The impact of menopause on health-related quality of life: results from the STRIDE longitudinal study (original) (raw)

Impact of hormone therapy on quality of life after menopause

Menopause, 2013

Objective: Given the complexity of the literature on quality of life (QOL) and hormone therapy (HT) among women in the menopausal transition and postmenopause, the purposes of this integrative review were to (1) define QOL as a multidimensional construct; (2) review validated instruments for measurement of QOL; (3) review results of HT and QOL clinical trials that have used validated instruments; and (4) assess the effectiveness of HT on QOL, including health-related QOL (HRQOL), menopause-specific QOL (MSQOL), and global QOL (GQOL). Methods: The literature on HT and QOL was searched for definitions of QOL and validated instruments for measuring QOL, and the results were summarized. The purposes of this integrative review were to evaluate the effects of HT on HRQOL, differentiating the effects of HT on GQOL, HRQOL, and MSQOL. As a basis for this review, we searched for published controlled clinical trials in which the effects of HT on QOL were studied using validated QOL instruments, in particular menopause-specific validated instruments. Results: Clear definitions are elucidated. Validated instruments for the measurements of HRQOL, GQOL, and MSQOL are summarized, and the necessity of their incorporation into future research and clinical practice is emphasized. The published effects on QOL of estrogens and progestogens administered to symptomatic and nonsymptomatic women in the menopausal transition and beyond are reviewed. Conclusions: The impact of various health stateYrelated symptoms on HRQOL and GQOL is now an integral component of contemporary health care. Effects of HT include GQOL and HRQOL and should be menopausespecific. There is clearly a need for further studies on menopause and menopause-related therapies using appropriate and validated instruments. Literature review shows that HT provides a significant benefit for MSQOL in midlife women, mainly through relief of symptoms, but treatment also may result in a global increase in sense of well-being (GQOL). HRQOL benefits are contingent on symptom status, as are MSQOL outcomes. Women who are severely symptomatic experience a significant improvement in HRQOL and MSQOL, although this improvement is not significant among women without severe symptoms at baseline measures in clinical trials.

Quality of life (QOL) in menopause

Maturitas, 2007

Quality of life (QOL) is generally not precisely defined or measured. This has resulted in confusing and often misleading conclusions in multiple publications, including those coming from both the HERS and the WHI writing groups. Health-related QOL and global QOL are accurately defined, and current instruments for measuring them are available. In the continuing effort to determine the true risks and benefits of postmenopausal hormone usage, it is critical that the full spectrum of effects be measured. There is no excuse for future studies on hormone use not to include well-validated instruments for measuring QOL and for not reporting those effects as part of the rest of the study. Questionnaire instruments can often provide more information than many of the invasive tests that are part of contemporary trials. They also add little cost, yet can be invaluable in the analysis of real cost-effectiveness of interventions in contemporary women's health care. Beyond safety and efficacy evaluation of drug therapies, there is an absolute need to know about the real impact of these therapies on overall quality of life.

A menopause-specific quality of life questionnaire: development and psychometric properties

Maturitas, 1996

Objective: to develop a condition-specific quality of life questionnaire for the menopause with documented psychometric properties, based on women's experience. Methods: Subjects: Women 2-7 years post-menopause with a uterus and not currently on hormone replacement therapy. Questionnaire development: A list of 106 menopause symptoms was reduced using the importance score method. Replies to the item-reduction questionnaire from 88 women resulted in a 30-item questionnaire with four domains, vasomotor, physical, psychosocial and sexual, and a global quality of life question. Psychometric properties: A separate sample of 20 women was used to determine face validity, and a panel of experts was used to confirm content validity. Reliability, responsiveness and construct validity were determined within the context of a randomized controlled trial. Construct validation involved comparison with the Neugarten and Kraines' Somatic, Psychosomatic and Psychologic subscales, the reported intensity of hot flushes, the General Well-Being Schedule, Channon and Ballinger's Vaginal Symptoms Score and Libido Index, and the Life Satisfaction Index. Results: The face validity score was 4.7 out of a possible 5. Content validity was confirmed. Test-retest reliability measures, using intraclass correlation coefficients were 0.81, 0.79, 0.70 and 0.55 for the physical, psychosocial, sexual domains and the quality of life question. The intraclass correlation coefficient for the vasomotor domain was 0.37 but there is evidence of systematic change. Discriminative construct validity showed correlation coefficients of 0.69 for the physical domain, 0.66 and 0.40 for the vasomotor domain, 0.65 and -0.71 for the psychosocial domain, 0.48 and 0.38 for the sexual domain, and 0.57 for the quality of life question. Evaluative construct validity showed correlation coefficients of 0.60 for the physical domain, 0.28 fgr the vasomotor domain, 0.55 and -0.54 for the psychosocial domain, 0.54 and 0.32 for the sexual domain, and 0.12 for the quality of life question. Responsiveness scores ranged from 0.78 to 1.34. Conclusions: The MENQOL (Menopause-Specific Quality of Life) questionnaire is a self-administered instrument which functions well in differentiating between women according to their quality of life and in measuring changes in their quality of life.

