Validation of the traditional Chinese version of the Menopausal Rating Scale with WHOQOL-BREF

Changes in menopausal symptoms comparing oral estradiol versus transdermal estradiol

OBJECTIVE

This study aimed to compare the efficacy and safety of oral and transdermal estradiol in alleviating menopausal symptoms.

METHOD

A total of 257 recently menopausal women were randomized into two groups. The t-E2 group received transdermal estradiol (2.5 g per day) (n = 128) and the o-E2V group received oral estradiol valerate (2 mg per day) (n = 129) for 24 weeks; both groups received micronized progesterone (200 mg per day). The primary outcome measure is the change in the modified Kupperman Menopausal Index (KMI) after 24 weeks of treatment. Menopausal symptoms were recorded at screening and at 4, 12 and 24 weeks using both the KMI and the Menopause Rating Scale (MRS).

RESULTS

Significant amelioration was observed by KMI and MRS scores for both groups after treatment (p < 0.001). The mean KMI scores showed no difference between the two groups. The mean MRS scores were similar between the two groups at baseline and after 4 weeks of treatment. The results showed statistical differences after 12 weeks and 24 weeks of treatment (p = 0.005 and p = 0.011). Both the after-treatment scores minus the baseline scores of KMI and MRS and the incidence of adverse effects showed no difference between the two groups.

CONCLUSIONS

This study shows that both transdermal and oral estradiol are effective in relieving menopausal symptoms, with little difference in treatment efficacy and safety.

CLINICAL TRIAL NUMBER

ChiCTR2300073146.

Health-promoting behaviours and psychological distress in breast cancer with endocrine therapy: Mediating roles of menopausal symptoms and social support

OBJECTIVE

To investigate the relationship between health-promotion behaviour and psychological distress and whether menopausal symptoms and social support mediate these relationships in patients with breast cancer receiving endocrine therapy.

STUDY DESIGN

This was a cross-sectional study involving convenience sampling that involved 226 patients with breast cancer.

MAIN OUTCOME MEASURES

Participants were investigated by self-reporting questionnaires that included demographic and clinical information, the Kessler psychological distress scale, the Health-Promoting Lifestyle Profile Ⅱ, the Menopause Rating Scale, and the Perceived Social Support Survey to measure psychological distress, health-promoting behaviour, menopausal symptoms, and social support, respectively. Mediation analyses were conducted with the bootstrapping method to test for mediating factors.

RESULTS

In total, 78.7% patients reported that they were suffering from psychological distress. Their health-promoting behaviours were directly and negatively associated with psychological distress. In addition, health-promoting behaviour had a significant indirect effect on psychological distress through menopausal symptoms and social support. Mediating effects accounted for 34.8% and 27.6% of the total effect, respectively.

CONCLUSIONS

There was a high prevalence of psychological distress in patients with breast cancer receiving endocrine therapy. Menopausal symptoms and social support mediated the association between health-promoting behaviour and psychological distress. Health professionals should evaluate menopausal symptoms and health lifestyles, and provide professional interventions to increase health-promoting behaviours and manage unpleasant somatic symptoms for patients and their caregivers; these actions may improve their psychological distress.

Treatment-induced menopause symptoms among women with breast cancer undergoing chemotherapy in China: a comparison to age- and menopause status-matched controls

OBJECTIVE

Whether women with breast cancer experience more severe menopause symptoms than comparison women without a history of breast cancer diagnosis remains unclear. We aimed to investigate whether women with breast cancer undergoing chemotherapy experience more severe menopause symptoms than comparison women and explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy.

METHODS

This cross-sectional observational study recruited 423 women with breast cancer undergoing chemotherapy and 1,829 community women without breast cancer. All participants completed a questionnaire assessing menopause symptoms using the Menopause Rating Scale and general characteristics (eg, sociodemographic and clinical data). Propensity score matching was used to reduce the confounders between the two groups. Student's t test or Mann-Whitney U test and chi-square tests were used to compare the differences in menopause symptoms between the two groups. Multivariate linear regression analysis was performed to explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy.

