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• There is a paucity of studies on workplace interventions related to menopause. • An educational workplace intervention on menopause increases women's self-efficacy regarding working during the climacteric. • An educational workplace intervention on menopause increases self-reported knowledge and leads to smaller reductions in work performance due to menopausal symptoms • More research is needed to confirm these results. To evaluate the effects of a workplace educational intervention on menopause on self-efficacy regarding working during the climacteric. Quasi-experimental design, with one intervention and one control group. Women aged 40 to 67, working in one of the two participating departments of a large municipality in the Netherlands, were recruited to participate in the study. The allocation of participants to intervention or control group was done at the departmental level. The main component of the multifaceted intervention consisted of educational workshops on menopause and work. The primary outcome was score on the Self-Efficacy to Manage Symptoms Scale. Secondary outcomes were scores on other self-efficacy scales, knowledge about the menopausal transition, menopausal symptoms, beliefs and behaviours and work-related variables. Differences between groups were analysed with Pearson's chi-square, Student's t -test or Mann–Whitney U. Analysis of covariance (ANCOVA) was used to correct for baseline and potential confounders. Data from 54 women were analysed, 25 in the intervention group and 29 in the control group. After 12 weeks of follow-up, the mean score on the Self-Efficacy to Manage Symptoms Scale was higher in the intervention group than in the control group: 6.52 (SD 1.45) versus 5.84 (SD 1.51), respectively, adjusted mean difference 0.75 (95 % CI 0.03–1.46, p = 0.040). The educational intervention increased self-reported knowledge (scored on the range 1–10) (adjusted mean difference 0.7, 95 % CI 0.26–1.15, p = 0.002) and resulted in a lower level of presenteeism (i.e., less impaired work performance) due to menopausal symptoms, measured by the Dutch Stanford Presenteeism Scale (adjusted mean difference 2.15, 95 % CI 0.13–4.18, p = 0.038), compared to the control group. This educational workplace intervention study shows promising positive effects on self-efficacy regarding working during the climacteric, knowledge about the menopausal transition and presenteeism due to menopausal symptoms. This is especially true for women already experiencing menopausal symptoms, while premenopausal women were harder to engage in the intervention. A larger study, with longer follow-up, preferably a randomized controlled trial, is needed to investigate the clinical relevance of these findings. [ABSTRACT FROM AUTHOR]

Study Objectives: Menopausal symptoms exist in most climacteric women, which can harm the quality and satisfaction of life for them. Moreover, a series of ineluctable negative life changes experienced in middle-age usually make the situation more complicated and stressful. We aimed to determine the trajectories and influential factors of sleep quality and menopausal symptoms and their longitudinal interrelationships among climacteric women.Methods: A total of 1875 community-dwelling climacteric women were included in this study. The Pittsburgh Sleep Quality Index (PSQI) and the Menopause Rating Scale (MRS) were adopted to assess sleep quality and menopausal symptoms, respectively. Data were collected 4 times from March 2019 to December 2019, at a 3-month interval.Results: The Cross-lagged analysis showed that worse sleep quality and more severe menopausal symptoms over time after controlling for specified covariates, and more severe menopausal symptoms were predicted by declined sleep quality. The Generalized estimation equation model showed that education level, marital status, chronic diseases, life events, income, and age were the influential factors of sleep quality, while menopausal symptoms were impacted by marital status and income.Conclusions: Increasing negative sleep quality and more severe menopausal symptoms over time contribute to the health burden of climacteric women. Menopausal symptoms could be alleviated by sleep quality improvement, which is influenced by education level, marital status, chronic diseases, life events, age, and economic factors. [ABSTRACT FROM AUTHOR]

• A program of cognitive behavioral therapy (CBT) has been developed specifically for perimenopausal women in Korea. • It proved effective for menopausal emotional and somatic symptoms, as well as quality-of-life problems. • The CBT program effectively manages anxiety through education. • It represents a non-pharmaceutical intervention for menopause. Therapeutic interventions are crucial for perimenopausal women, given the challenging physical and psychological symptoms they face. This study focused on the development and verification of the efficacy of a cognitive behavioral therapy (CBT) protocol designed specifically for Korean perimenopausal women. A CBT protocol for perimenopausal women was newly developed based on theory and evidence. Forty menopausal women were randomly assigned to either the CBT group (n = 19) or treatment-as-usual (TAU) group (n = 21). Participants in the CBT group underwent 60-min weekly sessions for eight weeks. The TAU group received standard care from gynecologists. At baseline and follow-up, participants completed the Menopausal Rating Scale (MRS), World Health Organization Quality of Life Brief Version (WHOQOL-BREF), Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 (PHQ-15), Menopause Emotional Symptom Questionnaire (MESQ), and Subjective Memory Complaints Questionnaire. The CBT group showed significant changes in their MRS (F = 4.18, p =.048), WHOQOL-BREF (7.60, 0.009), GAD-7 (4.61, 0.038), PHQ-15 (5.49, 0.025), and MESQ scores (7.19, 0.011) compared to the TAU group. In the CBT group, changes in GAD-7 scores were correlated with PHQ-15 (ρ = 0.57, p <.05), MESQ (0.57, < 0.05), and WHOQOL-BREF scores (−0.53, < 0.05). CBT prevents the worsening of menopausal and emotional symptoms, anxiety, and quality of life. CBT may have had a therapeutic effect through the following mechanisms: managing anxiety by changing perceptions of menopause through education and training for coping with various menopausal symptoms and improving self-efficacy in symptom management. KCT0007517. [ABSTRACT FROM AUTHOR]

With growing interest in the role of the gut microbiome in the pathogenesis of menopausal disorders, probiotic supplementation is emerging as a novel therapeutic strategy for postmenopausal women. In this study, we investigated the protective effects of several probiotic strains against menopausal symptoms using an ovariectomized (OVX) mouse model fed a high-fat diet, in comparison with the effects of 17β-estradiol (E2) replacement. Among the eight tested probiotic strains, we selected four (Limosilactobacillus fermentum MG901, Lactiplantibacillus plantarum MG4604, Ligilactobacillus salivarius MG4679, and Lacticaseibacillus reuteri MG5463) that showed superior estrogen-like activity in an uterotrophic assay. We then examined their effects in OVX mice. The probiotic MG4679 was tested in combination with MG5463. During the 12-week experimental period, oral administration of the four probiotics reduced blood glucose and body temperature and ameliorated depression-like behavior in OVX mice. In the Barnes maze test, MG901 and MG4604 improved the spatial memory deficits observed in OVX mice. Micro-CT analysis of mouse femurs revealed that MG5463 prevented the OVX-induced reduction in cortical bone mineral density and bone volume fraction. Importantly, similar to E2 replacement, most of the test probiotics increased Akt phosphorylation in skeletal muscle, estrogen receptor-α (ER-α) protein expression in the liver, and ERK phosphorylation in the brain of OVX mice. However, unlike E2 treatment, all probiotics did not affect uterine weight, uterine ER-α expression, and serum E2 concentration. These results indicated that the probiotics used in this study exhibited protective effects against menopausal symptoms, partly through estrogen-mimetic action, without unfavorable uterine stimulation in OVX mice. • Probiotic supplementation ameliorated menopausal symptoms in ovariectomized mice. • Lacticaseibacillus reuteri MG5463 prevented the ovariectomy-induced bone loss. • Probiotics increased hepatic protein expression of estrogen receptor-α. • Unlike estradiol, all probiotics did not cause unfavorable uterine stimulation. [ABSTRACT FROM AUTHOR]

• The analysis of menopausal transition among women with a background of migration gains in importance. • The number of menopausal women with a background of migration, refugees, and asylum seekers is increasing in Austria. • More studies on the menopausal transition of women with a migration background are needed. Globalization and international migration movements have massively changed the population structure of most industrial nations in recent decades. The ever-increasing proportion of people with a migration background also poses a challenge for the medical sector. A particular problem is the stressful phase of the menopausal transition, which - although not a pathological phenomenon but part of the female life history - can lead to psychological and physical symptoms due to hormonal changes, which significantly impair the quality of life of the women affected. However, treatment concepts, as well as access to medical facilities and information, are geared towards Western women from high-income countries. Women with a history of voluntary or forced migration originating from non-Western countries represent a particularly vulnerable group. To enable personalized treatment, studies on menopausal transition in women with a migration background are required. The present review shows that studies on menopausal women with a migration background have been conducted primarily in classic immigration countries such as the USA, Australia, or the UK, but that there is a lack of such studies in countries with no long tradition as an immigration country, such as Austria or Germany. This is becoming a growing problem, as the number of menopausal women with a migration background is increasing. [ABSTRACT FROM AUTHOR]

Objective: To chart peer-reviewed literature regarding the psychological and social health outcomes of physical activity (PA) around menopause in a systematic manner.Methods: Nine electronic databases and 10 core journals were searched using specific search strings to identify eligible articles. Manual checking of reference lists was also performed. The selection process was guided by the stages in PRISMA-ScR.Results: Eighty peer-reviewed articles representing 67 studies from 25 countries were included. All articles were published between 1994 and 2021. For all studies, surveys were the primary method of measuring psychological and social health outcomes, in cross-sectional studies (36 papers), intervention studies (33), longitudinal cohort studies (10) and one paper reporting a mixed-method study. The dataset comprised a total of 103,826 women, with an average age of 52.6 and a variety of menopausal states. Most of the studies involved primarily Caucasian, relatively healthy, married and employed participants. Nineteen psychological and social health outcomes were assessed, including psychological menopause symptoms (N = 34), quality of life (N = 33), depression (N = 30), anxiety (N = 11), mental wellbeing (N = 21), perceived stress (N = 9), satisfaction with life (N = 7) and self-esteem (N = 5).Conclusions: Collectively, the findings of these studies indicate a relatively evident positive impact of PA on the respective health outcomes, with only a few studies reporting no association. It is also noteworthy that most studies did not report any difference related to menopausal status. Future studies would benefit from, inter alia, a qualitative approach to lived experiences of psychological and social health outcomes of PA during the menopausal transition. [ABSTRACT FROM AUTHOR]

