Abstract
The menopause transition is characterized by significant hormonal changes that may predispose women to psychosocial maladjustment. Prospective studies to date have focused primarily on negative mood states and show equivocal findings. The primary goal of this study was to identify patterns of change with respect to positive and negative mood states (vigor, depression, tension, and stress) over a 5-year period in a cohort of women undergoing the transition to menopause. A secondary aim was to determine whether the identified trajectories were associated with menopause status as well as baseline health-related and psychological characteristics. This longitudinal study observed 102 healthy Canadian women who were premenopausal at baseline (age 47–55 years). Analyses consisted of latent class growth modeling. Mood states were predominantly normal and stable, raising doubts regarding the notion that psychosocial distress is a common and natural occurrence during the transition to menopause. Neither time spent in perimenopause nor BMI had a significant influence on levels of mood indicators. However, higher scores on body image, self-esteem, and general health perceptions were predictive of more positive psychological outcomes over the 5-year period. Targeting improvements in self-perceptions may promote a healthier psychological adjustment during this natural transitional period in a women’s lifespan.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abdulnour J, Doucet E, Brochu M, Lavoie JM, Strychar I, Rabasa-Lhoret R, Prud’homme D (2012) The effect of the menopausal transition on body composition and cardiometabolic risk factors: a Montreal-Ottawa New Emerging Team group study. Menopause 19:760–767. doi:10.1097/gme.0b013e318240f6f3
Abdulnour J, Stacey D, Dionne IJ, Brochu M, Doucet É, Prud’homme D (2016) Vasomotor symptoms and cardiometabolic risk factors in menopausal women: a MONET group study. Climacteric 19:381–386
Airila A, Hakanen JJ, Luukkonen R, Lusa S, Punakalio A (2013) Positive and negative mood trajectories and their relationship with work ability, self-rated health, and life satisfaction: a 13-year follow-up study. J Occup Environ Med 55:779–785. doi:10.1097/JOM.0b013e3182988925
Alexander J, Dennerstein L, Woods N et al (2007) Role of stressful life events and menopausal stage in wellbeing and health. Expert Rev Neurother 7:S93–S113
Allaz AF, Bernstein M, Rouget P, Archinard M, Morabia A (1998) Body weight preoccupation in middle-age and ageing women: a general population survey. Int J Eat Disord 23:287–294
Andruff H, Carraro N, Thompson A, Gaudreau P, Louvet B (2009) Latent class growth modelling: a tutorial. Quant Methods Psychol 5:11–24
Asparouhov T, Muthén B (2014) Auxiliary variables in mixture modeling: three-step approaches using Mplus. Struct Equ Model 21:329–341. doi:10.1080/10705511.2014.915181
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571
Bromberger JT, Meyer PM, Kravitz HM et al (2001) Psychologic distress and natural menopause: a multiethnic community study. Am J Public Health 91:1435–1442
Bromberger JT, Assmann SF, Avis N, Schocken M, Kravitz H, Cordal A (2003) Persistent mood symptoms in a multiethnic community cohort of pre- and perimenopausal women. Am J Epidemiol 158:347–356. doi:10.1093/aje/kwg155
Bromberger JT, Schott LL, Kravitz HM et al (2010) Longitudinal change in reproductive hormones and depressive symptoms across the menopausal transition. Arch Gen Psychiatry 67:598–607. doi:10.1001/archgenpsychiatry.2010.55
Bromberger JT, Kravitz HM, Chang YF et al (2011) Major depression during and after the menopausal transition: Study of Women's Health Across the Nation (SWAN). Psychol Med 41:1879–1888
Bromberger JT, Kravitz HM, Chang Y et al (2013) Does risk for anxiety increase during the menopausal transition? Study of Women’s Health Across the Nation. Menopause 20:488–495. doi:10.1097/GME.0b013e3182730599
Coakley EH, Kawachi I, Manson JE, Speizer FE, Willet WC, Colditz GA (1998) Lower levels of physical functioning are associated with higher body weight among middle-aged and older women. Int J Obes Relat Metab Disord 22:958–965
Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385–396. doi:10.2307/2136404
Darling CA, Coccia C, Senatore N (2012) Women in midlife: stress, health and life satisfaction. Stress Health 28:31–40. doi:10.1002/smi.1398
Davis A, Gilbert K, Misiowiec P, Riegel B (2003) Perceived effects of testosterone replacement therapy in perimenopausal and postmenopausal women: an internet pilot study. Health Care Women Int 24:831–848. doi:10.1080/07399330390229902
Dennerstein L, Dudley EC, Hopper JL, Guthrie JR, Burger HG (2000) A prospective population-based study of menopausal symptoms. Obstet Gynecol 96:351–358
