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
Article

Abstract

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 

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References

  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

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