Objectives: This paper examines the utility of a common climacteric symptoms scale, the Greene Climacteric Scale (GCS), in two groups of women with a history of breast cancer, those who were at menopause before commencing breast cancer treatment, and those who were not.Study Design: This pooled analysis of 297 women previously diagnosed with breast cancer, aged 28-74 years, was undertaken on baseline data from two structured lifestyle interventions: the Women's Wellness After Cancer Program (WWACP) and the Younger Women's Wellness After Cancer Program (YWWACP). Data were split into two data subsets (women who were post-menopausal on commencement of breast cancer treatment and those who were either pre- or peri‑menopausal). Multitrait/multi-item analysis was conducted to test scaling assumptions for each group separately.Results: GCS domain scores were positively skewed, with significant floor effects for vasomotor symptoms and ceiling effects for sexual dysfunction. Multitrait analysis showed acceptable convergent validity (77% of items correlated ≥ 0.40 with their hypothesized domains) but weak discriminant validity for anxiety, depression, and somatic symptoms in both groups. The exploratory factor analysis in women who were menopausal at the commencement of breast cancer treatment and those who were not revealed distinct factor structures that accounted for 60.2% and 62.7% of the total variance, respectively.Conclusions: The original GCS factor structure was not replicated in this sample. Among women previously treated for breast cancer, the presence of multiple concurrent and severe menopausal symptoms with possible treatment-related causes underpins the need for a breast cancer-specific measure to enhance their identification and management.Trial Ids, Australian and New Zealand Clinical Trials Registry: WWACP, ACTRN12614000800628; YWWACP, ACTRN12614001087640. [ABSTRACT FROM AUTHOR]

• This scoping review found that menopausal symptoms are highly associated with future health and longevity. • Cardiovascular disease, psychiatric disorders, diabetes, and reduced bone mineral density are positively associated with menopausal symptoms. • Psychological menopausal symptoms and cognitive decline improve after menopause, except among women from low socioeconomic backgrounds. • Future work should assess whether cognitive decline is associated with developing dementia and investigate the long-term effects of underexplored menopausal symptoms such as sleep issues, fatigue, urogenital symptoms, period irregularities, joint pain, and headaches. • Future work should also endeavour to explore whether improving menopausal symptoms, as and when they arise, can reduce future health risks. Women live longer than men but spend more years in poor health. Menopausal symptoms are not generally associated with adverse health outcomes. However, increasingly, evidence suggests they can significantly impact future health and longevity. Understanding the long-term effects of menopausal symptoms will enable clinicians to identify risk factors and intervene with modifications to support healthy aging. This review examined the scope of research investigating the association between menopausal symptoms and future health outcomes. We searched for longitudinal cohort studies. Date and geographical restrictions were not applied. Articles were screened and data extracted using standardised methods. Included studies examined the role of menopausal symptoms on future health developments using a sample who had experienced menopause and were deemed healthy at baseline, with clear reporting of their menopausal status at symptom assessment. We identified 53 eligible studies with data from over 450,000 women enrolled in 28 longitudinal cohorts. Cardiovascular disease, psychiatric disorders, diabetes, and reduced bone mineral density were positively associated with menopausal symptoms. Breast cancer was associated with an asymptomatic menopause. Psychological menopausal symptoms and cognitive decline improved after menopause, except among women from low socioeconomic backgrounds. These findings demonstrate that menopausal symptoms are important indicators for future health risks. Future work should investigate the impact of underexplored menopausal symptoms on future health, such as sleeping problems and urogenital issues, and evaluate whether treating menopausal symptoms could lead to improvements in future health outcomes. Should future research continue to support these findings, clinical guidelines should be updated to support clinical decision-making in menopause care. [ABSTRACT FROM AUTHOR]

Little is known about the impact of menopausal symptoms on healthcare students' ability to study at higher education level. Attention on menopause is rapidly increasing in both the literature and media and is gaining political attention with particular focus on supporting those experiencing menopausal symptoms in the workplace. Policies are being developed to support individuals to remain in work for longer, reducing the number of people leaving the workplace due to challenging menopausal symptoms. However there is no evidence to suggest that support for higher education students experiencing menopausal symptoms is widespread. Whilst some higher education institutions and organisations are developing policies to support staff and, sometimes students, current literature does not reflect how students and their studies may be affected by menopausal symptoms. This is relevant to institutions where healthcare professions courses are delivered as this is thought to have contributed to the overall increase in the number of female students attending universities both in the UK and globally. A continued lack of understanding of menopausal symptoms' impact on students could not only be detrimental to the student experience, but it could also affect institutional reputations for being good places to study, resulting in increased attrition rates due to students withdrawing from courses because of the impact their symptoms have on their ability to continue studying. In this Contemporary Issues article our aim is to raise awareness of how menopausal symptoms may affect a student's ability to study, and to reinforce the need for university policy makers and educators to recognise and support women at this turbulent time of their lives to continue to study. • At least 1% of female university students worldwide are experiencing menopausal symptoms affecting their ability to study. • Current literature focuses on menopause in the workplace with little consideration to other settings including university. • Students experiencing menopause may consider leaving their course due to impactful symptoms such as cognitive decline. • A decline in cognitive function such as brain fog and lack of concentration may impede ability to study. • Withdrawing from university could adversely affect career progression, professional development and attrition rates. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the effects of using Vitex agnus-castus (VAC) plant on menstrual and menopausal symptoms in district where VAC is commonly used. The menstrual and menopausal symptoms of a total of 225 women aged between 18-65, living in Aydın province, Turkey, and its districts, who either used VAC or not were compared, following purposive sampling method. The research data were collected with an online survey form between March and December 2021. The data collected from the women in the VAC group (n=104, 46.2%) and the women in the non-VAC (n=121, 53.8%) group were compared in this study. It was found that the rate of experiencing symptoms before menstruation was higher in women who did not take VAC compared to the women who took VAC (P < 0.05). Almost all of those who experienced menopausal symptoms were in the group that did not take VAC. The type, duration and time of VAC use were associated with the effect of menstruation on daily life, but not with menopausal symptoms. [ABSTRACT FROM AUTHOR]

Objective: To evaluate in postmenopausal women the association between menopause symptom intensity and the quality of life and clinical, anthropometric, and lifestyle factors, focusing on food consumption by degree of processing.Study Design: A cross-sectional study of 288 postmenopausal women using interviews.Main Outcome Measures: The Kupperman-Blatt Menopausal Index and the Women's Health Questionnaire were used to evaluate the main outcomes of menopausal symptom intensity and quality of life, respectively. Data on socioeconomic, clinical, anthropometric, and lifestyle variables (smoking, alcohol intake, physical activity, and food consumption) were collected.Results: Most women had moderate to severe intensity of menopausal symptoms. The highest tertile of ultra-processed food consumption was associated with a greater intensity of vasomotor symptoms (prevalence ratio [PR] 0.73, 95% confidence intervals [CI] 0.55-0.96) and sexual behavior (PR 1.22, CI 1.01-1.49). Higher intakes of sugar-sweetened beverages and sausages were associated with somatic symptoms (PR 1.23, CI 1.01-1.49) and poorer memory/concentration (PR 1.22, CI 1.02-1.47/ PR 1.22, CI 1.01-1.48). The highest tertile of vegetable intake was associated with greater protection against depressive mood (PR 0.64, CI 0.43-0.96), vasomotor symptoms (PR 0.79, CI 0.63-0, 99), and sleep disorders (PR 0.83, CI 0.69-0.99), and better quality of life (PR 0.79, CI 0.62-0.99).Conclusion: More intense vasomotor, sexual, somatic, and memory and concentration symptoms are associated with a higher consumption of ultra-processed foods, whereas those with a higher consumption of vegetables reported lower menopause symptom intensity and a better quality of life. [ABSTRACT FROM AUTHOR]

Evidence suggests that being physically active may improve quality of life through the menopausal transition. This study is one of the first to investigate how meeting the UK Physical Activity Guidelines (PAG) impacted quality of life, stress, coping and menopausal symptoms in UK midlife women, aged 45-55 years, during the unfolding Covid pandemic (Phase 1 quantitative, n=164). The study also explored their motivation to undertake regular physical activity during Covid lockdown (Phase 2 qualitative, n=4). An explanatory sequential mixed-methods design was used to collate quantitative (survey) and qualitative (focus group) data. Participants who met PAG experienced fewer depressive symptoms and less perceived stress, and had better physical and mental health and quality of life than women who did not. This was supported by focus group discussions reporting lack of facilities, time constraints, reduced social support and existing health complaints as barriers to physical activity. Factors motivating women to exercise during Covid lockdown were benefits for physical and mental health, and support from friends (Qualitative). Women are postmenopausal for one-third of their lives, and health interventions need to promote positive healthy ageing around menopause. Menopausal changes could be used by clinicians as cues to action to promote female health and well-being. Clinicians should be promoting the health benefits of exercise and making women aware of the importance of aiming to meet the PAG for optimal health benefits. Women should be encouraged to increase their levels of physical activity by making plans and setting goals and gaining support by exercising with friends or family, as a way to better control menopausal symptoms. [ABSTRACT FROM AUTHOR]