Dennerstein L, Lehert P, Guthrie J (2002) The effects of the menopausal transition and biopsychosocial factors on well-being. Arch Womens Ment Health 5:15–22. doi:10.1007/s007370200018
Diener E (2006) Guidelines for national indicators of subjective well-being and ill-being. J Happiness Stud 7:397–404
Elavsky S, McAuley E (2007a) Exercise and self-esteem in menopausal women: a randomized controlled trial involving walking and yoga. Am J Health Promot 22:83–92
Elavsky S, McAuley E (2007b) Physical activity and mental health outcomes during menopause: a randomized controlled trial. Ann Behav Med 33:132–142. doi:10.1007/BF02879894
Freeman EW (2010) Associations of depression with the transition to menopause. Menopause 17:823–827. doi:10.1097/gme.0b013e3181db9f8b
Geiser C (2012) Data analysis with Mplus. Guilford Press Publications, New York
Ginsberg RL, Tinker L, Liu J et al (2016) Prevalence and correlates of body image dissatisfaction in postmenopausal women. Women Health 56:23–47. doi:10.1080/03630242.2015.1074636
Gold EB, Sternfeld B, Kelsey JL et al (2000) Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40-55 years of age. Am J Epidemiol 152:463–473
Gold EB, Colvin A, Avis N et al (2006) Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: Study of Women’s Health Across the Nation. Am J Public Health 96:1226–1235. doi:10.2105/AJPH.2005.066936
Gordon JL, Rubinow DR, Eisenlohr-Moul TA, Leserman J, Girdler SS (2016) Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition. Menopause 23:257–266
Green R, Santoro N (2009) Menopausal symptoms and ethnicity: the Study of Women’s Health Across the Nation. Womens Health 5:127–133. doi:10.2217/17455057.5.2.127
Guérin E (2012) Disentangling vitality, well-being, and quality of life: a conceptual examination emphasizing their similarities and differences with special application in the physical activity domain. J Phys Act Health 9:896–908
Han TS, Tijhuis MA, Lean ME, Seidell JC (1998) Quality of life in relation to overweight and body fat distribution. Am J Public Health 88:1814–1820
Hernandez I, Nunez Rodriguez MA (2015) Association of stress, anxiety and depression conditions with the presence of co-morbidities in patients in menopause and post-menopause transition stage. Menopause 22:1390–1390
Hess R, Thurston RC, Hays RD et al (2012) The impact of menopause on health-related quality of life: results from the STRIDE longitudinal study. Qual Life Res 21:535–544. doi:10.1007/s11136-011-9959-7
Hunter M, Rendall M (2007) Bio-psycho-socio-cultural perspectives on menopause. Best Pract Res Clin Obstet Gynaecol 21:261–274. doi:10.1016/j.bpobgyn.2006.11.001
Im E-O (2009) Ethnic differences in symptoms experienced during the menopausal transition. Health Care Women Int 30:339–355. doi:10.1080/07399330802695002
Judd FK, Hickey M, Bryant C (2012) Depression and midlife: are we overpathologising the menopause? J Affect Disord 136:199–211. doi:10.1016/j.jad.2010.12.010
Kerns RD, Okonkwo R (2010) Assessment of emotional functioning in persons with pain. In: Ebert M, Kerns RD (eds) Behavioral and psychopharmacologic pain management. Cambridge University Press, Cambridge, pp 94–113
Lyubomirsky S, King L, Diener E (2005) The benefits of frequent positive affect: does happiness lead to success? Psychol Bull 131:803–855. doi:10.1037/0033-2909.131.6.803
Matthews KA, Wing RR, Kuller LH et al (1990) Influences of natural menopause on psychological characteristics and symptoms of middle-aged healthy women. J Consult Clin Psychol 58:345–351. doi:10.1037//0022-006X.58.3.345
McCrea RL, Berger YG, King MB (2012) Body mass index and common mental disorders: exploring the shape of the association and its moderation by age, gender and education. Int J Obes 36:414–421. doi:10.1038/ijo.2011.65
McLaren L, Hardy R, Kuh D (2003) Women’s body satisfaction at midlife and lifetime body size: a prospective study. Health Psychol 22:370–377
Mendelson BK, Mendelson MJ, White DR (2001) Body-esteem scale for adolescents and adults. J Pers Assess 76:90–106. doi:10.1207/S15327752JPA7601_6
Mishra GD, Dobson AJ (2012) Using longitudinal profiles to characterize women’s symptoms through midlife: results from a large prospective study. Menopause 19:549–555. doi:10.1097/gme.0b013e3182358d7c
Mishra GD, Kuh D (2012) Health symptoms during midlife in relation to menopausal transition: British prospective cohort study. Br Med J 344:e402
Muthén B, Muthén LK (2000) Integrating person-centered and variable-centered analyses: growth mixture modeling with latent trajectory classes. Alcohol Clin Exp Res 24:882–891
Nagin DS (1999) Analyzing developmental trajectories: a semiparametric, group-based approach. Psychol Methods 4:139–157. doi:10.1037/1082-989X.4.2.139
Nagin D (2005) Group-based modeling of development. Harvard University Press, Cambridge
