Does menopausal transition affect the quality of life? A longitudinal study of middle-aged women in Kinmen

A cross-sectional study of symptoms and health-related quality of life in menopausal-aged women in China

OBJECTIVE

To measure symptoms and health-related quality of life in a cross-sectional cohort of menopausal-aged women in China.

METHOD

A cross-sectional survey was conducted in a general population cohort of 2,000 Chinese females over the age of 45 years. Patients completed the Chinese version of the EuroQol-5D five level (EQ5D5L) health-related quality of life instrument via Personal Digital Assistant. Raw scores were converted to utility tariffs using value sets for China. Statistical analysis included Pearson's chi-square test, z test for multiple comparisons with adjustment by the Bonferroni method, independent-sample t-test, ANOVA, and adjustment by the Tukey method for multiple comparison. Results were considered statistically significant when p < 0.05 and the study was reported according to the STROBE recommendations.

RESULTS

In a cohort of 2000 women, 732 (37%) were premenopausal, 798 (40%) were perimenopausal and 470 (23%) were postmenopausal. Perimenopausal women reported significantly more symptoms (91%) compared to premenopausal (77%) and postmenopausal (81%) women. Health-related quality of life was significantly lower in symptomatic perimenopausal women compared to premenopausal (0.919, p < 0.05) and postmenopausal (0.877, p < 0.05) women. Within each group there was a statistically significant difference between the health-related quality of life of women with symptoms compared to without symptoms.

CONCLUSION

The perimenopausal phase of menopause is associated with significantly more symptoms and significantly lower HRQoL compared to premenopausal and postmenopausal phases.

The Czech version of the Utian Quality of Life Scale questionnaire assessing women's quality of life during menopause

Introduction

Menopause is a physiological process, forming a part of a lifetime that most women go through. This period of life is briefly described by experts as a triple transformation: biological, social, and psychological. For menopausal women, health care professionals can use one of 10 specific questionnaires to assess health-related quality of life and its symptoms. The authors herein speak about the preparation of a Czech version of one such questionnaire – the Utian Quality of Life Scale (UQOL).

Material and methods

A Czech version of the UQOL was created by repeated and backward translation. It was validated on a sample of 204 women after natural menopause (45–65 years old). We judged the reliability of the Czech version of UQOL using Cronbach’s a. We assessed the instrument’s validity by means of confirmation factor analysis.

Results

The authors modified the original version of the UQOL. The Czech version has 4 new domains with 18 items. This form was created using the results of confirmation factor analysis.

Conclusions

The Utian Quality of Life Scale questionnaire is completed by the women themselves, thus meeting the golden rule of all quality-of-life research stating that the primary source should be data from the client him/herself. However, this requirement raises some methodological problems.

Menopause-Specific Quality of Life of Rural Women

Background:

Menopause is a natural process, but it causes hormonal and biological changes in the body, which can result in drastic effects on quality of life (QOL) of women.

Objective:

The study was conducted to assess the menopause-specific QOL (MENQOL) of rural women.

Subjects and Methods:

A descriptive cross-sectional design was used to assess MENQOL of rural women of the selected villages of Punjab. A total of 150 menopausal women were selected using simple random sampling technique. The MENQOL questionnaire was administered to assess the QOL in relation to menopausal symptoms.

Results:

The mean score of overall QOL was 3.4274 ± 0.99, which revealed a moderate impact of menopausal symptoms on the QOL. Stepwise linear regression revealed the significant impact of 16 out of 29 menopausal symptoms on QOL. Furthermore, MENQOL was found to be significantly associated with education, marital status, and sleep pattern of women.

Conclusions:

There is a significant effect of menopausal symptoms on QOL of women which emphasizes the need to create awareness among menopausal women regarding menopausal symptoms and management to improve their QOL.