RESULTS

After propensity score matching, 808 participants were included. The mean ages of women with breast cancer undergoing chemotherapy and comparison women were 49.58 and 49.10 years, respectively. Women with breast cancer undergoing chemotherapy experienced significantly more severe vasomotor symptoms than comparison women. However, comparison women had higher Menopause Rating Scale scores and more severe menopause symptoms than women with breast cancer undergoing chemotherapy. Age, occupational status, chemotherapy-induced amenorrhea, family history of cancer, chemotherapy stage, mindfulness, resiliency, and illness perception were associated with menopause symptoms in women with breast cancer undergoing chemotherapy.

CONCLUSIONS

Vasomotor symptoms are prominent among women with breast cancer undergoing chemotherapy. Understanding the factors contributing to menopause symptoms is crucial for healthcare practitioners to develop supportive guidelines for the well-being of women with breast cancer undergoing chemotherapy.

The middle-aged and older Chinese adults' health using actigraphy in Taiwan (MOCHA-T): protocol for a multidimensional dataset of health and lifestyle

BACKGROUND AND OBJECTIVES

Older adults keep transforming with Baby Boomers and Gen Xers being the leading older population. Their lifestyle, however, is not well understood. The middle-aged and older Chinese adults' health using actigraphy in Taiwan (MOCHA-T) collected both objective and subjective data to depict the health and lifestyle of this population. The objectives, design, and measures of the MOCHA-T study are introduced, and the caveats and future directions related to the use of the data are presented.

METHODS

People aged 50 and over were recruited from the community, with a subset of women aged 45-49 invited to supplement data on menopause and aging. Four instruments (i.e., self-reported questionnaires, diary, wrist actigraphy recorder, and GPS) were used to collect measures of sociodemographic, health, psychosocial, behavioral, temporal, and spatial data.

RESULTS

A total of 242 participants who returned the informed consent and questionnaires were recruited in the MOCHA-T study. Among them, 94.6%, 95.0%, and 25.2% also completed the diary, actigraphy, and GPS data, respectively. There was almost no difference in sociodemographic characteristics between those with and without a completed diary, actigraphy, and GPS data, except for age group and educational level for those who returned completed actigraphy data.

CONCLUSION

The MOCHA-T study is a multidimensional dataset that allows researchers to describe the health, behaviors, and lifestyle patterns, and their interactions with the environment of the newer generation of middle-aged and older adults in Taiwan. It can be compared with other countries with actigraphy and GPS-based lifestyle data of middle-aged and older adults in the future.

Role of age, menopausal status, and symptoms in midlife women: Examination of sleep patterns and rest-activity circadian rhythms

BACKGROUND

Midlife women experience menopausal transition at different ages with a variety of symptoms. This study aimed to identify the effects of age, menopausal status, and symptoms in women on their actigraphy-based sleep patterns and circadian rhythms.

METHODS

A total of 87 women aged 45-60 from the community and a gynecology clinic in Taiwan who had their sleep and circadian rhythms recorded with a 7-day actigraphy were analyzed. Multiple linear regression was used to estimate the association of age, menopausal status, and symptoms with sleep parameters and circadian rhythms.

RESULTS

A sleep efficiency below 85 % was observed in 46.0 % of women, and those with severe somatic-vegetative or psychological symptoms tended to have problems with sleep latency (β = 0.22 and β = 0.42, respectively) and efficiency (β = -0.26 and β = -0.36, respectively). Women with more severe urogenital symptoms only experienced significantly longer sleep latency (β = 0.33). There was a weak correlation between circadian rhythms and symptoms. Additionally, perimenopausal (β = 0.30 and β = 0.35, respectively) and late postmenopausal (β = 0.67 and β = 0.59, respectively) women had higher relative amplitude and stability in circadian rhythms than premenopausal women. Age had no significant effect on sleep parameters or circadian rhythms.

