Identifying symptom clusters during the menopausal transition: observations from the Seattle Midlife Women's Health Study

Abstract

Objectives First, to explore the variability in how symptoms clustered together over the late reproductive stage, early and late menopausal transition (MT) stages, and early postmenopause; second, to determine whether the symptom factor structure of the preceding MT stage would predict the symptom factor structure of the MT stage immediately following.

Methods The sample consisted of a subset of Seattle Midlife Women’s Health Study participants who were in late reproductive or early or late menopausal transition stages or early postmenopause and provided self-reported data on symptoms experienced between 1990 and 2005. Principal components analysis was used to determine how symptoms clustered together across the stages. Variables predicting the symptom factor structure were analyzed by multiple regression.

Results Principal components analysis with varimax rotation revealed different factor structures for each of the four stages. The three-factor solution in the late reproductive stage explained a total of 54.9% of the variance. The four-factor solutions in the early and late menopausal transition stages and postmenopause explained a total of 56.5%, 59.3%, and 60.7%, respectively.

Conclusions This analysis revealed similar factor structures across the four stages in that each stage revealed a mood component, a vasomotor component, and a pain component. However, the symptoms differed somewhat in how they grouped from stage to stage. Regression analysis demonstrated that a relationship exists between the symptom factor structures across stages. Controlling for demographic and lifestyle variables, it was revealed that the symptom clusters at the early and late menopausal transition stages and early postmenopause were best predicted by the symptom factor structure of the previous stage.

Key words::

• MENOPAUSE
• POSTMENOPAUSE
• MENOPAUSAL TRANSITION
• SYMPTOM CLUSTERS

Conflict of interest

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

Source of funding

This work was supported by grants from the National Institute of Nursing Research (NINR 1R21NR012218-01 Menopause Symptom Clusters: Refocusing Therapeutics; NR 04141 – Menopausal Transition: Biobehavioral Dimensions; P30 NR 04001, P50-NR02323 – Center for Women's Health and Gender Research).