• Guidelines on the management of menopause in women living with HIV are less informative than general guidelines on menopause management. • None of the HIV guidelines include all clinically relevant aspects of menopause. • No menopausal symptom assessment scales have been validated in women with HIV. • A comprehensive HIV-specific menopausal management guideline is needed. Women living with human immunodeficiency virus (HIV) today have life expectancies comparable to the general female population, leading to a growing number transitioning through menopause. Recent studies have highlighted healthcare professionals' lack of confidence in managing menopause in women with HIV, raising concerns about potential mismanagement. This review explores and compares information on menopause management in HIV-specific and general guidelines, with the aim of identifying disparities and assessing the comprehensiveness of HIV guidelines. The focus is on three key areas: the diagnosis of menopause, and the assessment and treatment of menopausal symptoms. Additionally, the review evaluates the usage and characteristics of menopausal symptom assessment scales known to have been used in studies involving women living with HIV. In total, five HIV and six general menopause management guidelines, published between 2015 and 2023, were identified through medical databases, internet search engines and searches of reference lists. Five menopausal symptom assessment scales were also included for review. The findings suggest minimal differences in recommendations for treating menopausal symptoms. The HIV guidelines include recommendations on screening for menopause, and some raise awareness of the possibility of drug-to-drug interactions, but none offers guidance on how to diagnose menopause or how to differentiate between HIV-related and menopause-related symptoms. Upon examining the characteristics of the menopausal symptom assessment scales, we found that none had been validated specifically for women with HIV. In conclusion, this review advocates for the development of a comprehensive guideline that addresses all relevant factors in managing menopause in women with HIV. [ABSTRACT FROM AUTHOR]

• We found four menopausal symptom trajectories: increase, decrease, moderate, rebound. • Estrogen receptor gene polymorphisms and estradiol influence group affiliation. • Estrogen receptor gene polymorphisms moderate estradiol's effect on menopausal symptoms. Fluctuating estradiol (E2) levels seem to be associated with menopausal symptoms, though not all women suffer from these symptoms to the same extent despite experiencing these hormonal changes. This suggests underlying, interindividual mechanisms, such as single-nucleotide polymorphisms (SNPs) influencing estrogen receptors α and β, and the g-protein-coupled estrogen receptor (GPER). As research is scarce, we aimed to address this research gap by assessing genetic traits, E2 levels, and menopausal symptoms longitudinally. 129 perimenopausal women (aged 40–56 years) participated in the 13-month longitudinal Swiss Perimenopause Study. Menopausal symptoms were assessed fortnightly using the Menopause Rating Scale (MRS II). Salivary E2 levels were assessed 14 times over two non-consecutive months. Blood samples were collected using the dried blood spot (DBS) technique to analyze ESR1 rs2234693, ESR1 rs9340799, ESR2 rs1256049, ESR2 rs4906938, and GPER rs3808350. Group-based trajectory modeling was performed to identify interindividual trajectories of menopausal symptoms. Multinomial logistic regression models were employed to identify factors associated with these trajectories. Four distinct trajectory groups of menopausal symptoms were identified (increase, moderate, rebound, decrease). ER gene polymorphisms and E2 fluctuation were significantly associated with group membership. Furthermore, ER gene polymorphisms modulated the effect of E2 fluctuations on menopausal symptom trajectory. This study illuminates the multifaceted factors contributing to the individuality of the perimenopausal experience. ER gene polymorphisms emerged as integral factors by modulating the effect of E2 fluctuations on menopausal symptom trajectory. This underscores the intricate interplay of genetic factors, E2 fluctuations, and menopausal symptoms during perimenopause. [ABSTRACT FROM AUTHOR]

Ovarian tissue cryopreservation has been proven to preserve fertility against gonadotoxic treatments. It has not been clear how this procedure would perform if planned for slowing ovarian aging. This study aimed to determine the feasibility of cryopreserving ovarian tissue to extend reproductive life span and delay menopause by autotransplantation near menopause. Based on the existing biological data on follicle loss rates, a stochastic model of primordial follicle wastage was developed to determine the years of delay in menopause (denoted by D) by ovarian tissue cryopreservation and transplantation near menopause. Our model accounted for (1) age at ovarian tissue harvest (21–40 years), (2) the amount of ovarian cortex harvested, (3) transplantation of harvested tissues in single vs multiple procedures (fractionation), and (4) posttransplant follicle survival (40% [conservative] vs 80% [improved] vs 100% [ideal or hypothetical]). Our model predicted that, for most women aged <40 years, ovarian tissue cryopreservation and transplantation would result in a significant delay in menopause. The advantage is greater if the follicle loss after transplant can be minimized. As an example, the delay in menopause (D) for a woman with a median ovarian reserve who cryopreserves 25% of her ovarian cortex at the age of 25 years and for whom 40% of follicles survive after transplantation would be approximately 11.8 years, but this extends to 15.5 years if the survival is 80%. As another novel finding, spreading the same amount of tissue to repetitive transplants significantly extends the benefit. For example, for the same 25-year-old woman with a median ovarian reserve, 25% cortex removal, and 40% follicle survival, fractionating the transplants to 3 or 6 procedures would result in the corresponding delay in menopause (D) of 23 or 31 years. The same conditions (3 or 6 procedures) would delay menopause as much as 47 years if posttransplant follicle survival is improved to 80% with modern approaches. An interactive Web tool was created to test all variables and the feasibility of ovarian tissue freezing and transplantation to delay ovarian aging (here). Our model predicts that with harvesting at earlier adult ages and better transplant techniques, a significant menopause postponement and, potentially, fertile life span extension can be achieved by ovarian tissue cryopreservation and transplantation in healthy women. [Display omitted] [ABSTRACT FROM AUTHOR]

Identifying risk factors for Alzheimer disease in women is important as women compose two-thirds of individuals with Alzheimer disease. Previous work links vasomotor symptoms, the cardinal menopausal symptom, with poor memory performance and alterations in brain structure, function, and connectivity. These associations are evident when vasomotor symptoms are monitored objectively with ambulatory skin conductance monitors. This study aimed to determine whether vasomotor symptoms are associated with Alzheimer disease biomarkers. Between 2017 and 2020, the MsBrain study enrolled 274 community-dwelling women aged 45 to 67 years who had a uterus and at least 1 ovary and were late perimenopausal or postmenopausal status. The key exclusion criteria included neurologic disorder, surgical menopause, and recent use of hormonal or nonhormonal vasomotor symptom treatment. Women underwent 24 hours of ambulatory skin conductance monitoring to assess vasomotor symptoms. Plasma concentrations of Alzheimer disease biomarkers, including amyloid β 42–to–amyloid β 40 ratio, phosphorylated tau (181 and 231), glial fibrillary acidic protein, and neurofilament light, were measured using a single-molecule array (Simoa) technology. Associations between vasomotor symptoms and Alzheimer disease biomarkers were assessed via linear regression models adjusted for age, race and ethnicity, education, body mass index, and apolipoprotein E4 status. Additional models adjusted for estradiol and sleep. A total of 248 (mean age, 59.06 years; 81% White; 99% postmenopausal status) of enrolled MsBrain participants contributed data. Objectively assessed vasomotor symptoms occurring during sleep were associated with significantly lower amyloid β 42/amyloid β 40, (beta, −.0010 [standard error,.0004]; P =.018; multivariable), suggestive of greater brain amyloid β pathology. The findings remained significant after additional adjustments for estradiol and sleep. Nighttime vasomotor symptoms may be a marker of women at risk of Alzheimer disease. It is yet unknown if these associations are causal. [ABSTRACT FROM AUTHOR]

Objective: To examine the association of adverse childhood experiences (ACEs) with overall menopausal symptom burden in midlife women.Study Design: This was a cross-sectional study of women between the ages of 40 and 65 years who were seen for specialty consultation in the Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN between May 1, 2015 and December 31, 2016.Main Outcome Measures: Participants completed the ACE questionnaire to assess childhood abuse and neglect, the Menopause Rating Scale (MRS) to assess menopausal symptom burden, the Patient Health Questionnaire (PHQ-9) to assess depression, the Generalized Anxiety Disorder questionnaire (GAD-7) to assess anxiety, and provided information on current abuse (physical, sexual and verbal/emotional).Results: Women meeting inclusion criteria (N = 1670) had a median age of 53.7 years (interquartile range: 49.1, 58.0). Of these women, 977 (58.5 %) reported any ACE and 288 (17.2 %) reported ≥4 ACEs. As menopausal symptoms increased in severity from the first to fourth quartile, the odds ratio of ACE 1-3 (vs. 0) increased from 1 to 2.50 (trend p < 0.01), and the odds ratio of ACE ≥ 4 (vs. 0) increased from 1 to 9.61 (trend p < 0.01), a pattern that was consistent across all menopausal symptom domains. The association between severe menopausal symptoms and higher childhood adversity (ACE score 1-3 or ≥4 vs. ACE = 0) remained significant after adjusting for age, partner status, education, employment, depression, anxiety, and hormone therapy use (OR 1.84 and 4.51, p < 0.01).Conclusion: In this large cross-sectional study, there was a significant association between childhood adversity and self-reported menopausal symptoms that persisted even after adjustment for multiple confounders. These associations highlight the importance of screening women with bothersome menopausal symptoms for childhood adversity, and of offering appropriate management and counseling for the adverse experiences, when indicated. [ABSTRACT FROM AUTHOR]