The psychometric properties of the Persian menopause rating scale

Background

To measure the severity of menopausal complaints and determine the pattern of menopausal symptoms, a valid and reliable instrument is needed in women’s healthcare. The Menopause Rating Scale (MRS) is one of the best-known tools in response to the lack of standardized scales. The purpose of this study was to examine the psychometric properties of the MRS in an Iranian example.

Methods

Participants were randomly selected from women referred to healthcare centers in Miandoab, West Azerbaijan, Iran. A total of 330 questionnaires were completed (response rate of 96.9%). Two samples were considered for analysis in the validation process. An exploratory factor analysis (EFA) was conducted on the first sample (n₁ = 165), and a confirmatory factor analysis (CFA) was done using a second study sample (n₂ = 165). The psychometric properties process was concluded with assessment of internal consistency and test-retest reliability.

Results

The EFA with Principal Component Analysis extracted three factors explaining 75.47% cumulative variance. The CFA confirmed a three-factor structure of the 11-items MRS. All fit indices proved to be satisfactory. The relative chi-square (χ2/df) was 3.686 (p < .001). The Root Mean Square Error of Approximation (RMSEA) of the model was .04 (90% CI = .105–.150). All comparative indices of the model, including the Comparative Fit Index, Normed Fit Index, and Relative Fit Index, were more than .80 (.90, .87, and .80, respectively). For the overall scale, Cronbach’s alpha was .931, whereas the alpha for the subscales ranged from 0.705–0.950. The intraclass correlation was .91 (95% CI = .89–.93), p < 0.001.

Conclusion

The results of the study indicate that the Persian model of the MRS is a valid and reliable scale. As a screening tool, the Persian MRS could be used to identify the pattern of symptoms among menopausal, premenopausal, and postmenopausal women to care for and educate them on how to identify and treat the symptoms.

Health-related quality of life and its influencing factors in Chinese with knee osteoarthritis

PURPOSE

To evaluate the health-related quality of life (HRQoL) of knee osteoarthritis (KOA) patients in China, compare their HRQoL with norm population, and examine the associations between the potential influencing factors and HRQoL.

METHODS

A cross-sectional study was conducted in 912 KOA patients from 4 provinces between March and November 2017. All participants were diagnosed according to the National Institute for Health and Care Excellence (NICE)'s criterion or the Chinese Medical Association (CMA)'s criterion. Recruited patients were surveyed for HRQoL using the 12-item Short Form (SF-12) and sociodemographic, disease-related factors. We assessed the associations between potential influencing factors and HRQoL using multiple linear regression models.

RESULTS

Among the KOA patients, the mean physical component summary (PCS) of HRQoL was 40.91 ± 11.62, lower than norm (P < 0.001). And the mean mental component summary (MCS) was 50.25 ± 11.99, similar to the norm. Patients who were older (β = - 0.155, P = 0.001), women (β =  - 4.589, P < 0.001), had ever been treated (β =  - 2.426, P = 0.006), had longer course of KOA (β =  - 0.164, P = 0.012), and were in early stage (β =  - 2.968, P = 0.001) or progressive/late stage (β =  - 7.636, P < 0.001) showed lower scores of PCS. Patients who lived in Hunan (β = 4.988, P < 0.001) and had education levels of junior high school (β = 3.134, P = 0.012) or senior high school and above (β = 3.050, P = 0.010) had better mental status. Those suffered from non-knee pains (β =  - 2.308, P = 0.027) and with progressive or late KOA (β =  - 4.690, P = 0.016) had lower MCS scores.

CONCLUSION

KOA patients had worse physical condition. The mental and physical health of patients were affected by different factors. Targeted management measures should be taken to improve their HRQoL.