Nagin DS, Odgers CL (2010) Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol 6:109–138. doi:10.1146/annurev.clinpsy.121208.131413
Pérez-López FR, Pérez-Roncero G, Fernández-Iñarrea J et al (2014) Resilience, depressed mood, and menopausal symptoms in postmenopausal women. Menopause 21:159–164. doi:10.1097/GME.0b013e31829479bb
Poomalar GK, Arounassalame B (2013) The quality of life during and after menopause among rural women. J Clin Diagn Res 7:135–139. doi:10.7860/JCDR/2012/4910.2688
Pressman SD, Cohen S (2005) Does positive affect influence health? Psychol Bull 131:925–971. doi:10.1037/0033-2909.131.6.925
Prichard I, Tiggemann M (2008) Relations among exercise type, self-objectification, and body image in the fitness centre environment: the role of reasons for exercise. Psychol Sport Exerc 9:855–866. doi:10.1016/j.psychsport.2007.10.005
Rosenberg M (1965) Society and the adolescent self-image. Princeton University Press, Princeton
Russell JA, Carroll JM (1999) On the bipolarity of positive and negative affect. Psychol Bull 125:3–30. doi:10.1037/0033-2909.125.1.3
Sabiston CM, O’Loughlin E, Brunet J et al (2013) Linking depression symptom trajectories in adolescence to physical activity and team sports participation in young adults. Prev Med 56:95–98. doi:10.1016/j.ypmed.2012.11.013
Schneider HPG, Schultz-Zehden B, Rosemeier HP, Behre HM (2000) Assessing well-being in menopausal women. In: Studd J (ed) The management of the menopause—the millenium review 2000. Parthenon Publishing, New York
Shacham S (1983) A shortened version of the profile of mood states. J Pers Assess 47:305–306. doi:10.1207/s15327752jpa4703_14
da Silva Lima AFB, de Almeida Fleck MP (2007) Subsyndromal depression: an impact on quality of life? J Affect Disord 100:163–169. doi:10.1016/j.jad.2006.10.010
Slaven L, Lee C (1997) Mood and symptom reporting among middle-aged women: the relationship between menopausal status, hormone replacement therapy, and exercise participation. Health Psychol 16:203–208
Soules MR, Sherman S, Parrott E et al (2001) Executive summary: Stages of Reproductive Aging Workshop (STRAW). Climacteric 4:267–272. doi:10.1080/cmt.4.4.267.272
Sowislo JF, Orth U (2013) Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychol Bull 139:213–240. doi:10.1037/a0028931
Statistics Canada (2014) Statistics Canada. Health fact sheets: body composition of adults, 2012 to 2013. Government of Canada. 2014. Available: Government of Canada, Ottawa, ON
Tabachnick BG, Fidell LS (2007) Using multivariate statistics. Allyn & Bacon, Boston
Tangen T, Mykletun A (2008) Depression and anxiety through the climacteric period: an epidemiological study (HUNT-II). J Psychosom Obstet Gynaecol 29:125–131. doi:10.1080/01674820701733945
Thurston RC, Everson Rose SA, Matthews KA (2008) Finding a way through the forest: a biopsychosocial model of hot flashes. Menopause 15:1027–1028. doi:10.1097/gme.0b013e3181846cc6
Tiggemann M (2004) Body image across the adult life span: stability and change. Body Image 1:29–41. doi:10.1016/S1740-1445(03)00002-0
Vermunt JK (2010) Latent class modeling with covariates: two improved three-step approaches. Polit Anal 18:450–469. doi:10.1093/pan/mpq025
Ward-Ritacco CL, Adrian AL, O’Connor PJ et al (2015) Feelings of energy are associated with physical activity and sleep quality, but not adiposity, in middle-aged postmenopausal women. Menopause 22:304–311
Ware JE (1993) SF-36 health survey: manual and interpretation guide. The Health Institute, New England Medical Center, Boston
Weber MT, Maki PM, McDermott MP (2014) Cognition and mood in perimenopause: a systematic review and meta-analysis. J Steroid Biochem Mol Biol 142:90–98. doi:10.1016/j.jsbmb.2013.06.001
Webster J, Tiggemann M (2003) The relationship between women’s body satisfaction and self-image across the life span: the role of cognitive control. J Genet Psychol 164:241–252. doi:10.1080/00221320309597980
Wyrwich KW, Yu H (2011) Validation of POMS questionnaire in postmenopausal women. Qual Life Res 20:1111–1121. doi:10.1007/s11136-011-9846-2
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
This study was funded by the Canadian Institutes of Health Research (Grant No. T 0602145.02).
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Conflict of interest
Eva Guérin, Gary Goldfield, and Denis Prud’homme declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Guérin, E., Goldfield, G. & Prud’homme, D. Trajectories of mood and stress and relationships with protective factors during the transition to menopause: results using latent class growth modeling in a Canadian cohort. Arch Womens Ment Health 20, 733–745 (2017). https://doi.org/10.1007/s00737-017-0755-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-017-0755-4