Objectives: To examine the associations of childhood adiposity with menopausal symptoms in women aged 45-49 years.Study Design: National population-based cohort study of 334 girls prospectively followed from childhood (aged 11-15) through to midlife (aged 45-49). Childhood overweight and obesity were defined by international age- and sex-specific standards for body mass index (BMI), and abdominal obesity was defined as waist/height ratio≥0.5.Main Outcome Measures: Vasomotor symptoms (VMS), vaginal dryness, total menopausal symptoms and domain-specific symptoms (somatic, psychological and urogenital) were measured during 2018-19 using the Menopause Rating Scale (MRS) and classified as none, mild, moderate or severe.Results: The prevalence of mild, moderate and severe VMS was 24.0 %, 9.0 % and 3.9 %, and of vaginal dryness was 12.6 %, 4.8 % and 2.4 %. No significant associations of childhood overweight/obesity or abdominal obesity with VMS or vaginal dryness were found after adjustment for childhood age, follow-up length, smoking, socioeconomic status and diet quality. Childhood overweight/obesity was associated with increased risks of more severe total (RR:1.17, 95 % CI:1.02-1.36), psychological (RR:1.19, 95 % CI:1.04-1.35) and urogenital (RR:1.29, 95 % CI:1.14-1.46) symptoms measured using the MRS. Associations with childhood abdominal obesity were mostly stronger with more severe total (RR:2.19, 95 % CI:1.48-3.23), somatic (RR:1.52, 95 % CI:1.15-2.02), psychological (RR:1.21, 95 % CI:1.04-1.42) and urogenital (RR:2.11, 95 % CI:1.39-3.20) symptoms.Conclusions: Childhood adiposity was not associated with increased risks of more severe VMS or vaginal dryness in women aged 45-49 years. Childhood adiposity, especially abdominal obesity, was associated with more severe total, somatic, psychological and urogenital symptoms. However, the association between these symptoms and menopause is not established. [ABSTRACT FROM AUTHOR]

The menopausal syndrome caused by rapid changes in hormone levels greatly influences the quality of life of women. Though hormone replacement therapy (HRT) is widely used to treat the menopausal syndrome, it exhibits many side effects, including the risk of thrombosis, cardiovascular diseases, and increased incidence of breast cancer; thus, diversifying the interest for phytotherapy-based materials as alternatives to HRT. Here, we isolated a crude polysaccharide fraction (CWPF) from Cynanchum wilfordii root that alleviated the ovariectomy-induced uterine atrophy and bone loss without changes in plasma estradiol concentration in mice. Increased plasma levels of follicle-stimulating hormone (FSH), alkaline phosphatase (ALP), osteocalcin (OC) in ovariectomized mice were also reduced to normal levels by CWPF administration. We found that the inhibitory effects of CWPF on menopausal symptoms were mediated by the estrogen receptor β (ER-β) specific activation, not ER-α. Moreover, CWPF treatment suppressed the phosphorylation of Akt, suggesting that CWPF alleviates post-menopausal symptoms by regulating ER-β related Akt signaling pathway. These results demonstrate that the polysaccharides corresponding to CWPF among the water-soluble extracts of CW could be used as a beneficial herbal alternative for the development of therapeutic agents to prevent menopausal syndrome in women. • The polysaccharides corresponding to the CWPF alleviated the menopausal syndromes. • CWPF exhibits estrogen-like activity on the uterine and serum lipid profiles. • It affects the OVX-induced bone loss and osteoclast differentiation. • CWPF acts as a selective estrogen receptor beta agonist. • It has a significantly higher ability to activate the ER-β as compared to CWE at the same concentrations. [ABSTRACT FROM AUTHOR]

Background: There is a prevalence peak of depression in the perimenopause, with this reproductive phase being considered a window of vulnerability due to major biopsychosocial changes. Depression has been associated with physical and psychosocial impairment. Prior depression has been shown to be a risk factor for the development of several somatic and mental diseases. We assume that women with prior depression will exhibit increased burdensome symptoms in the perimenopause compared to women without prior depression.Methods: A total of 135 perimenopausal women aged 40-56 years participated in the longitudinal Swiss Perimenopause Study. For the purpose of this investigation, a cross-sectional design was chosen. A wide range of validated psychosocial questionnaires were used to compare women with and without prior depression regarding their experience of the perimenopause. Findings were statistically adjusted for multiple testing.Results: Women with prior depression showed significantly more depressive symptoms (U = 1215.5, p < .01), more menopausal symptoms (U = 1395.0, p < .01), and more sleep disturbances (U = 1583.5, p < .05) than women without prior depression. Moreover, women with a history of depression reported lower subjective mental health (U = 1573.0, p <  05) and felt more isolated (U = 1524.0, p < .05) than those without prior depression.Limitations: Self-report data may affect the results. Furthermore, due to the cross-sectional design, causality cannot be inferred.Conclusions: Prior depression affects women's experience of the perimenopause. Women with prior depression exhibit significantly more negative health outcomes in the perimenopause than those without prior depression. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and severity of menopausal symptoms and their related risk factors among middle-aged Korean women according to their reproductive stages.Methods: This cross-sectional study included 3039 Korean women, aged 45-65 years, who attended their routine health checkup. Their scores from the Menopause Rating Scale (MRS) were compared and participants were categorized into four groups according to stage of menopause: premenopause, early menopause (≤2 years from their last menstruation), mid-menopause (2-8 years), and late menopause (>8 years).Results: The mean age of the participants was 52.81 ± 5.39 years, and 98.5 % of them reported one or more symptoms included in the MRS. The most common symptom was physical/mental exhaustion, experienced by 86.7 % of participants. The prevalence of moderate to severe symptoms, including vasomotor symptoms, heart discomfort, sleep problems, sexual problems, vaginal dryness, and joint/muscular discomfort, increased in the early menopausal period. This increased in the late menopausal period compared with its prevalence at premenopause. The prevalence of moderate to severe psychological symptoms, heart discomfort, and sleep problems followed a U-shaped trend after menopause: high at early menopause, low at mid-menopause, and high again at late menopause. A low level of physical exercise was an independent risk factor for a high total MRS score; however, the menopausal stages, age, and weight were also variously associated with menopausal symptoms.Conclusions: Several menopausal symptoms remain severe, or are aggravated, until the late menopausal period among Korean women. More attention is warranted to manage these symptoms in postmenopausal women. [ABSTRACT FROM AUTHOR]

The incidence of breast cancer in premenopausal women in South Korea is higher compared to the West. This study aimed to identify factors associated with the health-related quality of life (HRQoL) among survivors with premenopausal young breast cancer undergoing endocrine therapy by examining the effects of menopausal symptoms, social support, and resilience on HRQoL. Cross-sectional study was used to select survivors with breast cancer undergoing endocrine therapy. The study instruments used included a basic information questionnaire, Menopause Rating Scale, Multidimensional Scale of Perceived Social Support, Connor–Davidson Resilience Scale, and Health-Related Quality of Life Instrument with 8 items. Researchers utilized independent t-tests, one-way analysis of variance, Pearson's correlation coefficients, and multiple linear regression to analyze the data. The data were collected from August to September 2021, and the questionnaire was administered via a link posted on a bulletin board of an online breast cancer survivors community. Finally, 133 questionnaires were included in the final analysis. Among 150 participants, 133 completed the questionnaires. HRQoL was higher in the groups with a monthly income of ≥5 million KRW (β = 0.231, p =.011), fewer menopausal symptoms (β = −0.399, p <.001), and higher social support (β = 0.170, p =.038), and lower in the group receiving endocrine therapy and OFS (β = −0.192, p =.010). The explanatory power for HRQoL of premenopausal young breast cancer survivors undergoing endocrine therapy was 38.3% (F = 10.634, p <.001). Breast cancer survivors should be supported to participate in economic activity, utilize rehabilitation and intervention programs to alleviate menopausal symptoms, and benefit from a social support network formed by the hospital, community, and government. • Endocrine therapy is crucial to improve overall survival in breast cancer patients. • In premenopausal young breast cancer survivors undergoing endocrine therapy, the factors associated with quality of life were monthly income, current treatment, menopausal symptoms, and social support. • Improvement of health-related quality of life requires multifaceted strategies. [ABSTRACT FROM AUTHOR]

We aimed to explore patient's experience of chemotherapy-induced menopausal symptoms; to ascertain how patients tried to alleviate their symptoms and how health professionals supported them in order to identify current unmet needs. We designed a retrospective cross-sectional exploratory study of a sample of 11 women who received multi-agent combination chemotherapy for Gestational Trophoblastic Neoplasia. Postal surveys using the Greene Climacteric Scale (GCS) questionnaire followed up by semi-structured telephone interviews were used. Framework analysis technique was used to generate descriptions of patient's experiences. Symptoms of feeling tired or lacking in energy, loss of interest in sex, muscle and joint pains and difficulty in concentrating affected participants the most. The menopausal symptoms appear to be temporary; symptoms such as hot flushes and night sweats seem to subside with resumption of menses. Others are more gradual with some evidence that mental health takes longer to recover. Regarding potential symptoms, some women do not retain the information given to them at discharge following end of treatment, which GTD services need to take into consideration when supporting patients. Patients need to be more optimally prepared for post-chemotherapy recovery with each patient's needs and support being individually tailored. How information is discussed and disseminated needs improving to ensure patients retain the information they receive at discharge. Recommendations include the creation of menopause information booklet, alongside further developing virtual nurse-led follow up clinics post chemotherapy. • Menopausal symptoms appear to be temporary; some subside after the resumption of menses with mental health taking longer to recover. • Patients need to be optimally prepared for post chemotherapy recovery. The provision of information and how it is delivered plays an important role in preparing patients. • The increase in virtual nurse-led clinics will highlight the specific support needs of patients. [ABSTRACT FROM AUTHOR]

