Physical and mental health: Changes during menopause transition

Objective: To measure changes in physical and mental health in six groups of women defined by menopausal status or use of hormone replacement therapy (HRT). Design: Longitudinal study with 2 years follow-up. Participants: Eight thousand six hundred and twenty three women participating in the Australian Longitudinal Study on Women's Health, aged 45-50 years in 1996. Main outcome measures: Changes in the eight dimensions of the Short Form General Health Survey (SF-36) adjusted for baseline scores, lifestyle, behavioural and demographic factors. Results: At baseline, mean scores for five of the eight dimensions of the SF-36 were highest ( indicating better state of health or well-being) in premenopausal women. There were declines ( that is, worsening health) in the SF-36 dimensions in most groups of women. Declines were largest in physical functioning ( adjusted mean change of) 4.9, standard error ( SE) 0.7) and physical role limitation (-5.7, SE: 1.3) in women who remained peri-menopausal throughout the study period and in women taking HRT at the time of either survey ( physical functioning:) 5.3 ( 0.7), role physical limitation:) 7.5 ( 1.2)). They were smallest in women who remained pre-menopausal ( physical functioning:) 3.2 ( 0.7); role physical limitation:) 2.1 ( 1.1)). Conclusions: Physical aspects of general health and well-being decline during the menopausal transition. Sensitive measures and careful analysis are needed to understand why these changes are worse for peri-menopausal women and those taking HRT.