Bothersome menopausal symptoms amongst postmenopausal Iranian women

Abstract

Objectives: This study was undertaken to determine the impact of menopause on middle-eastern women.

Methods: This was a cross-sectional study of 1520 women, aged 40–64 years, living in Sari, Northern Iran, recruited by multistage cluster sampling between October 2016 and April 2017. All women completed the Menopause Quality of Life Questionnaire (MENQOL) and Beck Depression Inventory-II (BDI-II).

Results: Of all the women, 54.5% were perimenopausal or postmenopausal. The prevalences of any vasomotor symptom (VMS) and moderate-severely bothersome VMS were greatest for postmenopausal women aged <55 years (66.4%, 95% confidence interval (CI) 59.9–72.3% and 13.5%, 95% CI 9.6–18.6%, respectively). Having moderate-severe VMS was associated with moderate-severe depressive symptoms (adjusted odds ratio (AOR) 2.9; 95% CI 1.6–5.2; p < 0.001). Symptoms of vulvovaginal atrophy (VVA) were reported by 41.1% (95% CI 37.4–45.0%) of perimenopausal and postmenopausal women, with 22.9% (95% CI 19.8–26.3%) reporting their symptoms as moderate-severely bothersome. In women with moderate-severe VMS, the proportion with both moderate-severe depressive symptoms and moderate-severe VVA symptoms (12.1%) was four times that in women with no or mild VMS (3.3%) (p < 0.001).

Conclusion: One in seven perimenopausal and postmenopausal women has moderate-severely bothersome VMS and few women receive appropriate therapy. The reporting of moderate-severe VMS should alert clinicians to the likelihood of significant concurrent VVA and depressive symptoms.

Keywords:

• Menopausal symptoms
• midlife women
• Iranian women
• risk factors
• population-based
• cross-sectional

Acknowledgements

We would like to thank Miss Farahani, an employee of the Statistical Center of Mazandaran Budget and Planning Organization, who assisted us in cluster sampling by retrieving population data of the Sari city. We are also grateful to all women who provided data for this study.

Contributors

SRD, RJB, EF, and ZA designed the study. MA and MM collected and managed the data. EF analyzed the data and prepared the first draft of the publication and was responsible for revisions and ensuring overall integrity of the process. All co-authors (SRD, RJB, ZA, MM, and MA) approved the final version of the manuscript.

Conflict of interest

SRD has received honoraria from Lawley Pharmaceuticals, Pfizer Pharmaceuticals and Besins Healthcare and research funding from Lawley Pharmaceuticals. Other authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Vice-Chancellor of Research, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran under grant number [IR.MAZUMS.REC.95.2344]; and National Health and Medical Research Council of Australia under grant number [1135843].