CONCLUSIONS

Premenopausal women had the most unstable day-to-day rhythms compared to their peri- and postmenopausal counterparts. Women with higher somatic-vegetative, psychological, and urogenital symptoms showed greater sleep problems. Psychological symptoms (e.g., depression, irritability, anxiety, exhaustion) were the strongest predictors for all sleep parameters. The mechanisms underlying these associations warrant investigation.

Menopausal symptoms in breast cancer patients receiving adjuvant endocrine therapy and their relationships with health-promoting behaviors and social support

OBJECTIVE

To investigate the prevalence and severity of menopausal symptoms in patients with breast cancer undergoing adjuvant endocrine therapy and explore the relationships of these symptoms with health-promoting behaviors and social support.

METHODS

This cross-sectional study investigated 226 participants from December 2020 to December 2021 in China. Data were collected using the sociodemographic information questionnaire, Menopause Rating Scale, the Health-Promoting Lifestyle Profile II, and Perceived Social Support Survey. Multivariate step regression was used to analyze the potential factors of menopausal symptoms.

RESULTS

In our sample of 226 patients, 92.9% reported at least one menopausal symptom with a mean score of 13 points (interquartile range, 9-18 points). The highest prevalence of most symptoms included hot flashes/night sweats, fatigue, joint and muscular discomfort, irritability, and sleep problems. In the regression models, health responsibility ( β = -0.15, P = 0.03), spiritual growth ( β = -0.28, P < 0.01), friend support ( β = -0.43, P < 0.01), and other support ( β = -0.31, P = 0.01) were negatively associated with menopausal symptoms.

CONCLUSIONS

The prevalence and severity of menopausal symptoms are high in breast cancer patients undergoing adjuvant endocrine therapy. Higher health-promoting behaviors and social support are associated with fewer menopausal symptoms. The findings highlight the clinical implications in terms of developing appropriate strategies for managing menopausal symptoms.

Psychometric properties and validity of the Menopause Rating Scale in postmenopausal Portuguese women

OBJECTIVE

The aim of the study is to analyze the reliability and validity of the Portuguese version of the Menopause Rating Scale (MRS) among postmenopausal Portuguese women.

METHODS

A total of 184 postmenopausal women completed the Portuguese MRS. Internal consistency and test-retest reliability were studied. Construct, convergent, and concurrent validity were assessed. The 10-item Cervantes Scale and the Hospital Anxiety and Depression Scale were used to determine convergent and concurrent validity, respectively. The ability and accuracy of the Portuguese MRS to discriminate between women with and without anxiety and depression cases were evaluated, and a receiver operating characteristic curve analysis was used.

RESULTS

The Portuguese MRS showed an appropriate level of internal consistency (Cronbach α, 0.84 for MRS total score) and test-retest reliability (MRS total score; intraclass correlation coefficient, 0.92; 95% confidence interval, 0.85-0.96). Factor analysis (construct validity) revealed a 3-factor structure (explained variance of 62.08%). The MRS total score and its 3 factors showed good convergent (10-item Cervantes Scale) and concurrent (Hospital Anxiety and Depression Scale anxiety and depression) validity (all P < 0.001). The Portuguese MRS total score was significantly able to discriminate between postmenopausal women with and without anxiety (P < 0.001) and depression (P = 0.001), with a cutoff point of 15.50 (80.00% sensitivity and 63.70% specificity) for detecting depression and a cutoff point of 16.50 (82.35% sensitivity and 78.57% specificity) for identifying anxiety.

CONCLUSIONS

The Portuguese MRS has been shown to be a valid and reliable questionnaire for assessing the severity of menopausal symptoms and discriminating among postmenopausal women with and without anxiety and depression.

