Dietary intake and menopausal symptoms in postmenopausal women: a systematic review

Comparison of Metabolic Syndrome (MetS) Risk and Nutritional Status According to Menopause Age and the Impact of Socioeconomic Status on MetS Prevalence in Postmenopausal Women: A Cross-Sectional Study Based on the 8th Korea National Health and Nutrition Examination Survey (KNHANES)

The increased life expectancy and the occurrence of premature menopause prolong the mean postmenopausal phase in women's lifespans. Although the roles of poor socioeconomic status (SES), anthropometric characteristics, and nutritional status in premature menopause and the health of postmenopausal women are well understood, the differences in nutritional status and metabolic syndrome (MetS) prevalence in postmenopausal women depending on their menopause age are less explored. Furthermore, the association between SES and MetS risk in postmenopausal women is not studied. Thus, this study aimed to compare distinct nutritional status and MetS risk between women with premature menopause and natural menopause. Additionally, the association among SES, health-related lifestyle behaviors (HLBs), and MetS risk in postmenopausal women was studied. This study included 31,799 postmenopausal women from the 8th National Health and Nutrition Examination Survey (KNHANES). The relationship between disease prevalence and nutrient intake of the subjects was analyzed using analysis of variance (GLM), and Scheffé test was performed. Multiple logistic regression analysis was used to evaluate the association among SES, HLBs, and MetS as well as premature menopause. Women with premature menopause showed poor SES, anthropometric characteristics, and HLBs compared with women with natural menopause. Additionally, premature menopausal women had markedly lower intakes of protein, polyunsaturated fatty acid, n-3 fatty acid, and β-carotene, but higher intakes of energy, carbohydrate, saturated fatty acid, and sugar than women with natural menopause (p < 0.0001). Premature menopausal women showed significantly higher MetS prevalence by having hypertriglyceridemia (p < 0.0001), hypertension (p = 0.0145), and reduced HDL cholesterol levels (p < 0.0001) relative to natural menopausal women. Furthermore, our findings indicate a substantial link among SES, HLBs, and the risk of premature menopause. In postmenopausal women, deteriorating SES and HLBs appear to influence the prevalence of MetS. Notably, our study reveals that higher intakes of protein, calcium, phosphate, and iron are correlated with a lower risk of developing MetS. These observations suggest that proactive nutritional education for premature menopausal women is necessary to improve MetS risk and their nutritional status. Also, SES-dependent interventions regarding nutrition and HLBs in postmenopausal women will be significant to lower MetS risk, MetS-derived chronic disease, and mortality in postmenopausal women.

Level of adherence to diet and physical activity among menopausal women and influencing factors in Jordan: a descriptive cross-sectional study

Background

During menopause, a woman's lifestyle may change significantly, which will have implications on her quality of life. Women will experience menopause for more than a third of their life; therefore, maintaining good health during this period is crucial. A healthy diet and physical activity can help women maintain their health during menopause. Hence, assessing adherence to a healthy diet and physical activity among menopausal women is important.

Purpose

This study aims to assess the degree of adherence to a healthy diet and physical activity of menopausal women in Jordan and determine the most influential factors.

Methods

A descriptive cross-sectional design was used in this study, and an online self-administered questionnaire was sent to 299 menopausal women selected through simple random sampling. A valid and reliable questionnaire was used to assess the menopausal women's adherence to a healthy diet and physical activity. The questionnaire consisted of 14 items covering two domains: 12 questions for the diet domain and two questions for the physical activity domain. Descriptive statistics were obtained, mean weight and body mass index (BMI) were calculated, and stepwise regression was conducted for the data analysis.

Results

The overall degree of adherence to a healthy diet and physical activity of the women was moderate (49.25, SD = 7.17). Most of the participants reported eating refined food items once a month or less (n = 188, 62.9%) and not exercising weekly (n = 119, 39.8%), and only a few reported eating refined food items at least once a day (n = 5, 1.7%) and exercising 5-6 times a week (n = 15, 5%). The regression analysis showed that age (B = 0.145, p = 0.014), having two children (B = 0.123, p = 0.034) and completing primary or secondary education (B = 0.120, p = 0.038) were statistically significant and the strongest predictors of adherence. The predictors accounted for 68% of the variance in adherence to a healthy diet and physical activity (R2 = 0.068, F [343.54] = 7.123, p = 0.000).