Quality of Life among Iranian Postmenopausal Women: A Systematic Review and Meta-Analysis

Menopause can cause mental, physical, vasomotor, and sexual symptoms and problems, which negatively affect the quality of life (QOL). The aim of this study was to systematically evaluate QOL among Iranian postmenopausal women. This systematic review was conducted on cross-sectional studies that were published between 2000 and 2018. An online search to find studies published in English or Persian was conducted in the databases of Web of Science, PubMed, ScienceDirect, Scopus, Google Scholar, Scientific Information Database, Magiran, and IranMedex. Search key terms were "quality of life", "menopause", and "Iran". Fourteen studies were eligible for this study. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used for quality appraisal. The mean and standard deviation of QOL and its domains were extracted from the selected studies. Study data were analyzed using the Review Manager (v. 5.0) and the STATA (v. 12.0) software. The mean of total QOL among 3413 postmenopausal women was 57.89±12.8 (in the possible range of 0–174). The means of its vasomotor, psychosocial, physical, and sexual domains were 7.86±2.14, 19.43±2.05, 40.58±3.33, and 6.71±1.77, respectively. The QOL among Iranian postmenopausal women is nearly higher than the moderate level. The lowest and the highest levels of QOL are related to the physical and sexual domains, respectively. Health authorities need to develop educational interventions to promote postmenopausal women’s QOL, particularly in the physical domain.

Midlife Predictors of Health-Related Quality of Life in Older Women

Background

Midlife represents an important time to evaluate health status and health behaviors that may affect health-related quality of life (HRQL) in later years. This study examines change in women's HRQL over 11 years from ages 47-59 to 57-69 and identifies midlife characteristics that predict HRQL at older ages.

Methods

Physical (PCS) and mental component summaries (MCS) of the SF-36 were used to assess HRQL from 2002 to 2013 in 2,614 women from the Study of Women's Health Across the Nation (SWAN), a multiethnic/racial cohort study. We used locally weighted scatterplot smoothing (LOESS) models to obtain unadjusted predicted mean trajectories of PCS and MCS as a function of age.

Results

LOESS predicted PCS declined from 51.6 to 47.1, whereas MCS increased from 49.2 to 53.1. In multivariable models, controlling for baseline PCS, higher baseline physical activity (p = .002) and increase in physical activity from baseline (p < .0001) predicted better PCS. Time since baseline (ie, aging; p < .001), higher baseline body mass index (p < .0001), increased body mass index over time (p < .0001), smoking (p < .05), two or more medical conditions (p < .0001), sleep problems (p < .0001), and urinary incontinence (p < .0001) were related to lower PCS. Early (p = .004) and late postmenopause (p = .001; vs. premenopause) and aging (p = .05) predicted higher MCS. Predictors of lower MCS were less than very good health (p < .0001), sleep problems (p < .0001), stressful life events (p < .0001), higher perceived stress (p < .0001), and higher trait anxiety (p = .004). Race/ethnicity was related to MCS, but not PCS.

Conclusions

Several potentially modifiable midlife factors, such as improved sleep hygiene, physical activity, and body mass index, might improve HRQL for older women.

Relationships between body image, sexual dysfunction, and health-related quality of life among middle-aged women: A cross-sectional study

OBJECTIVES

To examine whether body image, sexual function, and relationship with a partner influence health-related quality of life (HRQoL) among middle-aged women, as well as to identify the association with menopausal symptoms.

MAIN OUTCOME MEASURES

Physical component summary and mental component summary of HRQoL.

METHODS

This was an analysis of 1026 women (2013-2014); data regarding demographic characteristics, sexual function, body image, relationship with partner, menopausal symptoms and HRQoL during middle age were collected. HRQoL, sexual function, body image, relationship with partner, and menopausal symptoms were measured using the Medical Outcomes Study SF-12, Female Sexual Function Index (FSFI), Multidimensional Body-Self Relations Questionnaire-Appearance Scale, the Relationship Assessment Scale, and the Greene Climacteric Scale, respectively. A multivariate regression was used to examine factors influencing HRQoL.