Translation and validation of the Work-Related Quality of Life Scale (WRQoLS-2) in a nursing cohort

OBJECTIVES

The purpose of this study was to translate the Work-Related Quality of Life Scale (WRQoLS-2) into Chinese and validate the capacity of the tool to effectively measure this concept in a cohort of nursing professionals from mainland China.

METHODS

The Chinese version of the WRQoLS-2 (WRQoLS-2C) was developed using forward and backward language translation. In total, 639 nurses were invited to complete the WRQoLS-2C. Two weeks later, 79 (12.4%) nurses were retested. Construct validity was analysed using exploratory and confirmatory factor analysis (EFA, CFA). Cronbach's α and the intraclass correlation coefficient (ICC) were used to assess internal consistency, reliability and test-retest reliability. Correlation between the WRQoLS-2C and the Quality of Nursing Work Life scale (QNWL) total score was used to assess criterion-relation validity.

RESULTS

A seven-factor structure was revealed and confirmed using EFA (explaining 70.3% of the variance) and CFA (χ²= 680.39, df = 413, χ²/df = 1.65, p < 0.001). The goodness-of-fit index was 0.88, and adjusted goodness-of-fit index 0.86 indicating a reliable model. The internal consistency (Cronbach's α = 0.94) and test-retest reliability (ICC = 0.84) of the WRQoLS-2C were high. The correlation coefficient between the WRQoLS-2C and QNWL total scores was 0.79 (p < 0.01).

CONCLUSION

The WRQoLS-2C was a reliable and valid instrument that can be used to assess WRQoL in the mainland China nursing profession.

IMPACT STATEMENT

There are few options available to assess work related quality of life in Chinese language. This study has confirmed that the WRQoLs-2C is an effective instrument to measure this concept in nurses from mainland China.

PLAIN LANGUAGE SUMMARY (PLS)

Work related quality of life is an important predictor of workplace turnover intension. Managers can take measures to improve work related quality of life and reduce employee attrition. There are very few tools to measure work related quality of life and fewer in Chinese language. We translated the WRQoLS-2 into Chinese according to Brislin's translation model, following cross-cultural adaption guidelines, and verified its reliability and validity in a cohort of mainland Chinese nurses. The translated instrument has good reliability and validity in nurses, but has not yet been verified in other occupational groups.

Menopause Rating Scale (MRS) in the Malay language-translation and validation in a multiethnic population of Selangor, Malaysia

Background

The Menopause Rating Scale (MRS) is an internationally used tool to measure menopause-related symptoms and to date it is unavailable in the Malay language. We aimed to translate and validate the Malay language version of the MRS.

Methods

Translation of the English version of MRS into Malay was done by a bilingual expert and back translated. Translated version of MRS was reviewed by a panel to determine the face validity. A sample of 321 women aged 40–60 years residing in Klang, Selangor, Malaysia was selected by stratified random sampling method in a house-to-house survey. The Malay language version of MRS was self-administered. Reliability analyses, including test–retest reliability (on 30 women after a two-week interval) were conducted. To ascertain the construct validity, 11 items were analyzed confirmatory factor analysis was conducted to evaluate the structural model fit of the Malay language version of MRS.

Results

A total of 294 (91.6%) completed the survey and their mean age was 50.9 years (SD = 6.3). An overall Cronbach’s alpha for MRS was 0.904. Cronbach’s alpha for psychosomatic, urogenital, and somatovegetative subscales were 0.889, 0.846, and 0.776 respectively. The corrected item correlations were approximately 0.6 and inter-item correlations were between 0.3 and 0.9. On exploratory structural equation modelling, the chi-square test of goodness of fit yielded a significant value; χ2 = 78.4, df = 25, p < 0.001, (reported if N > 200). Additionally, the value of Tucker–Lewis Index (TLI) = 0.954showed a good fit to the model.

Conclusion

The translated English version of the Menopause Rating Scale into the Malay language showed excellent reliability, test–retest reliability, and construct validity. The instrument can be used to assess menopause-related symptoms among Malaysian women.