• Most midlife Singaporean women experience moderate to severe menopausal symptoms. • Ethnic differences in the prevalence and type of menopausal symptoms were observed. • A score of over 6 on the Menopause Rating Scale (MRS) was associated with menstrual irregularity at 25 years and poor performance on the repeated chair stand (RCS) test. • Moderate disability and poor self-rated health were associated with high MRS scores. • Lower education levels and age ≥65 were inversely associated with high MRS scores. Menopausal symptoms can substantially impact quality of life. We studied somatic, psychological, and urogenital symptoms and their associated factors. Cross-sectional study of healthy midlife Singaporean women from three major Asian ethnic groups. In 2014–16, women aged 45 to 69 attending well-woman clinics at the National University Hospital Singapore completed the Menopause Rating Scale (MRS). Sociodemographic, reproductive, medical, anthropometric, body composition, and physical performance characteristics were assessed using validated questionnaires and strict protocols. We analysed sub-scales and total scores by median split, and adjusted odds ratios using multivariable logistic regression. Of the 1054 eligible women, 62.6 % reported at least one moderate to extremely severe symptom. The top five menopausal symptoms were joint and muscle discomfort, sleep problems, vaginal dryness, physical and mental exhaustion, and hot flushes. Higher total scores on the MRS were associated with moderate disability (adjusted odds ratio: 9.80, 95 % confidence interval: 2.88–33.34), poorer self-rated health status (2.18, 1.60–2.97), menstrual irregularity at 25 years (1.63, 1.07–2.49), and slower chair stands (1.49, 1.09–2.03). Age ≥65 (0.54, 0.30–0.94) and a lower level of education (0.45, 0.26–0.76) had significant inverse associations with total MRS score. Menopausal symptoms were associated with disability, poorer health status, and weaker lower-body muscle strength. These data add to the limited Asian evidence and raise the profile of this important area of health. [ABSTRACT FROM AUTHOR]

and Purpose: Menopause is associated with physical and emotional discomfort for women and has major negative effects on their quality of life. The purpose of this study was to determine the effects of royal jelly on menopausal symptoms. This double-blind randomized clinical trial was carried out in Bandar Abbas, Iran, from June to November 2018. The study population consisted of 200 postmenopausal women (45–60 years). Each participant received either 1000 mg of royal jelly capsules or placebo daily for eight weeks. The mean baseline menopausal score did not differ between groups. The menopausal score reduced significantly after eight weeks of intervention in experimental group whereas reduction was not significant in control group. The findings showed that daily consumption of oral royal jelly (1000 mg) for eight weeks was effective in alleviating the menopausal symptoms. However, further research is necessary to confirm the effects. • The severity of menopausal symptoms in the experimental group was significantly lower than control group after intervention. • There was a significant difference between the mean of menopausal score before and after the intervention in the experimental group. • Daily consumption of oral royal jelly (1000 mg) for eight weeks was effective in alleviating the menopausal symptoms. [ABSTRACT FROM AUTHOR]

In the market of botanical dietary supplements, Cimicifuga heracleifolia (CH) has always been considered as an adulterated species of Cimicifuga racemosa (CR), a conventional American herb with promising benefits to counteract troubles arising from the menopause. However, the detailed comparison of their therapeutic effects is lacking. In present study, the pharmacological and metabolomics studies were comparatively conducted between CH and CR in ovariectomized (OVX) female rats. Specifically, estrogen-like, anti-hyperlipidemia and anti-osteoporosis effects were evaluated through measuring serum biochemical parameters, histopathological examination and micro computed tomography (Micro-CT) scanning. At the same time, a gas chromatography-mass spectrometry (GC-MS)-based serum metabolomics method was employed to profile the metabolite compositional changes. As a result, both CR and CH displayed anti-osteoporosis and anti-hyperlipemia on menopause syndrome. Meanwhile, their potentials in improving the OVX-induced metabolic disorders were discovered. In conclusion, these results demonstrated that CH is therapeutically similar to CR in relieving menopausal symptoms and CH could be considered as a promising alternative to CR instead of an adulterant in the market of botanical dietary supplements. [ABSTRACT FROM AUTHOR]

Objective: In this study we aimed to pilot test the hypothesis that in women who are severely bothered by their menopausal complaints, improvement of menopausal symptoms is associated with an improvement in self-perceived work ability.Study Design: This retrospective cohort study assessed the work ability of first-time attendees (n = 31) of a menopause clinic at baseline (T0) and 3-9 months follow-up (T1). All patients received care as usual according to local protocol, no interventions were applied by the researchers. Self-reported questionnaire data assessing work ability (Work Ability Index; WAI) and menopausal symptoms (Greene Climacteric Scale; GCS) were used.Main Outcome Measures: Multiple linear regression was used in an exploratory analysis to examine the relationship between change in WAI score (ΔWAI) and change in menopausal symptoms (ΔGCS), after adjustment for potential confounders. Additional exploratory univariate linear regression analyses were performed to assess the associations of change in WAI score with change in the different GCS domains and with type of treatment.Results: Twenty-seven out of 31 women reported improvement in work ability at follow-up (T1) (M = 30.73, SD = 6.42 respectively, M = 34.86, SD = 5.98). All women reported to be less bothered by their menopausal symptoms at T1 (M = 26.57, SD = 8.69 respectively, M = 14.73, SD = 6.36). Multivariate linear regression demonstrated a significant association between the WAI and GCS change scores after correction for confounders (beta ΔGCS = 0.283, p = 0.014). After additional adjustment for WAI at baseline, this association was no longer significant (beta ΔGCS = 0.172, p = 0.164). Change in GCS depression domain (ΔGCS depression) was significantly associated with ΔWAI, although after correction for WAI at baseline the effect of ΔGCS depression was no longer significant (beta = 0.855, p = 0.113). The WAI and GCS change scores were highly correlated, as a result their coefficients were not statistically significant separately.Conclusions: Treatment aimed at alleviating menopausal symptoms in symptomatic women could lead to improvement of menopausal symptoms along with improvement in work ability. Improvement of depressive symptoms seem particularly important for this outcome. [ABSTRACT FROM AUTHOR]

• Women in the perimenopause have a lower work ability, poorer health and more emotional exhaustion. • Of women in the perimenopause, 80 % experience menopausal symptoms. • Menopausal symptoms are associated with a lower work ability. • Menopausal symptoms are associated with poorer health and more emotional exhaustion. In this study we examined the associations between menopausal symptoms and work ability and health among a general population of Dutch female workers. This nationwide cross-sectional study was a follow-up of the Netherlands Working Conditions Survey 2020. In 2021, 4010 Dutch female employees aged 40–67 years completed an online survey on a variety of topics, including menopausal symptoms, work ability and health. Linear and logistic regression analyses were performed to investigate the association between the degree of menopausal symptoms with work ability, self-rated health and emotional exhaustion, after adjustment for potential confounders. Almost one-fifth of participants were in the perimenopause (n = 743). Of these women, 80 % experienced menopausal symptoms: 27.5 % 'often' and 52.5 % 'sometimes'. Experiencing menopausal symptoms was associated with lower work ability, poorer self-rated health, and more emotional exhaustion. These associations were most pronounced among perimenopausal women 'often' experiencing symptoms. Menopausal symptoms threaten the sustainable employability of female workers. Interventions and guidelines are needed to support women, employers and (occupational) health professionals. [ABSTRACT FROM AUTHOR]

Abstract Purpose This study evaluated the psychometric properties of the Thai Menopause Specific Quality of Life Questionnaire (MENQOL) instrument in menopausal Thai women with a history of breast cancer. Methods Two hundred and ninety women with a history of breast cancer who reported hot flashes completed the Thai MENQOL. Internal consistency reliability and item analysis were used to evaluate the reliability of the Thai MENQOL. Construct validity was evaluated by examining the correlations between the self-reported hot flash frequency and severity with the vasomotor MENQOL subscale (convergent validity); and assessed using exploratory factor analysis (structural validity). Results The Cronbach's alpha coefficient for the MENQOL total scale was 0.86 and for the vasomotor, psychosocial, physical, sexual domains were 0.73, 0.78, 0.81, and 0.83, respectively. Self-reported frequency and severity of hot flashes were correlated significantly with the vasomotor subscale (r's ≥ 0.50, p's < 0.001). The single item "increased facial hair" was poorly correlated with most items (r = 0.13). Confirmatory factor analysis supported four factors explaining 42.35% of the total variance. Item-domain correlation analysis showed that all items correlated more strongly with their own domains than with other domains. Conclusions The Thai version of the MENQOL demonstrates good psychometric properties (internal consistency reliability, convergent validity, and structural validity). We recommend removal of the single item, "increased facial hair" from the Thai version due to low correlations with most items. The Thai MENQOL can be used to measure menopause-related quality of life in Thai women with a history of breast cancer experiencing menopausal symptoms. Highlights • Provides evidence for the validity of the Thai Menopause Specific Quality of Life Questionnaire (MENQOL). • Sets the stage for intervention research around menopause in Thai women now that a valid questionnaire is available. • The first study to evaluate the psychometric properties of the Thai MENQOL questionnaire in breast cancer women. [ABSTRACT FROM AUTHOR]

