title: Effects of reproductive history on symptoms of menopause: a brief report.
abstract: OBJECTIVE
  The aim of this study was to examine the relationship between reproductive history and menopausal symptoms among urban women.
  
  
  METHODS
  This was a cohort study of women aged 35 to 47 years recruited in Philadelphia, PA. Two hundred ninety-one premenopausal women meeting the study eligibility criteria and contributing reproductive health history and infertility information completed the assessments of occurrence and severity of several menopausal symptoms over a 14-year period. Reproductive history included the number of pregnancies, live births, preterm deliveries, and miscarriages. Trying to get pregnant for more than 1 year was used as an assessment of infertility. The occurrence of severe hot flashes, vaginal dryness, and decreased libido was evaluated.
  
  
  RESULTS
  Women scoring positive on the infertility index were significantly more likely to report severe decreased libido (odds ratio [OR], 1.86; 95% CI, 1.05-3.31) and were more than twice as likely to report severe vaginal dryness (OR, 2.79; 95% CI, 1.19-6.94) in multivariable models. None of the other reproductive health indices were related to the report of severe hot flashes, vaginal dryness, or decreased libido. The race-specific models continued to find a significant increased risk of severe vaginal dryness (OR, 2.79; 95% CI, 1.22-6.36) and decreased libido (OR, 1.87; 95% CI, 1.04-3.34) among white women scoring positive on the infertility index; however, the relationship did not remain significant among African American women.
  
  
  CONCLUSIONS
  Severe vaginal dryness and decreased libido are common and important considerations of the menopausal transition, and the experience of infertility problems may influence the report of severe vaginal dryness and decreased libido particularly among white women.
authors.affiliation: Department of Public Health and Obstetrics & Gynecology, Temple University, Philadelphia, PA, USA. dnelson@temple.edu
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Nelson
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Freda
authors.initials: F
authors.lastname: Patterson
authors.forename: Hui
authors.initials: H
authors.lastname: Lin
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D020073:Gravidity; D019584:Hot Flashes / Q000453:epidemiology; D006801:Humans; D007989:Libido; D008593:Menopause; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D014621:Vagina / Q000503:physiopathology; D044465:White People / Q000706:statistics & numerical data