RESULTS

After adjusting for covariates, significant factors predicting the physical component summary (PCS) of HRQoL among middle-aged women included the orgasm domain of the FSFI (β = 0.69; p =  0.023), appearance evaluation (β = 0.93; p =  0.037), and menopausal symptoms (β = -0.25; p <  0.001). The factors predicting the mental component summary (MCS) of HRQoL included the satisfaction domain of the FSFI (β = 0.70; p =  0.014), appearance evaluation (β = 2.09; p < 0.001), self-classified weight (β = 1.21; p <  0.001), relationship with partner (β = 0.16; p =  0.034), and menopausal symptoms (β = -0.36; p <  0.001).

CONCLUSION

The results indicated that negative appearance evaluation and menopausal symptoms predicted poor HRQoL among middle-aged women. Higher frequency of orgasm predicted better PCS; sexual satisfaction and satisfaction with relationship with a partner predicted better MCS of HRQoL.

Depression and Quality of Life among Postmenopausal Women in Bangladesh: A Cross-sectional Study

OBJECTIVES

The aims of the research are to examine the problems of abnormal menopausal women: the relationship between depression and menopausal-specific quality of life (MENQOL)-symptoms among postmenopausal women; the association of MENQOL-symptoms between pre- and postmenopausal female society in Bangladeshi real community.

METHODS

This cross sectional study was conducted on 435 women of Tangail, aged (≥ 17) years, using a structured questionnaire where is inaacluded the information of MENQOL and one of the main outcomes "depression" is measured by beck depression inventory.

RESULTS

Menopausal status and MENQOL symptoms (except pain) are significantly (P < 0.05) associated. By using post-hoc analysis, the proportion of menopausal women, classified as having a depressive mood of early menopause is significantly higher than natural-menopause. Among postmenopausal women, there is a significant correlation between "concentration problem" and "depression". Here mean depression score (29.40 ± 6.42) of menopausal women who have any difficulty in concentrating is higher than mean depression score (20.89 ± 6.64) of menopausal women who have no difficulty in concentrating. Another six factors (osteoporosis, heart-beating, fatigue, pressure, tingling, headaches) of MENQOL-symptoms were significantly correlated with depression and P-values are 0.000, 0.000, 0.000, 0.033, 0.006, and 0.002, respectively. Finally the presence of "difficulty in concentrating" and "fatigue" are strongly associated factors with depression score (P < 0.001).

CONCLUSIONS

The early postmenopausal women have to face more psychological problems (e.g., depression) compare to others. Among postmenopausal women, there is no significant relation between depression and vasomotor symptom (e.g., hot-flashes) perspective to menopausal female society of Bangladesh.

Health-Related Quality of Life During the Menopausal Transition: Testing a Theoretical Model

The purpose of this study was to test the hypothetical model of health-related quality of life (HRQOL) during the menopausal transition. The model was developed to test specific components of the Wilson and Cleary's model for HRQOL. A cross-sectional, correlational study was carried out using self-report questionnaires on a convenience sample of 162 Korean women in the menopausal transition. The model was tested by a path analysis using Analysis of Moment Structure (AMOS) program. The path analysis showed that 5 affecting variables explained 69% of the variance in HRQOL during the menopausal transition. Based on the results, the Wilson and Cleary's model may be useful in explaining HRQOL during the menopausal transition. Symptoms, functional status, and health perceptions mediated the effect of individual and environmental characteristics on HRQOL. However, the results suggest that some paths need to be added or modified in the model. To date, most research using Wilson and Cleary's model has been conducted in the United States, Africa, and Europe (e.g., Austria, Norway, and Spain). This study shows the applicability of the model in Asian people.

Association between quality of life, menopausal status, and sociodemographic factors among middle-aged women in Iran

OBJECTIVE

Assessment of overall health, well-being, and quality of life (QoL) during middle age and menopause deserves special attention. The aim of this study was to investigate the effect of menopausal status and some sociodemographic variables on QoL among middle-aged women in Semnan, Iran.

PARTICIPANTS AND METHODS

This cross-sectional survey was conducted in 2012 in Semnan, Iran. The participants included 770 women aged 45-60 years. The data were collected by interview using a structured questionnaire that included sociodemographic characteristics, data on menopausal status, and QoL measurement using the Menopause-Specific Quality of Life questionnaire.