Objectives: Lifestyle modifications that may reduce menopausal symptoms have generated much interest. The vegetarian diet has been associated with a lower risk of chronic disease as well as a more healthy hormonal milieu. Our objective in this cross-sectional study was to survey peri- and postmenopausal women to investigate menopausal symptoms and dietary pattern.Study Design: Survey distribution in 2015-2016 was aimed at female vegans, vegetarians, and omnivores between the ages of 45 and 80 years, who were active on senior and vegetarian social networking websites and at vegan restaurants and events.Main Outcome Measures: We investigated vasomotor and physical symptoms as measured by the Menopause-specific Quality of Life Questionnaire (MENQOL) and dietary pattern classified by animal protein intakes reported in response to food frequency questions.Results: Out of 754 participants who completed the survey, 604 reported they were perimenopausal (n = 121) or postmenopausal (n = 483), of whom 539 also completed the food frequency questions. We compared vasomotor and physical symptoms in omnivores (n = 304, consumed meat and/or poultry at least monthly) and vegans (n = 125, abstained from all animal proteins) using general linear models; covariates included age, exercise, hormone replacement therapy, presence of reproductive organs, and age at menopause. Among perimenopausal women, vegans reported less bothersome vasomotor (p < 0.01) and physical symptoms (p < 0.01) than omnivores. For both symptom types, more vegetables and less flesh food were associated with less bothersome symptoms (p values < 0.05).Conclusion: Eating a plant-based diet may be helpful for women in menopausal transition who prefer a natural means to manage their symptoms. [ABSTRACT FROM AUTHOR]

More than 6 million women worldwide are living with a past diagnosis of breast cancer. Most survive their illness, and management of the long-term consequences of treatment has become a priority in cancer care. Menopausal symptoms affect most breast cancer survivors and may significantly impair quality of life. We describe a multidisciplinary model to evaluate and manage these women using a patient-focused approach. The 'Multidisciplinary Menopause After Cancer Clinic' includes gynecologists, endocrinologists, GPs, a psychologist and a clinical nurse specialist. Benefits of this model include improved coordination of patient care, education, communication and evidence-based decision making. [ABSTRACT FROM AUTHOR]

Background: Hot flushes and night sweats (HFNS) - the main symptoms of the menopause transition - can reduce quality of life and are particularly difficult to manage at work. A cognitive behaviour therapy (CBT) intervention has been developed specifically for HFNS that is theoretically based and shown to reduce significantly the impact of HFNS in several randomised controlled trials (RCTs). Self-help CBT has been found to be as effective as group CBT for these symptoms, but these interventions are not widely available in the workplace. This paper describes the protocol of an RCT aiming to assess the efficacy of CBT for menopausal symptoms implemented in the workplace, with a nested qualitative study to examine acceptability and feasibility.Methods/design: One hundred menopausal working women, aged 45-60 years, experiencing bothersome HFNS for two months will be recruited from several (2-10) large organisations into a multicentre randomised controlled trial. Women will be randomly assigned to either treatment (a self-help CBT intervention lasting 4 weeks) or to a no treatment-wait control condition (NTWC), following a screening interview, consent, and completion of a baseline questionnaire. All participants will complete follow-up questionnaires at 6 weeks and 20 weeks post-randomisation. The primary outcome is the rating of HFNS; secondary measures include HFNS frequency, mood, quality of life, attitudes to menopause, HFNS beliefs and behaviours, work absence and presenteeism, job satisfaction, job stress, job performance, disclosure to managers and turnover intention. Adherence, acceptability and feasibility will be assessed at 20 weeks post-randomisation in questionnaires and qualitative interviews. Upon trial completion, the control group will also be offered the intervention.Discussion: This is the first randomised controlled trial of a self-management intervention tailored for working women who have troublesome menopausal symptoms.Trial Registration: Clin.Gov NCT02623374. [ABSTRACT FROM AUTHOR]

Objectives: This study proposed a method for assessing menopause-specific health literacy (knowledge and beliefs about menopausal symptoms which aid their recognition, assessment, and management) using a vignette methodology.Study Design: A cross-sectional web-based survey was conducted in September 2015 among Japanese women aged 30-59 years. Of 1236 women surveyed, 1196 eligible participants who were not under treatment for menopausal symptoms were included.Main Outcome Measures: Participants were presented with a vignette describing a woman with menopausal symptoms and were then asked a series of questions to assess their recognition of menopausal symptoms, attitude, subjective norm, perceived behavior control, availability, and intention to seek medical care if they themselves had the problems described in the vignette.Results: The majority (87%) of participants correctly labelled the vignette as menopausal symptoms and 60% expressed an intention to seek medical care if they had the symptoms presented. Logistic regression showed that attitude, subjective norm, and perceived behavior control were significant predictors of the intention to seek medical care. A structural equation model depicting these relationships with intention to seek medical care revealed acceptable fit indices: goodness of fit index (GFI)=0.948, adjusted goodness of fit index (AGFI)=0.913, comparative fit index (CFI)=0.883, and root mean square error of approximation (RMSEA)=0.089. Subjective norm had the greatest direct effect on intention to seek medical care.Conclusions: The assessment of menopause-specific health literacy may be useful for understanding why women hesitate to seek medical care for menopausal symptoms and for developing interventions to improve the coping behaviors of women with menopausal symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Chronic diseases may aggravate or simulate climacteric symptoms. Although acknowledged in clinical practice, there is a lack of research systematically analysing the association between chronic diseases and climacteric symptoms.Study Design and Main Outcome Measures: Our study was a cross-sectional population-based study, which included 3421 women, aged 41-54 years. Climacteric symptoms were evaluated using the Women's Health Questionnaire (WHQ), of which we included seven symptom domains (vasomotor, sleep, depressive, anxiety/fears, cognitive, sexual, and menstrual) and a question concerning whether the women were worried about growing old. The occurrence of various diseases (cardiovascular, neurological, sensory organ, bronchopulmonary, musculoskeletal, gastrointestinal, urological, dermatological, and thyroid disease, diabetes, and cancer) was recorded. The associations between the diseases and symptoms were defined with multivariable analyses, adjusting for various confounding factors.Results: The women with the diseases had more symptoms. Vasomotor symptoms and sleep problems were associated only with gastrointestinal diseases, and lower sexual functioning only with diabetes. The remaining symptoms were associated with several diseases, except being worried about growing old, which was not associated with any.Conclusions: Many symptoms connected to the climacteric may manifest also due to chronic diseases. Thus, health-care professionals should consider the origin of the symptoms when treating middle-aged women with chronic diseases. [ABSTRACT FROM AUTHOR]

Objective: We examined the differences in coping with menopausal symptoms between nurses and general workers, and we examined the association of the differences with understanding of menopausal symptoms in Japan.Methods: Three hundred and ninety-seven nurses and 217 general workers aged 45-60 years who had experienced menopausal symptoms completed a health questionnaire including questions on coping with menopausal symptoms and an understanding of causes and treatment of menopausal symptoms.Results: Approximately 50% of both nurses and general workers had experience in coping with menopausal symptoms. Both nurses and general workers who had a sufficient understanding of menopausal symptoms were likely to cope with the symptoms and to visit hospitals. For coping strategies, the proportions of women who used diversion and dietary supplements were high in nurses and general workers, and the proportion of nurses who used diversion was significantly higher than that in general workers. Nurses with a sufficient understanding of menopausal symptoms had received hormone replacement therapy, and general workers with a sufficient understanding of menopausal symptoms had received herbal medicine.Conclusion: The proportions of nurses and general workers coping with menopausal symptoms were similar, although nurses had better knowledge regarding menopausal symptoms. More efforts to provide information and appropriate education regarding menopausal medicine and coping strategies may be required for both nurses and general workers. [ABSTRACT FROM AUTHOR]

Menopausal transition can be challenging for many women. This study tested the effectiveness of an intervention delivered in different modes in decreasing menopausal symptoms in midlife women. The Women's Wellness Program (WWP) intervention was delivered to 225 Australian women aged between 40 and 65 years through three modes (i.e., on-line independent, face-to-face with nurse consultations, and on-line with virtual nurse consultations). All women in the study were provided with a 12-week Program Book outlining healthy lifestyle behaviors while women in the consultation groups were supported by a registered nurse who provide tailored health education and assisted with individual goal setting for exercise, healthy eating, smoking and alcohol consumption. Pre- and post-intervention data were collected on menopausal symptoms (Greene Climacteric Scale), health related quality of life (SF12), and modifiable lifestyle factors. Linear mixed-effect models showed an average 0.87 and 1.23 point reduction in anxiety ( p < 0.01) and depression scores ( p < 0.01) over time in all groups. Results also demonstrated reduced vasomotor symptoms ( β = −0.19, SE = 0.10, p = 0.04) and sexual dysfunction ( β = −0.17, SE = 0.06, p < 0.01) in all participants though women in the face-to-face group generally reported greater reductions than women in the other groups. This lifestyle intervention embedded within a wellness framework has the potential to reduce menopausal symptoms and improve quality of life in midlife women thus potentially enhancing health and well-being in women as they age. Of course, study replication is needed to confirm the intervention effects. [ABSTRACT FROM AUTHOR]

Objectives The aims of this pilot study were to evaluate treatment effects, ascertain safety and formulate best practice Chinese medicine protocols relevant for London women suffering from menopausal symptoms. Study design This clinical pilot study employed a case series design within a wider action-based research project. 117 perimenopausal women between 45 and 55 years of age recruited from the general population were treated for menopausal symptoms by six experienced practitioners of Chinese medicine at the Polyclinic of the University of Westminster. Practitioners were instructed to treat as near to their usual practice style as possible. This involved using Chinese herbal medicine and/or acupuncture along with dietary and lifestyle advice. A maximum of 12 treatments over 6 months was allowed per patient. Outcome measures The menopause specific quality of life questionnaire (MenQoL), the Greene climacteric scale, and flushing diaries were used to evaluate treatment outcomes. Liver and kidney function tests were carried out at intake and after 1, 6 and 12 treatments to evaluate the safety particularly in relation to the use of herbal medicines. Results Patients showed significant improvement across all domains measured by the MenQoL and Greene climacteric scales. Reduction on the MenQoL scale between first and last visit was from 4.31 to 3.27 ( p < 0.001) and on the Green climacteric scale from 21.01 to 13.00 ( p < 0.001). Study participants did not reliably complete their flushing diaries. No adverse events or abnormal liver or kidney function values were observed during the course of the study. Conclusions Further research that seeks to investigate the effects observed in more detail and to evaluate them against other forms of treatment and/or no-treatment controls is warranted. This could be achieved by way of a pragmatic randomized controlled trial that evaluated Chinese medicine against orthodox medical care. [ABSTRACT FROM AUTHOR]

