Menopause characteristics and subjective symptoms in women with and without spinal cord injury.
OBJECTIVE
To examine menopause transition characteristics and symptom bother in women with spinal cord injury (SCI).


METHODS
Prospective cohort (4 data collection periods across 4 years).


METHODS
Community.


METHODS
Women (n=62) with SCI (injury levels C6-T12, nonambulatory, >36mo postinjury; 86.1% retention) and women without SCI (n=66; 92.9% retention) with intact ovaries, not using hormone therapy, and between the ages of 45 and 60 years volunteered. A total of 505 observations were collected and analyzed.


METHODS
None.


METHODS
Age at final menstrual period (FMP), transitions through menopause status classifications, and menopause symptom bother (vasomotor, somatic, psychologic symptoms).


RESULTS
The number of women transitioning through a menopause status classification over the course of the study did not significantly vary by group (P=.263), nor did age at FMP (P=.643). Women with SCI experienced greater bother of somatic symptoms (a subscale, P<.001), bladder infections (P<.001), and diminished sexual arousal (P=.012). Women without SCI had significantly greater bother of vasomotor symptoms (P=.020). There were no significant group by menopause status interactions; main effects for menopause status were significant only for vasomotor symptoms and vaginal dryness.


CONCLUSIONS
Results suggested that women with SCI experience greater symptom bother in certain areas, but that patterns of symptom bother across menopause, transition through menopause, and age at FMP are similar to those of their peers. Larger studies are needed to examine menopause outcomes with respect to level of injury and completeness of injury. These findings provide a framework that women with SCI and their health care providers can use to address the menopause transition and highlight the importance of multidisciplinary involvement to maximize health and well being during this transition.
Kalpakjian
Claire Z
CZ
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108-5744, USA. clairez@umich.edu
Quint
Elisabeth H
EH
Bushnik
Tamara
T
Rodriguez
Gianna M
GM
Terrill
Melissa Sendroy
MS
D000367:Age Factors; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology* / Q000523:psychology; D008875:Middle Aged; D010264:Paraplegia / Q000503:physiopathology* / Q000523:psychology; D011446:Prospective Studies; D011782:Quadriplegia / Q000503:physiopathology* / Q000523:psychology; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000523:psychology
Arch Phys Med Rehabil. 2007 May;88(5):638-45
17466734
Acta Obstet Gynecol Scand. 2002 Jul;81(7):588-94
12190832
Maturitas. 1997 Jun;27(2):117-23
9255746
J Sex Med. 2008 Jul;5(7):1681-93
18410300
Spinal Cord. 2009 Jan;47(1):44-9
18542089
Br J Obstet Gynaecol. 1997 Aug;104(8):923-33
9255084
Maturitas. 2002 Jan 30;41(1):69-77
11809345
Menopause. 2007 Jul-Aug;14(4):788-97
17507832
J Obstet Gynecol Neonatal Nurs. 2007 Jan-Feb;36(1):97-104
17238954
Ann Neurol. 2001 Jan;49(1):35-44
11198294
Menopause. 2003 Jan-Feb;10(1):19-28
12544673
Womens Health Issues. 2006 Nov-Dec;16(6):380-8
17188221
Am J Phys Med Rehabil. 1992 Feb;71(1):15-21
1739438
Maturitas. 2001 Apr 20;38(2):129-36
11306201
Maturitas. 1998 Sep 20;30(1):41-50
9819782
Spinal Cord. 2008 Jan;46(1):21-5
17406379
West J Nurs Res. 2002 Apr;24(3):264-81
11911379
Obstet Gynecol. 2000 Sep;96(3):351-8
10960625
Arch Phys Med Rehabil. 1999 Nov;80(11):1420-8
10569436
Maturitas. 2003 Mar 28;44(3):225-36
12648886
ANS Adv Nurs Sci. 2007 Apr-Jun;30(2):123-38
17510570
JAMA. 2003 Feb 19;289(7):895-902
12588275
Menopause. 2009 May-Jun;16(3):442-52
19212271
Menopause. 2001 Nov-Dec;8(6):402-7
21141649
Spinal Cord. 2009 Feb;47(2):108-14
18779835
Am J Hum Biol. 2001 Jul-Aug;13(4):453-64
11400216
Menopause. 2008 Jul-Aug;15(4 Pt 1):706-13
18709703
J Rehabil Med. 2008 Jan;40(1):61-9
18176739
Maturitas. 1998 May 20;29(1):51-60
9643517