Literature review of instruments to assess health-related quality of life during and after menopause

Quality of Life Research, 2005

Background and objectives: Menopause is a physiological event occurring in women at about the age of 50. It signals the end of the reproductive years and is associated with signs of estrogen deficiency having a considerable impact on women’s health-related quality of life (HRQoL). The most common form of treatment is hormone replacement therapy (HRT). Studies have shown negative events can arise from long-term use of HRT. The aim of this review is to determine if there are any HRQoL instruments that address the impact of menopausal symptoms including positive and negative effects of HRT. Methods: The following eight instruments were identified: Greene Climacteric Scale, Women’s Health Questionnaire (WHQ), Qualifemme, Menopause-Specific QOL Questionnaire (MENQOL), Menopausal Symptoms List (MSL), Menopause Rating Scale (MRS), Menopausal Quality of Life Scale (MQOL), and the Utian Quality of Life Scale (UQOL). Results: All instruments reviewed proved to be reasonably structured and have their place in applied research. None were found that addressed all aspects of the impact of HRT on HRQoL. Conclusion: In order to capture the possible short-term side effects of HRT on HRQoL, it is necessary to modify one or more of the existing instruments or develop a new instrument applicable in many different countries and languages.

Predictive and criterion validity of the Cervantes-SF menopause quality of life questionnaire

Menopause, 2021

Objectives:To determine the predictive and criterion-based validity of the Cervantes-SF scale that measures the impact of menopause on Health-Related Quality of Life.Methods:We recruited a noninstitutionalized sample of peri/postmenopausal women aged 40 to 65 years, who had their last menstrual cycle 12+ months prior to inclusion in the study of the psychometric validity of the Cervantes-SF scale. Predictive validity of the scale was confirmed for various health outcome measures administered concomitantly (years of disability-free life expectancy, work productivity and impact on daily activities, economic impact arising from loss of work productivity, hours of undisturbed sleep each day, and the utilization of healthcare facilities), whilst criterion validity was determined by the likelihood of identifying a moderate-to-severe vasomotor or genital syndrome requiring specific treatment.Results:A sample of 308 peri/postmenopausal women with a mean age of 55.7 years (SD: 5.3 y) was ana...

Assessing menopausal symptoms among healthy middle aged women with the Menopause Rating Scale

Background: The frequency and intensity of menopausal symptoms within a given population, as assessed by several tools, vary and depend on several factors among them age, menopausal status, chronic conditions and socio-demographic profile. Objective: Determine the frequency and intensity of menopausal symptoms as well as associated risk factors among healthy middle aged Ecuadorian women. Design: In this cross-sectional study healthy women aged 40 or more, with intact uterus and ovaries, working at the Luis Vernaza Hospital, Guayaquil, Ecuador, were asked to fill out the Menopause Rating Scale (MRS) questionnaire. Symptom frequency and intensity, as well as obtained scores, were assessed and correlated to demographic data. Results: During the study period, 300 subjects were surveyed. Mean age was 45.1 ± 3.1 years (median 45). According to menopausal status women were premenopausal (40.6%); perimenopausal (48%) and postmenopausal (11.4%). A 62% of women were not sexually active and 8.3% had less than 12 years of schooling. The 5 most frequent symptoms of the 11 composing the MRS (n = 300) were: muscle and joint problems (77%), depressive mood (74.6%), sexual problems (69.6%), hot flushes (65.5%) and sleeping disorders (45.6%). In general, peri-and postmenopausal women significantly presented higher rates of menopausal symptoms when compared to premenopausal women. Total and subscale MRS scores significantly increased in relation to age and the menopausal stage. Women with lower educational level presented higher somatic and psychological scorings in comparison to their counterparts. Sexually inactive women presented higher total as well as somatic, psychological and urogenital scorings. Logistic regression analysis confirmed significant associations found during univariate analysis. Conclusion: In this specific healthy population, age, the menopause, sexual inactivity and educational level were independent risk factors predicting more severe menopausal symptoms.