Background The majority of instruments used to evaluate menopausal symptoms are long and complex. In this sense, more simple tests are being designed to rapidly obtain a snapshot of the global clinical picture. Objective To assess menopausal symptoms in mid-aged women using the short 10 item version of the original menopause Cervantes Scale (CS-10). Method This was a cross sectional study in which a total of 451 Ecuadorian women (40-59 years) were surveyed with the CS-10 and a general socio-demographic questionnaire containing personal and partner data. Results Median age of the whole sample was 48 years. A 41.2% were postmenopausal, 44.3% abdominally obese (waist circumference >88 cm), 6% diabetic, 16.9% hypertense, 11.5% smoked, 6.9% currently used hormone therapy, 9.5% phytoestrogens and 6.7% psychotropic drugs. For the entire sample, median [interquartile range] CS-10 global scores were 10.0 [9.5], and for pre-, peri- and postmenopausal women: 5.0 [7.0], 11.0 [9.0] and 13.5 [8.0], respectively. The CS-10 displayed good internal consistency (Cronbach's alpha 0.87). According to the CS-10, the three most prevalent menopausal symptoms were: muscle and joint pains (88.5%), hot flushes (77.6%) and skin dryness (71.4%). Multiple linear regression analysis found that postmenopausal status, parity, unhealthy perceived status, psychotropic drug use, partner erectile dysfunction, lower coital frequency and living at high altitude were related to higher CS-10 global scores. Conclusion In this mid-aged Ecuadorian female sample severity of menopausal symptoms, as determined by the CS-10, were related to environmental and female/partner personal and socio-demographical aspects. [ABSTRACT FROM AUTHOR]

Objective The main objective was to ascertain the typical menopausal symptoms and job-related stress factors in Japanese nurses during the menopausal transition, and the associations of menopausal symptoms with job-related stress. A supplementary objective was to determine whether there were any differences in menopausal symptoms and job-related stress factors among nurses in managerial positions. Methods One thousand seven hundred female registered nurses aged 45-60 years who were working in hospitals in Japan were asked to complete a self-administered survey that included Greene's Climacteric Scale and the Brief Job Stress Questionnaire. Results The proportions of nurses who reported feelings of tiredness, irritability and difficulty in concentration were higher than the proportions with other menopausal symptoms. The proportions of nurses reporting feeling unhappy or depressed and having crying spells were higher among nurses in managerial positions than among other nurses. Stresses related to 'quantitative overload' on the Brief Job Stress Questionnaire among nurses in managerial positions were significantly greater than among nurses not in managerial positions, while stresses related to 'physical overload', 'job control', 'skill discretion', 'workplace environment' and 'job satisfaction' among nurses not in managerial positions were significantly greater than they were among nurses in managerial positions. Psychological symptoms were significantly correlated with poor job-related interpersonal relationships. Conclusions Health care practitioners should be aware that menopausal symptoms are associated with job-related stress during the menopausal transition. Information on the differences in these associations between nurses in managerial positions and other nurses is important as it will allow their health care to be managed on a more individual basis. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Somatosensory amplification is the experience of sensing everyday bodily sensations as intense, agitating, and unpleasant. Using data from menopausal breast cancer survivors and midlife women without cancer, the study purposes were to (1) explore the psychometric properties of the Somatosensory Amplification Scale and (2) to describe somatosensory amplification and its relationship to menopausal symptoms of hot flashes, mood and sleep disturbance. Study design: This was a cross-sectional, descriptive, correlational study using demographic, e-diary, and questionnaire data from 99 breast cancer survivors and 138 midlife women. Main outcome measures: Somatosensory amplification, hot flashes (frequency, severity, bother, interference, perceived control), mood, and sleep. Results: Cronbach's alphas for the scale were low. When an 8-item version of the scale was evaluated, alphas improved and item-total correlations remained strong or improved. Midlife women and breast cancer survivors did not have significantly different somatosensory amplification total or item scores after adjusting for group differences in demographics. Somatosensory amplification was significantly correlated with hot flash interference, perceived control over hot flashes, and mood and sleep disturbance in both groups but the patterns of correlations differed slightly between groups and depending on whether the 10-item or 8-item scale was used. Conclusion: Somatosensory amplification may be a relevant concept to assess in relation to the menopausal symptom experience of midlife women with and without breast cancer as it may represent a potential intervention target to improve the menopausal symptom experience. [Copyright &y& Elsevier]

Abstract: Women's care during perimenopause and postmenopause is taking new paths to help women cope with both somatic manifestations and changes related to psychological and social factors. An updated, systematic review was conducted on non-pharmacological psychosocial interventions with regard to peri- and postmenopause. Several databases complemented with reference lists and reviews were used to perform a literature search of any relevant article. Studies were selected if they included psychoeducational programmes, health education and promotion and cognitive-behavioural techniques applied to peri- or postmenopausal women, independently of study design, main outcomes and intervention comparators. A total of 33 reports and 3 relevant reviews published between 1987 and 2013 were included. Psychosocial options are promising intervention options for self-management and self-care, as they provide multiple benefits with no side effects. Moreover, these options are recommended for women in clinical, subclinical and asymptomatic groups, as they offer women the agency and skills necessary to manage and relieve menopausal symptoms, as well as provide information and alternatives to prevent menopausal symptoms and to have a more positive experience during these life stages. These options do more than reduce distress and complaints, as they allow women in any condition to enjoy enhanced health, well-being and quality of life. Moreover, these options are accompanied by important cost reductions in pharmaceutical investment and healthcare. Nevertheless, several issues remain controversial or have scarcely been investigated, and additional high-quality research should address these issues properly in the future. Despite these limitations and the weaknesses of the review, the findings of this review are interesting and positive. Thus, we encourage women-focused institutions and policies (e.g., healthcare centres, public organisations and women's associations) to offer psychosocial interventions to peri- and postmenopausal women within a comprehensive healthcare paradigm. [Copyright &y& Elsevier]

Abstract: Objective: To evaluate menopausal symptoms and their associated factors in HIV-positive women. Methods: A cross-sectional study was conducted with 537 women of 40–60 years of age, 273 of whom were HIV-positive and 264 HIV-negative. The women were interviewed to obtain data on their sociodemographic characteristics and menopausal symptoms. Results: The mean age of the seropositive women was 47.7±5.8 years compared to 49.8±5.3 for the seronegative women (p <0.001). Bivariate analysis showed a lower prevalence of vasomotor symptoms in the seropositive group (p =0.009), specifically hot flashes (p <0.002) and sweating (p =0.049). Vaginal dryness was also less prevalent in this group (p <0.005). There were no statistically significant differences between the groups with respect to depression or insomnia. Multiple analysis showed that hot flashes were associated with being peri- or postmenopausal (PR=2.12; 95%CI: 1.52–2.94). Vaginal dryness was less common in women without a partner (PR=0.67; 95%CI: 0.49–0.90) and was associated with older age (PR=1.03; 95%CI: 1.01–1.06) and being in the peri- or postmenopause (PR=1.69; 95%CI: 1.10–2.60). Depression was inversely associated with being employed (PR=0.74; 95%CI: 0.58–0.96) and directly associated with the presence of chronic diseases (PR=1.30; 95%CI: 1.01–1.067). Insomnia was associated with a lower body mass index (PR=0.96; 95%CI: 0.95–0.97) and with being peri- or postmenopausal (PR=1.48; 95%CI: 1.11–1.97). No correlation was found between HIV serological status and any of the menopausal symptoms. Conclusions: In this study, after controlling for confounding variables, HIV infection was not found to be associated with vasomotor, genitourinary or psychological symptoms or with insomnia. [Copyright &y& Elsevier]

Objective: To develop a short 10 item version of the original menopause Cervantes Scale (CS) in order to assess menopausal symptoms in a large cohort of mid-aged Colombian women. Methods: Reliability of the new short tool was assessed through internal consistency determination (Cronbach's alpha values) and intra-class correlation coefficient (ICC) analysis. Ten items out of the 31 composing the original CS were selected according to their clinical relation with menopausal symptoms. Subsequently the short tool was used to assess menopausal symptoms and related factors among 1739 mid-aged women. Results: The CS-10 displayed a mean (±SD) ICC value of 0.45 (±0.06) and a Cronbach's alpha of 0.778 suggesting good internal reliability. For the entire sample median [interquartile range] CS-10 global scores were 10.0 [12.0], and for pre-, peri- and postmenopausal women: 8.0 [9.2], 9.0 [9.0] and 14.0 [14.0], respectively. Median global CS-10 scores significantly increased with menopausal status, marital status and ethnicity. Multiple linear regression analysis determined that higher global CS-10 scores (worse quality of life) correlated with age, parity, years since menopause, body mass index, ethnics (black) and smoking habit. Conclusion: The CS-10 seems to be a simple instrument that may aid everyday clinical consultation and help at performing an accurate diagnosis of menopause-related symptoms. Further studies are needed to confirm our preliminary findings. [ABSTRACT FROM AUTHOR]

