The experience of perimenopausal distress: examining the role of anxiety and anxiety sensitivity

Abstract

Objective: The hormonal changes that occur in perimenopause can result in distress for a significant proportion of women years before reaching menopause. Previous studies have suggested that various biopsychosocial characteristics and personality traits contribute to more intense reactions to these hormonal changes. In the present study, we examined the contribution of trait anxiety and anxiety sensitivity in predicting the experience of perimenopausal distress in pre- and early perimenopausal women while controlling for some menstrual experiences.

Method: A sample of 660 women aged 35–52 years was selected from a broader online survey of biopsychosocial changes in middle-aged women that considered age, menstrual cycle pattern, physical and mental health, and childbearing experience. Three hierarchical multiple regression analyses were conducted for different age subgroups: women aged 35–40, women aged 41–45 and women aged 46–52.

Results: Results indicated that anxiety and anxiety sensitivity, along with a number of features of the menstrual experience, explained 56–66% of the perimenopausal distress variance. Different personality trait predictors were found to be important in different age subgroups. In the youngest and middle subgroups (45 years and younger), trait anxiety was found to be more significant, whereas anxiety sensitivity was found to be more important in explaining perimenopausal distress experienced by women older than 40.

Conclusion: Anxiety sensitivity (dimension of psychological concerns) might be an important vulnerability factor in the experience of perimenopausal distress among women closer to menopause, whereas the predisposition to an anxiety response might contribute to perimenopausal distress near the beginning of reproductive hormonal changes. Implications for better understanding the development of perimenopausal distress and psychological intervention are discussed.

• Anxiety
• anxiety sensitivity
• middle-aged women
• perimenopausal distress

Current knowledge on the subject

• hormonal changes in perimenopause can result in distress for a significant proportion of women years before reaching menopause and is characterized by a variety of specific and nonspecific complaints

• some biopsychosocial factors and personality traits contribute to more intensive perimenopausal distress

• trait anxiety and anxiety sensitivity have an important role in explaining vulnerability surrounding hormonal changes and reactivity to menstrual distress

What this study adds

• trait anxiety and anxiety sensitivity have an important role in predicting perimenopausal distress in middle-aged women

• highly anxious women are prone to anxious reactions to the experience of negative changes, which further “triggers” the severity of perimenopausal distress

• highly anxiety sensitive women are more vulnerable to experience perimenopausal distress, especially those sensitive to signs of reduced mental capacity (women expressed more psychological concern) above 40 years of age