Correlates of palpitations during menopause: A scoping review

Objective:

Palpitations during peri- and post-menopause are common. It is unclear what variables are related to palpitations in peri- and post-menopausal women. The purpose of this scoping review was to summarize potential correlates of palpitations in women transitioning through menopause.

Methods:

The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Authors included English-language, full-length, peer-reviewed, cross-sectional research articles on palpitations in menopausal women published through December 18, 2021, from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO searches. Following de-duplication, screening of titles and abstracts, and review of full-texts, independent reviewers extracted data on variables studied in relationship to palpitations from 84 articles and resolved discrepancies. Authors extracted data on (1) demographic, clinical, biomarker, and symptom/quality of life variables and (2) data analysis method (bivariate, multivariate). Authors classified each variable as a likely, unlikely, or unclear correlate of palpitations.

Results:

Articles were diverse in region of origin, sample sizes, and variables assessed in relationship to palpitations. Evidence for any one variable was sparse. Likely correlates of palpitations included race/ethnicity, lower physical activity, worse vasomotor symptoms (VMSs), worse sleep, and worse quality of life. Unlikely correlates included age, employment, education, marital status, socioeconomic status, comorbidities, body mass index, and sexual difficulties. Unclear correlates due to equivocal evidence were menopausal status, smoking, and depression. Unclear correlates due to insufficient evidence (less than three articles) included all of the assessed biomarkers, anxiety, and stress.

Conclusion:

Likely correlates were identified including race/ethnicity, physical activity, VMS, sleep, and quality of life. However, additional research is needed to better understand potential correlates of palpitations.

Correlation between menopausal symptoms and everyday cognition in Chinese (peri)menopausal women

OBJECTIVE

The aim of this study was to evaluate the relationship between the severity of menopausal symptoms and everyday cognitive decline in Chinese peri and postmenopausal women.

METHODS

The peri and postmenopausal Chinese Han female who first visited the menopausal clinic of Shanghai Jiao Tong University Affiliated Sixth People's Hospital was selected as the study participants. The general questionnaire was used to obtain the sociodemographic characteristics of the study participants. The menopausal rating scale (MRS) was used to assess the severity of menopausal symptoms. The short version of the Everyday Cognition (ECog-12) scales was used to assess everyday cognitive performance.

RESULTS

A total of 295 women were included, with an average age of 51.12 ± 5.15 years. The average ECog scores were 1.51 ± 0.49 and the average MRS scores were 6.89 ± 4.77. In multiple linear regression analysis, after adjusting for confounding factors age, body mass index (BMI), monthly income, occupational status, education level, menopausal status, parity, regular exercise, and history of chronic diseases, complaints of anxiety and physical/mental fatigue were positively correlated with everyday cognitive decline.

CONCLUSIONS

Menopausal anxiety and physical/mental fatigue were the independent predictors of everyday cognition.

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.

Menopausal symptoms inversely associated with quality of life: findings from a 5-year longitudinal cohort in Chinese breast cancer survivors

OBJECTIVE

This study assessed menopausal symptoms (MPS) after breast cancer in relation to quality of life (QoL) during the first 5 years of survival.

METHODS

An ongoing prospective study enrolled 1,462 Chinese women with early-stage breast cancer. They were longitudinally followed up at four time-points, namely baseline, 18-, 36-, and 60-month after diagnosis. At each follow-up, Menopause Rating Scale (MRS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were used to assess MPS and QoL, respectively.

RESULTS

In total, 1,462, 1,289, 1,125, and 1,116 patients were included into the analyses at baseline, 18-, 36-, and 60-months, respectively. The percentages of patients with no or little, mild, moderate, and severe MPS at baseline were 31.8%, 30.0%, 30.4%, and 7.7%, respectively; the corresponding figures at 18-, 36-, and 60-month follow-up were similar. Using data from four follow-ups, Generalized Estimating Equations analyses showed that MPS was inversely associated with QoL. Higher MRS scores were related to lower QoL scores. For instance, every 1 point increase in MRS score was associated with a 1.5 point decrease in global health status/QoL score (P < 0.01). In terms of symptoms, higher MRS scores were related to more severe symptoms.

