014481:United States; D014930:Women / Q000523:psychology*; D016387:Women's Health / Q000208:ethnology*