RESULTS

The mean±SD age of the women was 50.9±4.7 years. The overall unadjusted mean scores obtained for each domain were as follows: vasomotor: 1.83±1.86; psychosocial: 1.62±1.41; physical: 1.98±1.28; and sexual: 1.63±1.87. Logistic regression analysis showed that menopausal status was significantly associated with QoL in all domains, except the psychosocial domain. Age, BMI, household income, and number of children were significantly associated with impairment in QoL. Marital status, educational level, and residential area did not show any association with QoL in multivariate analysis.

CONCLUSION AND RECOMMENDATIONS

Our findings confirm previous literature on the negative impact of menopausal symptoms on QoL, and show the interaction of some sociodemographic characteristics including age, number of children, household income, and BMI, on QoL. Health professionals should ensure that they consider a range of factors in middle-aged women's lives and provide insight into possible treatment strategies and lifestyle interventions for improving QoL.

Relationship between menopause and health-related quality of life in middle-aged Chinese women: a cross-sectional study

Background

Chinese menopausal women comprise a large population and the women in it experience menopausal symptoms in many different ways. Their health related quality of life (HRQOL) is not particularly well studied. Our study intends to evaluate the influence of menopause on HRQOL and explore other risk factors for HRQOL in rural China.

Methods

An interview study was conducted from June to August 2010 in Beijing based on cross-sectional design. 1,351 women aged 40–59 were included in the study. HRQOL was measured using the EuroQol Group’s 5-domain (EQ5D) questionnaire. Comparison of HRQOL measures (EQ5D index and EQ5D-VAS scores) was done between different menopausal groups. Logistic regression and multiple regression analysis were performed to adjust potential confounders and explore other risk factors for health problems and HRQOL measures.

Results

Postmenopausal women who had menopause for 2–5 years (+1b stage) were more likely to suffer mobility problems (OR = 1.835, p = 0.008) after multiple adjustment. Menopause was also related to impaired EQ5D index and EQ5D-VAS scores after adjustment for age. Among menopausal groups categorized by menopausal duration, a consistent decrement in EQ5D index and EQ5D-VAS scores, that is, worsening HRQOL, was observed (p < 0.05). Multiple regression analysis revealed low education level and physical activity were associated with EQ5D index (β = -0.080, p = 0.003, and β = 0.056, p = 0.040, respectively). Cigarette smoking and chronic disease were associated with EQ5D index (β = -0.135, p < 0.001 and β = -0.104, p < 0.001, respectively) and EQ5D-VAS (β = -0.057, P = 0.034 and β = -0.214, p < 0.001, respectively).

Conclusions

Reduction in physical function was found within the first five years after menopause. Worsening EQ5D index and EQ5D-VAS scores were related to menopause. Education level, physical activity, cigarette smoking, and chronic disease history were associated with HRQOL in middle aged Chinese rural women.

Effect of auricular acupressure on peri- and early postmenopausal women with anxiety: a double-blinded, randomized, and controlled pilot study

We tested effects of auricular acupressure on peri- and early postmenopausal women with anxiety (PPWA). Fifty PPWA were randomly assigned to the auricular acupressure group (AG) or the sham group (SG). After 3 meals and before sleep every day for 4 weeks, the AG received auricular acupressure on the bilateral ear shenmen and subcortex points for 3 min per point on alternating ears. The SG received sham auricular acupressure. The Alprazolam was reduced from 0.5 mg/day at baseline to 0.3 mg/day 4 weeks after auricular acupressure (4 W) in the AG (P < .05) whereas maintained at 0.5 mg/day in the SG (P > .05). The Zolpidem was reduced from 3.0 mg/day at baseline to 1.5 mg/day at 4 W (P < .05) whereas was reduced from 2.4 mg/day to 1.9 mg/day at 4 W in the SG (P > .05), thus, significant tapering medication, suggesting auricular acupressure is helpful to PPWA.