CONCLUSIONS

This study highlighted patients with more severe MPS tend to have worse QoL. Future investigation should be conducted to assess different means of alleviating MPS to improve patient's QoL.

The influence of educational level in peri-menopause syndrome and quality of life among Chinese women

Objective: To investigate the influence of education level in the peri-menopausal symptoms and quality of life (QoL) among Chinese women.Methods: We carried out a cross-sectional study of 1632 peri-menopausal women (age 40-60 y) who visited Hangzhou Women's Hospital from November 2018 to November 2019. The menopausal symptoms were evaluated by modified Kupperman index (KI). World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to evaluate the QoL.Result: In total, 1501 women were included in the analysis. The mean age of natural menopause was 49.63 years in China. The five most frequent symptoms in menopausal women were Hot flash (75.53%), sexual problems (72.62%), insomnia (67.29%), fatigue (65.56%), and irritability (61.89%). Natural menopausal age, parity, BMI, bone mineral density, depression, skin formication, total score of KI, and the score of WHOQOL-BREF questionnaire were different in different educational background women (p < .05).Conclusions: The results of the study suggest that education level is associated with the age of natural menopause and menopausal symptoms. A high educational level is correlated with a better score of WHOQOL-BREF in peri-menopause women.

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.

The association between soy isoflavone intake and menopausal symptoms after breast cancer diagnosis: a prospective longitudinal cohort study on Chinese breast cancer patients

PURPOSE

This study investigated the association between soy isoflavone intake and menopausal symptoms (MPS) among Chinese women with early stage breast cancer in a prospective cohort study.

METHODS

In an on-going prospective cohort study that involved 1462 Chinese women with early stage breast cancer, MPS were assessed at 18, 36 and 60 months after cancer diagnosis using the validated menopausal rating scale (MRS) questionnaire. Daily soy food intake for the previous 12 months was assessed at the same time using a validated food frequency questionnaire. The associations between MPS and soy isoflavone intake were evaluated in multivariable logistic regression analyses.

RESULTS

The prevalence of MPS was almost the same during the first 60 months after cancer diagnosis, which were 64.5%, 65.2%, and 63.9% at 18, 36, and 60 months, respectively. Patients with MPS tended to be younger than those without MPS. The intake of soy isoflavones was not associated with the total score of MRS at 18-month follow-up [highest vs lowest tertile, odds ratio (OR) = 1.00, 95% CI 0.75-1.34]. Similarly, no significant association was noted at 36-month (OR = 1.25, 95% CI 0.92-1.69) and 60-month (OR = 1.21, 95% CI 0.84-1.74) follow-up. With regards to specific domain within MRS, the risk of symptoms presenting in somatic domain was higher among breast cancer patients who were in the highest tertile of soy isoflavone intake at 36 months post-diagnosis (OR = 1.44, 95% CI 1.07-1.94, P-trend = 0.02), compared with the lowest tertile, where a stronger significant association was noted among patients who were younger than 60 years (OR = 1.52, 95% CI 1.05-2.20, P-trend = 0.03) and pre-menopausal (OR = 3.81, 95% CI 1.85-8.11, P-trend < 0.01).

CONCLUSION

The present study provided further evidence that soy isoflavone consumption was not associated with MPS among Chinese breast cancer patients. In fact, patients with higher intake of soy isoflavone have increased risk of experiencing somatic symptoms.

