Menopausal symptoms within a Hispanic cohort: SWAN, the Study of Women's Health Across the Nation

Abstract

Introduction Since the designation of people as Hispanic involves the amalgamation of a number of different cultures and languages, we sought to test the hypothesis that menopausal symptoms would differ among Hispanic women, based upon country of origin and degree of acculturation.

Methods A total of 419 women, aged 42–52 years at baseline, were categorized as: Central American (CA, n = 29) or South American (SA, n = 106), Puerto Rican (PR, n = 56), Dominican (D, n = 42), Cuban (Cu, n = 44) and non-Hispanic Caucasian (n = 142). We assessed vasomotor symptoms, vaginal dryness and trouble in sleeping. Hispanics and non-Hispanic Caucasians were compared using the χ² test, t test or non-parametric alternatives; ANOVA or Kruskal–Wallis testing examined differences among the five Hispanic sub-groups. Multivariable regression models used PR women as the reference group.

Results Hispanic women were overall less educated, less acculturated (p < 0.001 for both) than non-Hispanic Caucasians and more of them reported vasomotor symptoms (34.1–72.4% vs. 38.3% among non-Hispanic Caucasians; p = 0.0293) and vaginal dryness (17.9–58.6% vs. 21.1% among non-Hispanic Caucasians, p = 0.0287). Among Hispanics, more CA women reported vasomotor symptoms than D, Cu, SA, or PR women (72.4% vs. 45.2%, 34.1%, 50.9%, and 51.8%, respectively). More CA (58.6%) and D women (38.1%) reported vaginal dryness than PR (17.9%), Cu (25.0%) and SA (31.4%) women. More PR and D women reported trouble in sleeping (66.1 and 64.3%, respectively) compared to CA (51.7%), Cu (36.4%), and SA (45.3%) women.

Conclusion Symptoms associated with menopause among Hispanic women differed by country of origin but not acculturation. Central American women appear to be at greatest risk for both vasomotor symptoms and vaginal dryness.

Key words:

• MENOPAUSE
• VASOMOTOR SYMPTOMS
• HISPANIC
• HOT FLUSHES
• VAGINAL DRYNESS

Acknowledgements

We thank the study staff at each site and all the women who participated in SWAN.

Clinical Centers  University of Michigan, Ann Arbor – MaryFran Sowers, PI; Massachusetts General Hospital, Boston, MA – Robert Neer, PI 1994–1999; Joel Finkelstein, PI 1999–present; Rush University, Rush University Medical Center, Chicago, IL – Lynda Powell, PI 1994–2009; Howard Kravitz, PI 2009; University of California, Davis/Kaiser – Ellen Gold, PI; University of California, Los Angeles – Gail Greendale, PI; University of Medicine and Dentistry, New Jersey Medical School, Newark – Gerson Weiss, PI 1994–2004; Nanette Santoro, PI 2004–present; and the University of Pittsburgh, Pittsburgh, PA – Karen Matthews, PI.

NIH Program Office  National Institute on Aging, Bethesda, MD – Marcia Ory 1994–2001; Sherry Sherman 1994–present; National Institute of Nursing Research, Bethesda, MD – Program Officers.

Central Laboratory  University of Michigan, Ann Arbor – Daniel McConnell (Central Ligand Assay Satellite Services).

Coordinating Center  New England Research Institutes, Watertown, MA – Sonja McKinlay, PI 1995–2001; University of Pittsburgh, Pittsburgh, PA – Kim Sutton-Tyrrell, PI 2001–present.

Steering Committee  Chris Gallagher, Chair, Susan Johnson, Chair.

Conflict of interest  The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Source of funding  The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women's Health (ORWH) (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495). N.S. was supported by HD041978. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, the NINR, the ORWH or the NIH.