Comparison of quality of life measures in Korean menopausal women

The psychometric properties of two menopause-specific quality of life (QoL) measures, the Menopausal Quality of Life (MQOL), and the Women's Health Questionnaire (WHQ), were evaluated and compared in a convenience sample of 304 Korean women in menopausal transition. Data were collected with a self-report questionnaire. Evaluation of validity included factor analysis, convergent and discriminant validity, and known-groups validity. Evaluation of reliability included internal consistency reliability and item analysis. The results indicated that both QoL instruments were valid, but the WHQ was more internally consistent in measuring QoL although with a factor structure different from previous research. Replication studies to identify factor structures are needed for both measures.

Assessment of quality of life in menopausal periods: a population study in kashan, iran

BACKGROUND

Menopause is a physiological process in women's life. The aim of this study was to assess QOL and related factors among menopausal women in Kashan city in Iran.

METHODS

Seven hundred women aged 40-60 years were assessed using cluster sampling. Women with mental and physical problems or systemic diseases were excluded. Data were collected by standard questionnaire of quality of life in the menopause.

RESULTS

The mean menopausal age was 47.6±4.1 years. 55.6% of women had been postmenopausal for less than 5 years. The overall mean scores obtained for each domain was 2.82±1.64 for vasomotor, 2.71±1.2 for psychosocial, 2.46±0.99 for physical and 2.89±1.73 for sexual domains.

CONCLUSION

Age, working status, physical activity, educational level, duration of menopause, income satisfaction, marriage satisfaction and the number of children in those living with family had influence on quality of life in menopausal women.

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

PURPOSE

We examine the impact of menopausal status, beyond menopausal symptoms, on health-related quality of life (HRQoL).

METHODS

Seven hundred thirty-two women aged 40-65, regardless of health condition or menopausal status, were enrolled from single general internal medicine practice. Women completed annual questionnaires including HRQoL, and menopausal status and symptoms.

RESULTS

The physical health composite of the RAND-36 is lower in late peri (45.6, P < .05), early post (45.4, P < .05), and late postmenopausal women (44.6, P < .01), and those who report a hysterectomy (44.2, P < .01) compared to premenopausal women (47.1), with effect sizes of Cohen's d = .12-.23. The mental health composite of the RAND-36 is lower in late peri (44.7, P < .01), early post (44.9, P < .01), and late postmenopausal women (45.0, P < .05) and those who report a hysterectomy (44.2, P < .01) compared to premenopausal women (46.8), with effect sizes of Cohen's d = .15-.20. Findings are comparable adjusted for menopausal symptom frequency and bother.

CONCLUSIONS

Over a 5-year follow-up period, we found a negative impact of menopause on some domains of HRQoL, regardless of menopausal symptoms. Clinicians should be aware of this relationship and work to improve HRQoL, rather than expect it to improve spontaneously when menopausal symptoms resolve.

Measurement of Quality of Life in Menopausal Women

Use of a wide variety of quality of life (QoL) instruments, each measuring a different aspect of menopause with a different type of underlying scale, has been a major problem in menopause research. The aim of this review was to identify instruments developed for menopausal women and evaluate the psychometric properties and appropriateness of instruments for the study of QoL in menopausal women. Seven measures from 16 papers were chosen for the review. The psychometric evaluations were conducted based on quality judgment criteria. Of the seven measures reviewed in this study, the psychometric quality scores of Women’s Health Questionnaire (WHQ) was the highest. However, the result indicates that most instruments of menopause-specific QoL need further testing and evaluation of the various aspects of their psychometric properties. In addition, future research assessing psychometric properties with cross-cultural samples may be beneficial in adapting measures to specific context and study populations.

The prevalence of depression symptoms and influencing factors among perimenopausal and postmenopausal women

OBJECTIVE

This study was conducted for the purpose of determining the prevalence of depression in perimenopausal and postmenopausal women and the factors that influence the development of depression.

