Kerry L. Hildreth
Increased frequency and severity of menopausal symptoms are associated with vascular dysfunction and lower quality of life during menopausal transition, according to findings published in Menopause.
Kerry L. Hildreth, MD, assistant professor for the University of Colorado School of Medicine’s division of geriatrics, and colleagues analyzed data from 138 women aged 19 to 70 years. Participants were stratified by menopausal stage: premenopausal, early or late perimenopausal, or early or late postmenopausal. Participants classified as premenopausal (n = 41) had regular menstrual cycles (21-35 days) with no change in cycle length and were aged 19 to 49 years. Generally, women aged 43 to 56 years were identified as perimenopausal if irregular cycles were observed. Of that group, participants were further classified as early perimenopausal (n = 25), defined as experiencing at least two menstrual cycles with cycle length changes of at least 7 days, and late perimenopausal (n = 26), defined as experiencing an absence of menstruation or amenorrhea for at least 2 months. Postmenopausal women presented with at least 12 months of amenorrhea and were aged 50 to 70 years. This group was also further categorized as early postmenopausal (n = 22) if the participant did not experience a menstrual cycle for up to 6 years and late postmenopausal (n = 24) if amenorrhea persisted for more than 6 years.
Researchers measured arterial stiffening and endothelial function using ultrasound imaging to determine carotid artery compliance and brachial artery flow-mediated dilation (FMD). Using the Menopausal Symptoms List (MSL), Hildreth and colleagues assessed menopausal symptoms in participants during a 3-month period. Specifically, MSL was used to evaluate the frequency and severity of eight psychological, nine vasosomatic and 10 general somatic symptoms. Depression was measured using the 20-item Center for Epidemiologic Studies Depression (CES-D) scale to assess frequency of depressive symptoms on a weekly basis. The Utian Quality of Life Scale (UQOL) was implemented to assess quality of life, monthly, by focusing on occupational, health, emotional and sexual subsets. To determine differences across the menopausal stages, Hildreth and colleagues used a one-way analysis of variance. To identify associations between vascular measures and MSL, CES-D and UQOL, Pearson’s correlation analysis was used.
While particularly prevalent in perimenopausal women, participants across all menopausal stages experienced worsened menopausal and depressive symptoms and impaired quality of life, according to the researchers. Researchers determined that carotid artery compliance and FMD (P < .05 for all) were inversely correlated with frequency and severity of vasomotor and general somatic symptoms, such as hot flashes. Similarly, there was a positive correlation between quality of life and carotid artery compliance (P = .01). The data did not show a correlation between carotid artery compliance or FMD with CES-D scores.
Researchers found that although frequency and severity of menopausal symptoms and a lower quality of life were associated with vascular dysfunction, depressive symptoms were not. Hildreth and colleagues recommended further study of the factors underlying these associations, such as inflammation or oxidative stress.
“The results suggest that the menopausal transition is a critical time for women’s health and highlight the connections between cardiovascular and mental health,” Hildreth told Endocrine Today. “We can’t make any conclusions about causation, but findings might encourage clinicians to pay closer attention to and routinely ask women nearing and in the perimenopausal and early postmenopausal years about physical, mental and emotional symptoms, in addition to addressing traditional cardiovascular risk factors, such as blood pressure, cholesterol, blood glucose and obesity.”
Disclosures: Hildreth reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.