Conclusion

The majority of the middle-aged menopausal women in this study showed moderate adherence to a healthy diet and physical activity. Age, having two children and completing primary or secondary education were associated with degree of adherence to a healthy diet and physical activity. Therefore, healthcare intervention, such as physical activity and dietary control programs, should target women in this age group and stage in life.

Nutritional interventions in treating menopause-related sleep disturbances: a systematic review

CONTEXT

Sleep disturbances are a core symptom of menopause, which refers to the permanent cessation of menstrual periods. Nutritional interventions may alleviate menopause-related sleep disturbances, as studies have shown that certain interventions (eg, tart cherry juice, or tryptophan-rich foods) can improve relevant aspects of sleep.

OBJECTIVE

The aim of this systematic review was to examine the effect of nutritional interventions for menopause-related sleep disturbances, in order to inform the subsequent development of specific interventional trials and assess their potential as a treatment for menopause-related sleep disturbances.

DATA SOURCES

Published studies in English were located by searching PubMed and PsycArticles databases (until September 15, 2022).

DATA EXTRACTION

Following full-text review, a final total of 59 articles were included. The search protocol was performed in accordance with PRISMA guidelines.

DATA ANALYSIS

A total of 37 studies reported that a nutritional intervention improved some aspect of sleep, and 22 studies observed no benefit. Most (n = 24) studies recruited postmenopausal women, 18 recruited menopausal women, 3 recruited perimenopausal women, and 14 recruited women from multiple groups. The majority of the studies were of low methodological quality. Due to the heterogeneity of the studies, a narrative synthesis without meta-analysis is reported.

CONCLUSION

Despite the large heterogeneity in the studies and choice of intervention, the majority of the identified studies reported that a nutritional intervention did benefit sleep, and that it is mainly subjective sleep that is improved. More high-quality, adequately powered, randomized controlled trials of the identified nutritional interventions are necessary.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42021262367.

Exogenous female sex steroid hormones and new-onset asthma in women: a matched case-control study

BACKGROUND

Evidence on the role of exogenous female sex steroid hormones in asthma development in women remains conflicting. We sought to quantify the potential causal role of hormonal contraceptives and menopausal hormone therapy (MHT) in the development of asthma in women.

METHODS

We conducted a matched case-control study based on the West Sweden Asthma Study, nested in a representative cohort of 15,003 women aged 16-75 years, with 8-year follow-up (2008-2016). Data were analyzed using Frequentist and Bayesian conditional logistic regression models.

RESULTS

We included 114 cases and 717 controls. In Frequentist analysis, the odds ratio (OR) for new-onset asthma with ever use of hormonal contraceptives was 2.13 (95% confidence interval [CI] 1.03-4.38). Subgroup analyses showed that the OR increased consistently with older baseline age. The OR for new-onset asthma with ever MHT use among menopausal women was 1.17 (95% CI 0.49-2.82). In Bayesian analysis, the ORs for ever use of hormonal contraceptives and MHT were, respectively, 1.11 (95% posterior interval [PI] 0.79-1.55) and 1.18 (95% PI 0.92-1.52). The respective probability of each OR being larger than 1 was 72.3% and 90.6%.

CONCLUSIONS

Although use of hormonal contraceptives was associated with an increased risk of asthma, this may be explained by selection of women by baseline asthma status, given the upward trend in the effect estimate with older age. This indicates that use of hormonal contraceptives may in fact decrease asthma risk in women. Use of MHT may increase asthma risk in menopausal women.