METHODS

A community-based sample of 685 women aged 45 to 59 years who were living in Malatya was recruited in this cross-sectional study. An information form that included questions on descriptive characteristics and lifestyle variables of cases, the Menopause-Specific Quality of Life Questionnaire, and the Beck Depression Inventory were administered to each woman in the sample. The data were collected through personal interviews with women at their home between February and May 2008.

RESULTS

The mean age of the respondents was 50.66 (4.15) years. The prevalence of depression symptoms among the perimenopausal and postmenopausal women was 41.8%. Of all women, 23.2% were premenopausal and 56.9% were postmenopausal. The logistic regression analysis revealed that depression symptom development was 1.8 times higher in the perimenopausal-postmenopausal period than in the premenopausal period, 3.6 times higher among those with an event history affecting life in a negative way than among those without, and 2.0 times higher among those with a body mass index of 25 kg/m or higher than among those with a body mass index of less than 25 kg/m.

CONCLUSIONS

There is a high level of prevalence of depression symptoms in perimenopausal and postmenopausal women.

Menopause and physical performance--a community-based cross-sectional study

OBJECTIVES

The aim of this study was to test whether menopause is associated with decreased physical performance and to determine the risk factors accounting for a decline in physical performance.

METHODS

We recruited 979 women (mean +/-SD age, 48.4 +/- 3.9 y; range, 43-57 y) from a community population in Taiwan. Menopause status (435 women [44.4%] in premenopause, 253 [25.8%] in perimenopause, and 291 [29.7%] in postmenopause) was determined by menstrual history. All women underwent three dimensions of physical performance assessment: flexibility was evaluated by stand-and-reach and sit-and-reach tests; muscular strength was determined by the grip and pinch strength tests; and balance was assessed by one-legged standing with eyes open or closed.

RESULTS

Flexibility did not vary among women in different menopausal states. Perimenopausal or postmenopausal women had weaker grip strength than premenopausal women (27.7 +/- 6.5, 25.1 +/- 6.5, and 23.5 +/- 6.5 kg for premenopausal, perimenopausal, and postmenopausal states, respectively; P < 0.001) and shorter standing balance time (93.9 +/- 33.7, 88.7 +/- 34.9, and 78.4 +/- 39.5 s for premenopausal, perimenopausal, postmenopausal states, respectively; P < 0.001). In a multivariate analysis, the associations of decreased grip strength and poor balance with menopause status remained significant after adjustment for baseline characteristics.

CONCLUSIONS

Menopause is an independent predictor of decreased muscle strength and balance.

Weight regain and health-related quality of life in postmenopausal women

Weight loss improves health-related quality of life (HRQoL). However, regain after loss is common; little is known about the impact of weight regain on HRQoL in postmenopausal women. Woman on the Move through Activity and Nutrition (WOMAN) is a randomized lifestyle intervention trial of diet, physical activity, and weight loss in 508 postmenopausal women aged 52-62 years. This analysis focused on the women who lost > or =5 lb during the initial phase of the study, baseline to 6 months (n = 248). This cohort was divided into three groups based on subsequent weight change between 6 and 18 months: weight loss (WL; > or =5 lb loss), weight stable (WS; <+/-5 lb change), and weight regain (WR; > or =5 lb gain). HRQoL was measured at baseline, 6, and 18 months using the Short Form-36. Of the 248 women studied, 51 (21%) continued to lose weight after initial weight loss, while 127 (51%) maintained a stable weight, and 70 (28%) regained weight. Between baseline and 6 months, women in WR group had decreased mental health and social-functioning scores, while the WL and WS groups improved in these subscales. Between baseline and 18 months, energy improved most significantly in those with continued weight loss (P = 0.0003). Weight loss was correlated with a small to moderate improvement in perceived general health and energy, which was reversed by weight gain. Further study is needed to investigate the impact of a decline in mental health and social functioning on future weight regain.