Current ecology, not ancestral dispersal patterns, influences menopause symptom severity

All human females who reach midlife experience menopause, however, it is currently unclear why women experience this period of infertility, and why it is accompanied by many unpleasant symptoms. Using primary data from four ethnic groups in China, we test an existing theory that age of menopause and its symptoms are the result of intragenomic conflict between maternally and paternally inherited genes, with the outcome of such conflict predicted to be contingent on the ancestral postmarital residence pattern of the female (Úbeda, Ohtsuki, & Gardner, Ecology Letters, 17, 2014, 165). The model predicts that being ancestrally patrilocal results in less intragenomic conflict, causing a shorter, less symptomatic perimenopause that terminates in a later menopause. Our findings show no support for this hypothesis and suggest current, rather than ancestral, residence patterns better predict aspects of the menopausal transition. Furthermore, current patrilocality when compared to duolocality is associated with more severe menopause symptoms, which may be due to sexual, rather than intragenomic, conflict.

OPEN RESEARCH BADGES

This article has earned an Open Data Badge for making publicly available the digitally-shareable data necessary to reproduce the reported results. The data is available at https://doi.org/10.5061/dryad.27s8k0p.

Menopausal symptoms and associated factors in women living with HIV in Cambodia

This study investigated the prevalence and severity of menopausal symptoms and associated factors among women living with HIV in Cambodia. Menopause Rating Scale (MRS) assessed the menopausal symptoms, and SPSS Version 20.0 analyzed the data. The three most dominant symptoms, which were also rated the top three "severe" symptoms, were psychological: physical and mental exhaustion (91.5%), irritability (84.1%), and depressive mood (83.6%). The highest incidence was among the perimenopausal women. Severity of symptoms was associated with personal income, abortion, and intake of calcium supplements. Health-care professionals need to provide appropriate individualized interventions to maintain the social, emotional, and overall well-being of menopausal women living with HIV.

Construct validity of the Menopause Rating Scale in Indonesia

Objective: This study assessed the construct validity of the Menopause Rating Scale (MRS) in Indonesia. Methods: The study included 240 women aged over 45 years in Indonesia. The MRS measures psychological, somatic-vegetative, and urogenital symptoms using 11 items obtained from participants' daily symptom records. The intraclass correlation coefficient (ICC) and Cronbach's alpha coefficient were measured to examine the test-retest reliability and internal consistency reliability. The test-retest reliability was evaluated by an extra 30 participants twice at 2-week intervals. For construct validity, exploratory factor analysis (EFA) was employed to assess factor structure and confirmatory factor analysis (CFA) was used to evaluate the structural model fit of the MRS. Results: The ICC for the test-retest reliability ranged between 0.90 and 0.95. The Cronbach alpha coefficients in the somatic-vegetative, psychological, and urogenital dimensions were 0.92, 0.93, and 0.95, respectively. The Kaiser-Meyer-Olkin value was 0.96, and the Bartlett's test of sphericity was statistically significant and adequate for EFA. CFA was tested using the second-order model with three first-order factors and yielded an excellent model fit. Conclusion: Results indicated that the brief questionnaire of the MRS possesses acceptable construct validity for evaluating menopause symptoms in Indonesian women.

Relationships between menopausal symptoms, sense of coherence, coping strategies, and quality of life

OBJECTIVES

The aims of this study were to examine the relationships between menopausal symptoms, sense of coherence (SOC), coping strategies, and quality of life, and to test the mediating effects of SOC and coping strategies on the relationships between menopausal symptoms and quality of life among Chinese women during menopausal transition.

METHODS

Two hundred one women aged 40 to 60 years and currently undergoing menopausal transition were recruited at community centers between June and August 2017. Menopausal symptoms, SOC, coping strategies, and quality of life were assessed by the Menopause Rating Scale, the Sense of Coherence Scale, the Brief COPE Inventory, and the Medical Outcomes Study Short-Form-36, respectively. Data were analyzed by path analysis.

RESULTS

Menopausal symptoms were associated with poorer quality of life, and both SOC and maladaptive coping were found to mediate the effects of menopausal symptoms on quality of life. The results suggest that SOC might alleviate the adverse effects of menopausal symptoms on quality of life, whereas maladaptive coping strategies might aggravate the adverse effects of menopausal symptoms on quality of life.