Changes in Food Consumption in Postmenopausal Women during the COVID-19 Pandemic: A Longitudinal Study

Studying the dietary habits and symptoms of postmenopausal women during situations such as the COVID-19 pandemic is important to mitigate long-term post-pandemic health problems. We compared the menopausal symptoms and food consumption in postmenopausal women before and during the COVID-19 pandemic. A longitudinal survey was conducted on postmenopausal Brazilian women between 2018 and 2021. The Kupperman-Blatt Menopausal Index, Women's Health Questionnaire, and 24 h food recall were used. Of 274 women, 78 (28.5%) participated in the study during the COVID-19 pandemic. The intensity of the symptoms was lower during the pandemic than during the previous period (p < 0.05). Energy and processed food consumption were lower during the pandemic than before (p = 0.003 and p = 0.003, respectively). Milk and plain yogurt consumption were also lower (p = 0.043), while the consumption of sugar-sweetened beverages and sweet foods was higher (p = 0.007 and p = 0.001, respectively) during the pandemic. There was also a decrease in the consumption of proteins and lipids (p = 0.001 and p = 0.004, respectively). In conclusion, we found that postmenopausal women consumed sweet foods and sugar-sweetened beverages in higher quantities and had a lower consumption of milk and plain yogurt and processed foods during the pandemic than during the pre-pandemic period. Furthermore, decreases in energy and macronutrient consumption were observed.

The role of diet in managing menopausal symptoms: A narrative review

Menopause is a natural stage that occurs when women stop menstruating, during which many women experience physical and psychological symptoms that can affect their quality of life and ability to work. Dietary modifications and food supplements may be explored by some women as alternatives to hormone replacement therapy, although existing reviews and expert position statements have given this limited consideration. This narrative review summarises the current evidence for dietary patterns, and botanical and food supplements, in the management of common menopausal symptoms, including vasomotor symptoms (VMS; hot flushes; night sweats), changes in bodyweight and composition, psychological symptoms (depression; anxiety; cognitive changes), sleep disturbances, joint pain, skin changes and urogenital symptoms. Soy isoflavones may reduce the frequency and/or severity of VMS, although results are inconsistent, and it is unclear whether dietary and supplemental sources have comparable effects. Adopting a healthier dietary pattern may support a healthy bodyweight and benefit VMS. However, evidence suggesting dietary patterns may benefit depression, anxiety, and cognition remains largely observational. While some botanicals, such as black cohosh and St John's Wort, have been reported in some studies to alleviate symptoms (such as VMS and depression), these are not currently recommended due to uncertainty about the appropriate dose and preparation, and potential safety concerns. Evidence for other symptoms is currently too limited to draw conclusions. While further trials at different menopausal stages are needed, adopting a healthier dietary pattern in accordance with dietary guidelines is likely to help support women's health before, during and after the menopausal transition.

Chronotype and Sleep Quality in Obesity: How Do They Change After Menopause?

PURPOSE OF REVIEW

This review primarily provides an overview of the current evidence on chronotype (which reflects an individual's preference for the timing of sleeping, eating, and activity in a 24-h period) and sleep quality changes in obesity in postmenopausal women. It also explores possible nutritional strategies to manage these changes in this phase of a woman's life.

RECENT FINDINGS

Menopause is a life stage frequently associated with sleep disturbances and changes in circadian rhythms. Sleep disturbances are one of the main symptoms of menopause and are caused by several factors such as hormonal changes, obesity, and melatonin reduction. In addition, the chronotype also changes following menopause. Nutritional strategies are essential because they could help manage menopausal sleep disturbances and circadian misalignment, particularly by tackling obesity and overweight. In the management of postmenopausal women, especially those experiencing obesity, careful assessment of sleep disturbances and chronotype and subsequent development of the most appropriate treatment, including nutritional management, should be part of the treatment routine.

Behavior Change Techniques in Digital Health Interventions for Midlife Women: Systematic Review

BACKGROUND

Digital health interventions are efficacious in health-promoting behaviors (eg, healthy eating and regular physical activity) that mitigate health risks and menopausal symptoms in midlife. However, integrated evidence-based knowledge about the mechanisms of change in these interventions is unclear.

OBJECTIVE

This systematic review aimed to evaluate studies on behavior change techniques (BCTs) and mechanisms of change in digital health interventions aimed at promoting health-enhancing behaviors in midlife women (aged 40-65 years).

