Symptoms and health behaviours of post-menopausal women in Ireland

Menopause is the cessation of a women's menstrual periods followed by a year of amenorrhea, part of the natural aging process of the female reproductive system. The average age for this to occur is 51, with around 4 years of irregular menstrual cycles leading up to the event ⁽¹⁾. The transition from pre- to peri- to post- menopause is accompanied by changes to circulating hormone levels, which can be symptomatic with potential impacts on quality of life ⁽²⁾. Women frequently report a wide and diverse array of symptoms leading up to and post menopause, including weight gain ⁽³⁾. To support midlife women with lifestyle interventions throughout the menopausal transition (MT), and post menopause, strategies need to be targeted and supportive to be successful ⁽⁴⁾. There is currently a lack of research exploring menopausal symptoms in Ireland. To address this a questionnaire was adapted for the Irish context to assess menopausal symptom experience alongside demographics including self-reported BMI and symptom management strategies including changes to diet and physical activity ⁽⁵⁾. This was electronically distributed to women who categorised themselves as symptomatic postmenopausal. Symptom ratings were scored (unweighted) and were used to both rank severity of individual symptoms as well as to generate an overall modified Kupperman Index. Data was gathered from 238 postmenopausal symptomatic women (mean age 57.14 ± 6.10 years) Low sex drive (33.2%), vaginal dryness (26.5%), insomnia (26.1%) and hot flashes (26%) were the most severe symptoms reported. The mean modified Kupperman Index was 22.55 ± 8.48 and this ranged from 3–41. The majority of women (67%) reported that their menopausal symptoms interfered with their normal daily activities. Self-reported mean BMI was 28.09 ± 5.53 kg/m². With 0.02% in the underweight category and 33%, 35% and 32% in the normal, overweight and obesity categories, respectively. The menopause symptom score for the normal, overweight, and obese categories were 20.22 (±9.37), 23.20 (±8.24) and 24.09 (±7.54) respectively and were significantly different between BMI categories when compared to the normal category P = 0.03 and P = 0.006 for the overweight and obese categories, respectively. Additionally, 83% of women reported changes in their weight since transitioning through menopause and 52% reported finding it difficult to manage their weight. Thirty nine percent of women reported adjusting their diet and 37% exercising to manage weight. Most women (72%) did not feel prepared for menopause, and 74% reported interest in a structured lifestyle programme to combat menopause symptoms throughout this period of change. This data suggests that a higher BMI may be associated with a more symptomatic postmenopausal experience, and that women in Ireland may be searching for strategies to manage menopausal symptoms, a potential area for future public health intervention.