CONCLUSIONS

The results provide new insights into the importance of considering SOC and coping strategies and their interactions with menopausal symptoms and quality of life in the situation of menopausal transition.

Association of Menopausal Symptoms with Different Constitutions in Climacteric Women

OBJECTIVE

The aim of this study was to assess the correlation between the body constitution and menopausal symptoms in climacteric women.

METHODS

This cross-sectional study recruited 427 women aged 40-60 years from the hospital and nearby community. In addition to filling out a questionnaire on menopause rating scale - Traditional Chinese version, the participants completed the body constitution questionnaire. This classifies a person to 1 or more of 3 imbalanced constitutional types, which are yin-xu, yang-xu and stasis-stagnation. We constructed logistic regression models to estimate probabilities of the menopausal symptoms among climacteric women presenting with various menopausal status and differing body constitutions.

RESULTS

The frequency and scores of the yin-xu, yang-xu, and stasis-stagnation constitutions were significantly higher in perimenopausal and postmenopausal than premenopausal women. Compared to the non-constitution women, the odds ratio of having hot flushes, sleeping disorders, sexual problems, irritability, and anxiety were significantly higher with the yin-xu constitution. The women with a yang-xu constitution had significantly higher odds ratios for having bladder problems, muscle and joint problems, depressive mood, and heart discomfort. Symptoms of heart discomfort, physical and mental exhaustion, and sleeping disorders were correlated to the stasis-stagnation constitution.

CONCLUSION

With the additional key symptoms related to the 3 constitutional types, physicians performing traditional Chinese medicine (TCM) are able to diagnose the menopausal syndrome more accurately. Integrating menopausal symptoms with TCM constitutional theory will contribute to a more rapid diagnosis and treatment of menopausal syndrome.

Cross cultural adaptation and analysis of psychometric properties of Sinhala version of Menopause Rating Scale

BACKGROUND

Menopause Rating Scale (MRS) evaluates eleven menopausal symptoms and health related quality of life (HRQOL) of postmenopausal women under three subscales. In this study we attempted cross cultural adaptation and evaluation of psychometric properties of a Sinhala translation of MRS.

METHODS

Sinhala version of MRS was adapted following standard methodology; forward and backward translations, review by an expert group, focus group discussion (FGD) and pre-testing. It was self-administered among randomly selected healthy, Sinhalese, community-dwelling 166 postmenopausal women (aged; median = 56.5, IQR, 53.0-59.0 years) along with the Short Form 36 (SF-36) survey questionnaire. MRS was re-administered among a subsample (n = 80) after two weeks of first administration. Psychometric properties; reliability and validity were evaluated.

RESULTS

In Sinhala version of MRS, both internal consistency (Cronbach's alpha coefficient = 0.79) and test retest reliability (intra class correlation / ICC = 0.86, 95%CI = 0.82-0.91, p < 0.001 and Pearson correlation / r = 0.93) were high. Factor analysis (FA) with Principal Component Analysis (PCA) extracted three factors explaining 59.82% cumulative variance with few exceptions from the original version. In the item-subscale correlation analysis items showed stronger correlations within their own subscale score (r range between 0.56-0.84) than with other subscales scores and subscales' scores showed strong correlations with the overall MRS score (r range between 0.70-0.86) indicating strong convergent validity. Mean (SD) symptom severities of each item were significantly different between symptomatic and asymptomatic women (p < 0.05) emphasizing good discriminant validity. The overall MRS and SF-36 scores correlated significantly (Pearson correlation: - 0.52, p < 0.01 and Kendall's tau-b: - 0.39, p < 0.01) ensuring strong criterion validity.

CONCLUSIONS

The Sinhala version of MRS we adapted is an informative tool with high reliability and validity and this tool can be used to evaluate the menopausal symptoms and HRQOL in postmenopausal women conversant in Sinhala.