METHODS

A systematic literature search of the electronic databases PubMed, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials in the Cochrane Library was conducted. In total, 2 independent reviewers selected the studies for inclusion, extracted data, and completed BCT mapping of eligible studies. The mechanism of action and intervention functions of eligible studies were evaluated using the behavior change wheel framework. Reporting of psychological theory use within these interventions was explored using the Theory Coding Scheme. Mode of delivery, psychological theory, and BCTs were presented as descriptive statistics.

RESULTS

In total, 13 interventions (including 1315 women) reviewed used 13 (SD 4.30, range 6-21) BCTs per intervention on average. The "Shaping knowledge" and "Repetition and substitution" behavior change categories were used most frequently, with 92% (12/13) of the interventions implementing at least one of the BCTs from these 2 categories. Only 13.98% (169/1209) of the 93 available BCTs were used, with "Instructions on behaviour" most frequently used (12/13, 92%). The behavior change wheel mapping suggests that half of the intervention content aimed to increase "Capability" (49/98, 50% of the intervention strategies), "Motivation" (41/98, 42%), and "Opportunity" (8/98, 8%). "Behavioural Regulation" was the most frequently used mechanism of action (15/98, 15%), followed by increasing "Knowledge" (13/98, 13%) and "Cognitive and Interpersonal skills" (10/98, 10%). A total of 78% (7/9) of the intervention functions were used in the studies to change behavior, primarily through "Enablement" (60/169, 35.5%), whereas no study used "Restriction" or "Modelling" functions. Although 69% (9/13) of the interventions mentioned a psychological theory or model, most (10/13, 77%) stated or suggested rather than demonstrated the use of a theoretical base, and none reported explicit links between all BCTs within the intervention and the targeted theoretical constructs. Technological components were primarily based on web-based (9/13, 69%) modes of delivery, followed by phone or SMS text message (8/13, 62%) and wearables (7/13, 54%).

CONCLUSIONS

The findings of this review indicate an overall weak use of theory, low levels of treatment fidelity, insignificant outcomes, and insufficient description of several interventions to support the assessment of how specific BCTs were activated. Thus, the identified limitations in the current literature provide an opportunity to improve the design of lifestyle health-enhancing interventions for women in midlife.

TRIAL REGISTRATION

PROSPERO CRD42021259246; https://tinyurl.com/4ph74a9u.

Bazedoxifene plus conjugated estrogens improve menopausal symptoms in postmenopausal women: a systematic review and meta-analysis

Our aim is to evaluate the efficacy of bazedoxifene (BZA) plus conjugated estrogens (CE) on menopausal symptoms in postmenopausal women. A series of databases including PubMed, EMBASE, Medline, Web of science, China national knowledge internet and Wanfang database up to 31 October 2021 were searched, and randomized controlled trials (RCTs) of BZA/CE for menopausal symptoms were included. Seven RCTs involving 5431 patients were included in this study. Compared with placebo group, there were significantly reduce in daily number of hot flushes, daily number of moderate or severe hot flushes, the percentages of parabasal cells and the time to fall sleep when patients treated with BZA/CE. Besides, there were significant improvement in sleep disturbance and total MENQOL. However, no significant improvements in sleep adequacy were observed in the three groups. Furthermore, BZA 20 mg/CE 0.625 mg was more effective than BZA 20 mg/CE 0.45 mg in improving the menopausal symptoms. Therefore, both bazedoxifene 20 mg plus conjugated estrogens 0.45 mg and bazedoxifene 20 mg plus conjugated estrogens 0.625 mg could significantly improve the menopause-related symptoms and MENQOL in postmenopausal women, and the curative effects of BZA 20 mg/CE 0.625 mg were better than that of BZA 20 mg/CE 0.45 mg. These findings need to be further confirmed by more high-quality RCTs.