Quality of Life Among of Menopausal Women

Journal of Biology Agriculture and Healthcare, 2014

Background: The transition through menopause is a life event that can profoundly affect quality of life. More than 80% of women report physical and psychological symptoms that commonly accompany menopause, with varying degrees of severity and life disruption. Studies find that most women experience at least one or more of these symptoms as they transition through the postmenopausal stage of life. The aim of this study was to assess the menopause related symptoms and their impact on the women's quality of life. Subjects and methods: A descriptive design was carried out in Obstetrics and Gynecological department at maternity and children hospital in Makkah Al Mukkarrmah.. Convenient sample composed of 90 women at range of from 40-60years were recruited in the study. Interviewing sheet that was designed by the investigators and Menopause Specific Quality of Life Questionnaire (MENQOL) were used to collect the data. Results: The present study showed that the most severe symptoms in vasomotor, psychosocial, physical and sexual domains were, hot flushes (29%), experiencing poor memory (48.3%), being dissatisfied with their personal life (44.8%), Low backache (41.9%), and change in your sexual desire (36.8%). The overall scores of menopausal quality of life for each MENQOL domain are indicated that the highest mean score in sexual domain (3.19± 1.99), following by psychosocial (2.94± 1.45) then vasomotor (2.55± 1.53) and finally physical symptoms (2.28± .749). Conclusion: The present study concluded that most severe symptoms in vasomotor, psychosocial, physical and sexual domains were, hot flushes, experiencing poor memory, being dissatisfied with their personal life, low backache, and change in your sexual desire. The mean scores of physical and vasomotor domain were significantly more in postmenopausal (PM) group then menopausal transition MT group. While the mean scores of each domain suggest that menopausal symptoms were associated with decrease in women quality of life. The current study recommended that: Health care providers need to play a more visible and instrumental role in continuously assessing menopausal women's needs as well as implement appropriate health educational programs. Also further research addressing women's health needs is also essential for improving the quality of life of menopausal women in Saudi Arabia

Menopausal symptoms: do life events predict severity of symptoms in peri- and post-menopause?

Maturitas, 2012

V RESUMO A menopausa tem sido genericamente definida como um fenómeno bio-médico, tendo como consequência a emergência de sintomas físicos e psicológicos decorrentes da diminuição de estrogénios endógenos. O presente trabalho pretende alargar esta conceptualização da menopausa, contextualizando-a no modelo bio-psico-sóciocultural, explorando se variáveis pessoais (como a espiritualidade) e contextuais (por exemplo, acontecimentos de vida) podem predizer sintomas reconhecidos como de menopausa. É ainda objectivo deste estudo explorar que variáveis estão associadas ao aumento de peso na transição para a menopausa e na pós-menopausa, e se uma intervenção breve cognitivo-comportamental pode promover a diminuição de peso em mulheres com obesidade e excesso de peso. Finalmente, pretende-se construir um modelo causal de bem-estar subjectivo na meiaidade. Uma amostra comunitária constituída por 1.003 mulheres com idades compreendidas entre os 42 e os 60 anos, recolhida maioritariamente através de estabelecimentos de ensino na área de Lisboa, preencheu um questionário para recolha de informação sóciodemográfica, relacionada com saúde, menopausa e estilo de vida. As participantes responderam ainda a instrumentos validados para averiguar o bem-estar subjectivo, depressão, ansiedade e stress, sintomas de menopausa, percepção de controlo sobre os afrontamentos, espiritualidade, acontecimento de vida e preocupações com a forma corporal. Desta amostra, 17 mulheres com excesso de peso ou obesidade participaram numa intervenção cognitivo-comportamental individual para a perda de peso. Antes da intervenção, imediatamente após e quatro meses depois do seu término, as participantes foram avaliadas em relação a medidas antropométricas, psicológicas e de comportamento alimentar. Os resultados mostram que, tanto os acontecimentos de vida, como a espiritualidade, predizem de forma significativa a gravidade dos sintomas de menopausa. Além destes, também variáveis de estilo de vida, sócio-demográficas e relacionadas com o estado de saúde associam-se de forma significativa a estes sintomas. Dos doze grupos de sintomas de menopausa averiguados (psicológicos e físicos), apenas três são preditos pelo estado de menopausa. Assim, sintomas vasomotores, sexuais e alterações na pele e nos pêlos faciais são os únicos sintomas que parecem decorrer das alterações hormonais. Observou-se ainda que mulheres com uma escolaridade mais baixa, com uma prática de exercício físico mais reduzida, com um problema psicológico auto-relatado, mais preocupadas com a forma corporal e em pós-menopausa apresentavam um ganho de peso maior. A perda de peso após a intervenção mostrou-se estatisticamente significativa, comparando o peso antes da intervenção e quatro meses após a mesma, ficando contudo abaixo dos 5% do peso corporal. Verificou-se ainda que o bem-estar subjectivo na meia-idade é predito pelo humor deprimido, presença de um problema psicológico, espiritualidade, stress, acontecimentos de vida e ainda consumo de café. Esta investigação permite concluir que a maior parte dos sintomas identificados como decorrentes da menopausa são, nesta amostra, determinados por factores não hormonais, VI sendo a única sintomatologia consequente do estado de menopausa os sintomas sexuais, vasomotores e alterações na pele/pêlos faciais. Tal contribui para uma compreensão da menopausa para além da abordagem medicalizada que tem vigorado na literatura. Adicionalmente, são identificados factores de vulnerabilidade em relação ao aumento de peso e bem-estar na meia-idade, que permitem potenciar mudanças neste âmbito.