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Large Range of Menopausal Symptoms Affect Quality of Life


A new study assessed which aspects of common menopausal symptoms (ie, vasomotor, physical, psychosocial) are the strongest predictors of poor quality of life.

Menopause is most often associated with hot flashes. But a new Brazilian study, published in the February issue of PloS One, highlights how symptoms of menopause affect a wide range of body systems, and may have a major impact on a woman’s quality of life (QoL).

“[T]he present study warns health professionals to evaluate climacteric women more carefully and judiciously, stimulating and promoting healthy lifestyles, valuing subjective aspects and appropriate and timely clinical manifestations, as a lack of information may restrict awareness of health choices, especially for less-educated women,” wrote researchers led by Geraldo Edson Souza Guerra Júnior, MD, of the State University of Montes Claros and Fipmoc University Center in Minas Gerais, Brazil.

Decreasing levels of estrogen contribute to menopausal changes, which can affect skin, cardiovascular, bone, genitourinary, and vascular systems. Common symptoms include night sweats, hot flashes, vaginal dryness, pelvic floor dysfunction, painful sex, and insomnia. Mood and appetite are often impacted and changes in self-image can contribute to anxiety or depression. 

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To see how these changes affect the QoL of women in Brazil, where recent population shifts have resulted in a growing number of elderly women, researchers conducted a cross-sectional study. The study included 849 women aged 40 to 65 years who were randomly chosen from public health-assisted primary care clinics in a medium-sized city in Minas Gerais, Brazil.

Researchers asked women about their symptoms using the standardized Menopause-Specific Quality of Life Questionnaire, a validated tool that is often used to evaluate psychosocial, physical, and sexual issues related to menopause. Analyses were categorized according to vasomotor symptoms (eg, hot flashes), psychosocial symptoms (eg, depression, anxiety, poor body image), and physical symptoms (eg, pain, fatigue, weight gain). Analyses were also adjusted for age, race/ethnicity, and a variety of socioeconomic factors and medical problems.

For vasomotor and physical problems, significant predictors of poor QoL included severe menopausal symptoms (p<.001), increased body mass index (p<.001-.006), sleep problems (p<.001-.022), and postmenopausal changes (p<.001).

For psychosocial symptoms, significant predictors of poor QoL included severe menopausal symptoms (p<.001) and sleep problems (p<.001). Obese women and those with poor sleep quality had higher scores across the board.

Sociocultural issues can have an impact on menopausal symptoms. In this study, 41% of women had <9 years of schooling and 44% had family income below minimum wage. So results may not generalize to other socioeconomic classes, or to women outside Brazil.

Also, the study could not evaluate the effects of hormone replacement therapy, which was not available to women in this study. Neither could it evaluate alternative treatments, such as herbal medicines.


Souza Guerra GE Júnior, Prates Caldeira A, Piana Santos Lima de Oliveira F, et al. Quality of life in climacteric women assisted by primary health care. PLoS One. 2019;14:e0211617.

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