Sociodemographic and Lifestyle Determinants of Adherence to Current Dietary Recommendations and Diet Quality in Middle-Aged Spanish Premenopausal Women

Background

A healthy diet when approaching menopause could prevent some of the symptoms associated with the climacteric. Few studies examine adherence to current healthy dietary recommendations in middle-aged premenopausal women. Our objective was to analyze the diet quality and the adherence to the Spanish Society of Community Nutrition (SENC) dietary recommendations in middle-aged Spanish premenopausal women, and to identify the associated sociodemographic and lifestyle factors.

Methods

This is a cross-sectional study based on 1251 premenopausal women, aged 39–50, who attended to Madrid City Council Medical Diagnostic Center. Women completed an epidemiological and a food frequency questionnaire. Degree of adherence to the SENC recommendations was estimated with a score that evaluated null (0 points) and full (1 point) adherence of each specific recommendation. Associations were explored using an ordinal logistic multivariable regression model.

Results

Regarding food groups, the worst adherence was found for sweets, red/processed meat, olive oil and eggs. Most of the participants exceeded the recommended caloric intake from proteins and fats, and practically all of them showed vitamin D intake deficiency. The overall score ranged from 2 to 12 (out of 15), with a median of 6.0 (interquartile range: 5.0–7.0). Former smokers (OR: 1.38; 95%CI: 1.08–1.78), as well as those with higher educational level (OR_SSecondary:1.68; 95%CI: 0.97–2.93, OR_University:1.82; 95%IC: 1.05–3.14), with two or more children (OR: 1.31; 95%IC: 1.00-1.72), with higher caloric intake (OR_{>2188.2kcal/day}: 8.22; 95%CI: 6.19–10.92) and with greater physical activity (OR_{≥21METS−h/week}: 1.29; 95%CI: 0.95-1.76) showed greater adherence.

Conclusions

Almost two-thirds of middle-aged premenopausal participants showed low or moderate compliance with SENC recommendations. Education, smoking, parity, and physical activity were associated with the degree of adherence to these recommendations.

Mental health and quality of life in postmenopausal women as a function of retrospective menopause symptom severity

OBJECTIVES

Perimenopause is commonly viewed as a window of vulnerability for developing psychiatric and eating disorders, especially for women who experience severe symptoms. However, menopausal symptoms may have a lasting effect on older women's mental health and quality of life (QOL) into postmenopause. The current study examined older (60+) postmenopausal women's mental health and QOL as a function of retrospective menopausal symptom severity.

METHODS

Participants were recruited via public online postings and included 227 postmenopausal women, ages 60 to 94 years old (M = 68.84, SD = 6.53). Participants completed an online questionnaire to assess past menopausal symptoms as well as current depression, anxiety, sleep difficulties, binge eating, QOL, and demographics. The relation between the retrospective severity of menopausal symptoms and mental health/QOL was evaluated using linear regressions, while controlling for demographic covariates.

RESULTS

Retrospective menopause symptom severity was significantly associated with depression, sleep difficulties, binge eating severity, and most QOL measures. Regarding covariates, having a psychiatric history was significantly associated with all outcome variables, except for anxiety. Time since menopause and body mass index were significantly associated with binge eating severity. Regarding specific symptom subgroups, psychological and somato-vegetative symptoms were most associated with mental health and QOL.

CONCLUSION

The menopausal transition is a significant change in a woman's life and the challenges of menopausal symptoms can have lasting impacts on women's health. It is imperative that future research seeks to further understand the lasting impacts of this transition on the lives of older women to ensure proper interventions are implemented for successful aging.

Life habits of postmenopausal women: Association of menopause symptom intensity and food consumption by degree of food processing

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.

Whole-diet interventions and cardiovascular risk factors in postmenopausal women: A systematic review of controlled clinical trials

OBJECTIVES

Menopause is accompanied by many metabolic changes, increasing the risk of cardiometabolic diseases. The impact of diet, as a modifiable lifestyle factor, on cardiovascular health in general populations has been well established. The purpose of this systematic review is to summarize the evidence on the effects of whole diet on lipid profile, glycemic indices, and blood pressure in postmenopausal women.