Abstract: Breast cancer is the most common female cancer in Spain. Its high prevalence, its high survival rate, and its incidence are the reasons treatment is increasingly sought for common problems by young women who have survived it. Besides the contraception and fertility issues, many breast cancer survivors develop sexual disorders and menopausal symptoms, whether as a consequence of treatment-induced menopause or side effects of treatment. For such reasons, a panel of experts from the Spanish Menopause Society has met to develop usage recommendations for the relief of vasomotor symptoms and for sexual and reproductive health in patients with breast cancer based on the best evidence available. [Copyright &y& Elsevier]

Abstract: Background: Root extracts of Cimicifuga racemosa (L.) Nutt. have been successfully used in the treatment of climacteric complaints. Method: In this observational study, Cimicifuga racemosa (CR) extract Ze 450 was studied in 442 unselected ambulatory female outpatients with menopausal complaints under daily practice conditions. Physicians were suggested to treat patients for the first 3 months with 13mg/d CR (high dose, HD) and to continue over additional 6 months either with this treatment or to switch to 6.5mg/d CR (low dose, LD). The choice of treatment and its dose, however, was fully at the discretion of the physician. Results: After 3-months treatment with HD, symptom severity (Kupperman Menopause Index, KMI) decreased significantly (p <0.001) from baseline values. Continuation of treatment with HD or LD decreased total KMI and its sub-item scores further (HD, LD: p <0.001). However, more patients (84.9%) responded to HD than to LD (78.4%) and showed an improvement of symptoms (p =0.011). Conclusion: This observational study demonstrated that treatment with CR in unselected patients with climacteric complaints under the conditions of daily practice resulted in a significant improvement of menopausal symptoms assessed by the total KMI score and its sub-item scores with an effect size similar to that in a previous randomized, controlled clinical trial. [Copyright &y& Elsevier]

Abstract: Background: Women with menopausal symptoms have been reported to have reduced risk of breast cancer, possibly reflecting differences in endogenous hormone levels. We examined the associations between menopausal symptoms and breast cancer in women under age 50. Methods: We carried out a sister-controlled case-control study, the Two Sister Study, comparing 1422 women with breast cancer diagnosed before age 50 and their 1669 sisters who were free of breast cancer and had enrolled in the prospective Sister Study cohort. History and age at first occurrence of menopause-associated symptoms (e.g. hot flashes, poor sleep or night sweats) were ascertained using computer-assisted telephone interviews. To equalise opportunity for exposure, we assessed exposures in relation to a sibship-based index age (the minimum of the age at diagnosis of the case sister and the age at interview of her control sister(s)), and estimated odds ratios using conditional logistic regression with adjustment for menopausal status and birth order. Findings: Having had menopause-associated symptoms (n =706) prior to the index age was associated with reduced risk of young-onset breast cancer (odds ratio (OR), 0.49; 95% confidence interval (CI), 0.40–0.61). Similar results were seen for hot flashes and for “other” menopausal symptoms. The association between menopausal symptoms and breast cancer risk was somewhat stronger for oestrogen receptor positive tumours than for oestrogen receptor negative tumours (heterogeneity p =0.07). Menopausal status, age at menopause, BMI and hormone replacement therapy did not modify the associations, but the inverse association between menopausal symptoms and breast cancer attenuated with increasing index age (p <0.01). Interpretation: Menopause-associated symptoms were associated with markedly reduced risk of young-onset breast cancer. Further studies are needed to confirm the association and elucidate possible pathways. [Copyright &y& Elsevier]

Abstract: Background: The management of hormonal deficiency symptoms in breast cancer survivors is an unsolved problem. While hormone replacement therapy (HRT) may increase the risk of breast cancer in healthy women, its effects on recurrence is unclear. Observational studies have suggested decreased recurrence rates from HRT. The few clinical trials in this field have all been closed preterm. Methods: The Stockholm trial was started in 1997 and designed to minimise the dose of progestogen in the HRT arm. Disease-free women with a history of breast cancer were randomised to HRT (n =188) or no HRT (n =190). The trial was stopped in 2003 when another Swedish study (HABITS, the Hormonal Replacement After Breast Cancer – Is it Safe?) reported increased recurrence. However the Stockholm material showed no excess risk after 4years of follow-up. A long term follow-up has now been performed. Findings: After 10.8years of follow-up, there was no difference in new breast cancer events: 60 in the HRT group versus 48 among controls (hazard ratio (HR)=1.3; 95% confidence interval (CI)=0.9–1.9). Among women on HRT, 11 had local recurrence and 12 distant metastases versus 15 and 12 for the controls. There were 14 contra-lateral breast cancers in the HRT group and four in the control group (HR=3.6; 95% CI=1.2–10.9; p =0.013). No differences in mortality or new primary malignancies were found. Interpretation: The number of new events did not differ significantly between groups, in contrast to previous reports. The increased recurrence in HABITS has been attributed to higher progestogen exposure. As both trials were prematurely closed, data do not allow firm conclusions. Both studies found no increased mortality from breast cancer or other causes from HRT. Current guidelines typically consider HRT contraindicated in breast cancer survivors. Findings suggest that, in some women symptom relief may outweigh the potential risks of HRT. [Copyright &y& Elsevier]

Abstract: Objective: To investigate the factors associated with the age of natural menopause and menopausal symptoms in a large population of Chinese middle-aged women. Study design: In this cross-sectional study, a total of 20,275 women (40–65 years) attending health screening in Jiangsu Province of China were enrolled. A structured questionnaire was used to collect data of demographics, menopausal status, chronic diseases, reproductive history, etc. Also we evaluated the severity of menopausal symptoms by Kupperman menopause index (KMI). Main outcome measure: Menopausal age and scorings of Kupperman menopause index. Results: The overall median age at natural menopause was 50 years. Lower educational level, poor economic status, lower body mass index (BMI), age at menarche less than 14 years, nulliparity and smoking were associated with earlier onset of natural menopause (P <0.05). The most frequently symptoms in postmenopausal women were sexual problems (57.05%), muscle/joint pain (53.29%) and insomnia (51.02%), while fatigue, insomnia and muscle/joint pain were predominant symptoms in pre- and peri-menopausal women. After adjusting for confounding factors, logistic regression analysis revealed that women with poor educational background, low income, divorce, higher BMI, higher parity, smoking and chronic diseases presented higher KMI scores (P <0.05). Conclusion: The study provided an estimate of median age at natural menopause in Chinese women. The main factors contributing to earlier onset of menopause and severity of menopausal symptoms were lower educational level, poor economic status, and smoking. Thus, this study provides important insights for physicians to prevent and treat menopause related symptoms. [Copyright &y& Elsevier]

Abstract: Introduction: The intensified treatment of breast cancer improves survival but has a price in terms of side-effects. The main side-effects, such as vasomotor symptoms and impaired sexual functioning, are related to premature menopause due to chemotherapy and/or anti-hormonal therapy. Though for some women these symptoms are bearable, for others they have a large impact on their quality of life. The paper discusses the menopausal symptoms most frequently reported by breast cancer survivors and current treatment options. Methods: A literature review is presented of menopausal symptoms after breast cancer and management strategies, illustrated by two cases. Summary: Vasomotor symptoms can be relieved by lifestyle adaptation, acupuncture and non-hormonal agents such as venlafaxine, gabapentin or clonidine. Impaired sexual functioning can be treated by couple-based sexual counselling or psycho-educational therapy. Painful intercourse due to vaginal dryness can be alleviated by vaginal lubricants and moisturizers, but is most effectively treated by vaginal estriol. Local estriol seems safe if used for a short period (less than six weeks). Because of proven increased risk of recurrence with hormone replacement therapy (HRT), it should not be prescribed for breast cancer survivors, although exceptions could be made of selected cases of fully informed BRCA mutation carriers after ER-negative breast cancer and with severe menopausal symptoms due to prophylactic oophorectomy at a young age and (preferably) after mastectomy. Conclusion: The management of vasomotor symptoms and impaired sexual functioning in breast cancer survivors should focus on lifestyle and, if necessary, non-hormonal pharmacological interventions. [Copyright &y& Elsevier]

Abstract: Objective: Hormonal changes during menopausal transition are linked to physical and psychological symptoms’ emergence. This study aims to explore if life events predict menopausal symptoms. Methods: This cross-sectional research encompasses a community sample of 992 women who answered to socio-demographic, health, menopause-related and lifestyle questionnaires; menopausal symptoms and life events were assessed with validated instruments. Structural equation modeling was used to build a causal model. Results: Menopausal status predicted only three symptoms: skin/facial hair changes (β =.136; p =.020), sexual (β =.157; p =.004) and, marginally, vasomotor symptoms (β =.094; p =.054). Life events predicted depressive mood (β =−.391; p =.002), anxiety (β =−.271; p =.003), perceived cognitive impairment (β =−.295; p =.003), body shape changes (β =−.136; p =.031), aches/pain (β =−.212; p =.007), skin/facial hair changes (β =−.171; p =.021), numbness (β =−.169; p =.015), perceived loss of control (β =−.234; p =.008), mouth, nails and hair changes (β =−.290; p =.004), vasomotor (β =−.113; p =.044) and sexual symptoms (β =−.208; p =.009). Conclusions: Although women in peri- and post-menopausal manifested higher symptoms’ severity than their pre-menopausal counterparts, only three of the menopausal symptoms assessed were predicted by menopausal status. Since the vast majority of menopausal symptoms’ severity was significantly influenced by the way women perceived their recent life events, it is concluded that the symptomatology exacerbation, in peri- and post-menopausal women, might be due to life conditions and events, rather than hormonal changes (nonetheless, the inverse influence should be investigated in future studies). Therefore, these should be accounted for in menopause-related clinical and research settings. [Copyright &y& Elsevier]