Quality of Life Research

, Volume 12, Issue 4, pp 405–412 | Cite as

Physical and mental health: Changes during menopause transition

  • Gita D. Mishra
  • Wendy J. Brown
  • Annette J. Dobson


Objective: To measure changes in physical and mental health in six groups of women defined by menopausal status or use of hormone replacement therapy (HRT). Design: Longitudinal study with 2 years follow-up. Participants: Eight thousand six hundred and twenty three women participating in the Australian Longitudinal Study on Women's Health, aged 45–50 years in 1996. Main outcome measures: Changes in the eight dimensions of the Short Form General Health Survey (SF-36) adjusted for baseline scores, lifestyle, behavioural and demographic factors. Results: At baseline, mean scores for five of the eight dimensions of the SF-36 were highest (indicating better state of health or well-being) in pre-menopausal women. There were declines (that is, worsening health) in the SF-36 dimensions in most groups of women. Declines were largest in physical functioning (adjusted mean change of −4.9, standard error (SE) 0.7) and physical role limitation (−5.7, SE: 1.3) in women who remained peri-menopausal throughout the study period and in women taking HRT at the time of either survey (physical functioning: −5.3 (0.7), role physical limitation: −7.5 (1.2)). They were smallest in women who remained pre-menopausal (physical functioning: −3.2 (0.7); role physical limitation: −2.1 (1.1)). Conclusions: Physical aspects of general health and well-being decline during the menopausal transition. Sensitive measures and careful analysis are needed to understand why these changes are worse for peri-menopausal women and those taking HRT.

Menopause SF-36 Well-being 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dennerstein L. Well-being, symptoms and the menopausal transition. Maturitas 1996; 23: 147–157.Google Scholar
  2. 2.
    Utian WH. Overview on menopause. Am J Obstet Gynecol 1987; 156: 1280–1283.Google Scholar
  3. 3.
    Kauffert P. Women and their health in the middle years: A Manitoba project. Soc Sci Med 1984; 3: 279–281.Google Scholar
  4. 4.
    Greer G. The Change, Women, Ageing and the Menopause. London: Hamish Hamilton, 1991.Google Scholar
  5. 5.
    McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Maturitas 1992; 14: 103–115.Google Scholar
  6. 6.
    Dennerstein L, Smith AMA, Morse C, et al. Menopausal symptoms in Australian women. Med J Aust 1993; 159: 232–236.Google Scholar
  7. 7.
    Witt DM, Lousberg TR. Controversies surrounding estrogen use in postmenopausal women. Ann Pharmacother 1997; 31(6): 745–755.Google Scholar
  8. 8.
    Calaf I, Alsina J. Benefits of hormone replacement therapy-overview and update. Int J Fertil Women Med 1997; 42 (Suppl 2): 329–346.Google Scholar
  9. 9.
    Colditz GA. Relationship between estrogen levels, use of hormone replacement therapy, and breast cancer. J Nat Cancer I 1998; 90(11): 814–823.Google Scholar
  10. 10.
    Brown WJ, Bryson L, Byles JE, et al. Women's Health Australia: Establishment of the Australian Longitudinal Study on Women's Health. J Women's Health 1996; 5(5): 467–472.Google Scholar
  11. 11.
    Brown WJ, Mishra GD, Dobson AJ. Changes in physical symptoms during the menopause transition. Int J Behav Med (in press).Google Scholar
  12. 12.
    Kauffert PA, Gilbert P, Tate R. The Manitoba project: A re-examining of the link between menopause and depression. Maturitas 1992; 14: 143–156.Google Scholar
  13. 13.
    Avis N, Brambilla D, McKinlay SM, Vass K. A longitudinal analysis of the association between menopause and depression-results from the Massachusetts women's health study. Ann Epidemiol 1994; 4: 214–220.Google Scholar
  14. 14.
    Ware JE, Kosinski M, Keller SD. SF-36 Physical and Mental Health Summary Scales: A User's Manual. Boston MA: The Health Institute, New England Medical Centre, 1994.Google Scholar
  15. 15.
    Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston MA: The Health Institute, New England Medical Centre, 1993.Google Scholar
  16. 16.
    Hemingway H, Stafford M, Stanfeld S, Shipley M, Marmot, M. Is the SF-36 a valid measure of change in population health? Results fromthe Whitehall II study. Br Med J 1997; 315(7118): 1273–1279.Google Scholar
  17. 17.
    Brown WJ, Bryson L, Byles JE, et al. Women's Health Australia: Recruitment for a national longitudinal cohort study. Women Health 1998; 28(1): 23–40.Google Scholar
  18. 18.
    McCallum J. The SF-36 in an Australian sample: Validating a new generic health status measure. Austr J Public Health 1995; 19: 160–166.Google Scholar
  19. 19.
    Dudley EC, Hopper JL, Taffe J, Guthrie JR, Burger HG, Dennerstein L. Using longitudinal data to define the perimenopause by menstrual cycle characteristics. Climacteric 1998; 1: 18–25.Google Scholar
  20. 20.
    Brown WJ, Lee C, Mishra G, Bauman A. Leisure time physical activity in Australian women: Relationship with well-being and symptoms. Res Q Exercise Sport 2000; 71: 206–216.Google Scholar
  21. 21.
    Department of Primary Industries and Energy, Department of Human Services and Health. Rural, Remote and Metropolitan Areas Classification: 1991 Census Edition. Canberra: Australian Government Publishing Service, 1994.Google Scholar
  22. 22.
    SAS Institute Inc. SAS/STAT User's Guide, Version 6, 4th ed, Vol 2. Cary, NC: SAS Institute Inc., 1989.Google Scholar
  23. 23.
    National Health Survey Australia, 1995: SF-36 Population Norms. National Health Survey. Canberra: Australian Bureau of Statistics, 1997.Google Scholar
  24. 24.
    Brown WJ, Dobson AJ, Mishra G. What is a healthy weight for middle-aged women? Int J Obesity 1998; 22: 520–528.Google Scholar
  25. 25.
    Guthrie JR, Dudley EC, Dennerstein L, Hopper JL. Changes in physical activity and health outcomes in a population-based cohort of mid-life Australian-born women. Aust J Public Health 1997; 21(7): 682–687.Google Scholar
  26. 26.
    McKinlay JB, McKinlay SM, Brambilla D. The relative contributions of endocrine changes and social circumstances to depression in mid-aged women. J Health Soc Behav 1987; 28: 345–363.Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Gita D. Mishra
    • 1
    • 2
  • Wendy J. Brown
    • 3
  • Annette J. Dobson
    • 4
  1. 1.Research Centre for Gender and HealthUniversity of NewcastleAustralia
  2. 2.Medical Research CouncilHuman Nutrition ResearchCambridgeUK
  3. 3.School of Human Movement StudiesUniversity of QueenslandAustralia
  4. 4.School of Population HealthUniversity of QueenslandAustralia

Personalised recommendations