METHODS

Embase, Medline, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from inception to February 2021. We included controlled clinical trials in postmenopausal women that assessed the effect of a whole-diet intervention on lipid profile, glycemic indices, and/or blood pressure. The risk of bias in individual studies was assessed using RoB 2 and ROBINS-I tools.

SUMMARY OF EVIDENCE

Among 2,134 references, 21 trials met all eligibility criteria. Overall, results were heterogenuous and inconsistent. Compared to control diets, some studies showed that participants experienced improvements in total cholesterol (TC), low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), fasting blood sugar (FBS), and apolipoprotein A (Apo-A) after following fat-modified diets, but some adverse effects on triglycerides (TG), very low-density lipoprotein cholesterol (VLDL), lipoprotein(a) (Lp(a)), and high-density lipoprotein cholesterol (HDL) concentrations were also observed. A limited number of trials found some effects of the Paleolithic, weight-loss, plant-based, or energy-restricted diets, or of following American Heart Association recommendations on TG, TC, HDL, insulin, FBS, or insulin resistance.

CONCLUSION

Current evidence suggests that diet may affect levels of some lipid profile markers, glycemic indices, and blood pressure among postmenopausal women. However, due to the large heterogeneity in intervention diets, comparison groups, intervention durations, and population characteristics, findings are inconclusive. Further well-designed clinical trials are needed on dietary interventions to reduce cardiovascular risk in postmenopausal women.

Association of dietary patterns, number of daily meals and anthropometric measures in women in age of menopause

OBJECTIVE

To investigate the association of dietary patterns, number of daily meals and anthropometric measures among women in age of menopause.

METHODS

This was a transversal study with 320 women over 50 years old from Caxias do Sul, Brazil. The outcomes were body mass index (BMI) and waist circumference (WC). Multiple linear regression was performed.

RESULTS

Three dietary patterns: regional, fruits and vegetables, and common Brazilian was identified by Principal Component Analysis. After adjustment, higher adoption of the regional dietary pattern was associated with increased BMI (β = 0.56 [CI95% = 0.03-1.08], p = 0.037) and WC (β = 1.28 [CI95% = 0.17-2,55], p = 0.047). The highest number of meals per day (>=5/day) was associated with reduced BMI (β = -1.18 [CI95% = -2.30 to -0.05], p = 0.041) and WC (β = -2.77 [CI95% = -5.41 to -0.13], p = 0.039), and a mid-afternoon snack BMI (β = -2.16 [CI95% = -3.66 to -0.65], p = 0.005) and WC (β = -5.76 [CI95% = -9.29 to -2.23], p = 0,001). The regional dietary pattern was inversely associated with have five or more meals per day (β = -0.51 [CI95% = -0.84 to -0.18], p = 0.002) and have a mid-afternoon snack (β = -0.63 [CI95% = -1.07 to -0.18], p = 0.006). The fruit and vegetables dietary pattern was positively associated with have five or more meals per day (β = 0.35 [CI95% = 0.02-0.69], p = 0.034).

CONCLUSION

The regional dietary pattern has resulted in higher BMI and WC measures and contributes to decreased meals per day, behavior associated with higher anthropometric measures.

Review of menopausal palpitations measures

Palpitations are reported commonly by women around the time of menopause as skipped, missed, irregular, and/or exaggerated heartbeats or heart pounding. However, much less is known about palpitations than other menopausal symptoms such as vasomotor symptoms. The objective of this review was to integrate evidence on menopausal palpitations measures. Keyword searching was done in PubMed, CINAHL, and PsycINFO for English-language, descriptive articles containing data on menopause and palpitations and meeting other pre-specified inclusion criteria. Of 670 articles, 110 met inclusion criteria and were included in the review. Results showed that 11 different measures were used across articles, with variability within and between measures. Inconsistencies in the wording of measurement items, recall periods, and response options were observed even when standardized measures were used. Most measures were limited to assessing symptom presence and severity. Findings suggest that efforts should be undertaken to (1) standardize conceptual and operational definitions of menopausal palpitations and (2) develop a patient-friendly, conceptually clear, psychometrically sound measure of menopausal palpitations.