Vasomotor and Sexual Symptoms in Women Aged 60 to 65 Years
Objective. This study aims to determine the prevalence and severity of menopausal symptoms in older postmenopausal women and, hence, the need for treatment options for women of this age.
Methods. This is a cross-sectional questionnaire-based study conducted between October 2013 and March 2014 among 2,020 women aged 40 to 65 years and living independently across Australia. The main outcome measures were the prevalence of moderate to severe vasomotor symptoms (VMS), as measured by the Menopause-Specific Quality of Life Questionnaire, and the current use of prescription therapy for menopausal symptoms.
Results. The prevalence of moderate to severe VMS was as follows: 2.8% in premenopausal women, 17.1% in perimenopausal women, 28.5% in postmenopausal women younger than 55 years, 15.1% in postmenopausal women aged 55 to 59 years, and 6.5% in postmenopausal women aged 60 to 65 years. Prescription therapy for menopausal symptoms was used by 135 women: 120 (5.9%) women using hormone therapy and 15 (0.7%) women using nonhormonal medication. The factors positively associated with moderate to severe VMS were smoking (odds ratio, 1.6; 95% CI, 1.1-2.3; P < 0.05) and a body mass index of 25 to 29.9 kg/m (odds ratio, 1.7; 95% CI, 1.1-2.5; P < 0.05); education beyond high school was inversely associated (odds ratio, 0.7; 95% CI, 0.5-0.9; P < 0.05).
Conclusions. In this large, representative, community-based sample of women, there is a high prevalence of untreated moderate to severe VMS even in women aged 60 to 65 years. The use of vaginal estrogen and nonhormonal prescription therapy with proven efficacy for treatment of menopausal symptoms is strikingly low, suggesting that menopause remains an undertreated condition.
The sustained fall in estrogen levels in menopause may result in a range of symptoms, including vasomotor symptoms (VMS; hot flashes and night sweats), joint pain, urogenital atrophy (vaginal dryness, dyspareunia and sexual dysfunction, urinary tract infection, and urinary urgency), and fragmented sleep, independent of night sweats. Menopausal hormone therapy (HT) was the mainstay of management of bothersome menopausal symptoms until the first publication of the Women's Health Initiative Study findings in 2002. As a consequence, the use of HT has more than halved, and use beyond age 60 years is not recommended. Whether many women were unnecessarily treated in the past or whether a considerable proportion of women are now highly symptomatic and without treatment is not known.
Therefore, we have investigated the current prevalence of menopausal symptoms, using a validated questionnaire, in women aged 40 to 65 years and randomly recruited from the Australian community. The questionnaire used in this study allowed us to evaluate a range of menopausal symptoms and the degree to which women were bothered by these symptoms. We have also documented the current use of hormonal and nonhormonal prescription therapy for management of menopausal symptoms.
Abstract and Introduction
Abstract
Objective. This study aims to determine the prevalence and severity of menopausal symptoms in older postmenopausal women and, hence, the need for treatment options for women of this age.
Methods. This is a cross-sectional questionnaire-based study conducted between October 2013 and March 2014 among 2,020 women aged 40 to 65 years and living independently across Australia. The main outcome measures were the prevalence of moderate to severe vasomotor symptoms (VMS), as measured by the Menopause-Specific Quality of Life Questionnaire, and the current use of prescription therapy for menopausal symptoms.
Results. The prevalence of moderate to severe VMS was as follows: 2.8% in premenopausal women, 17.1% in perimenopausal women, 28.5% in postmenopausal women younger than 55 years, 15.1% in postmenopausal women aged 55 to 59 years, and 6.5% in postmenopausal women aged 60 to 65 years. Prescription therapy for menopausal symptoms was used by 135 women: 120 (5.9%) women using hormone therapy and 15 (0.7%) women using nonhormonal medication. The factors positively associated with moderate to severe VMS were smoking (odds ratio, 1.6; 95% CI, 1.1-2.3; P < 0.05) and a body mass index of 25 to 29.9 kg/m (odds ratio, 1.7; 95% CI, 1.1-2.5; P < 0.05); education beyond high school was inversely associated (odds ratio, 0.7; 95% CI, 0.5-0.9; P < 0.05).
Conclusions. In this large, representative, community-based sample of women, there is a high prevalence of untreated moderate to severe VMS even in women aged 60 to 65 years. The use of vaginal estrogen and nonhormonal prescription therapy with proven efficacy for treatment of menopausal symptoms is strikingly low, suggesting that menopause remains an undertreated condition.
Introduction
The sustained fall in estrogen levels in menopause may result in a range of symptoms, including vasomotor symptoms (VMS; hot flashes and night sweats), joint pain, urogenital atrophy (vaginal dryness, dyspareunia and sexual dysfunction, urinary tract infection, and urinary urgency), and fragmented sleep, independent of night sweats. Menopausal hormone therapy (HT) was the mainstay of management of bothersome menopausal symptoms until the first publication of the Women's Health Initiative Study findings in 2002. As a consequence, the use of HT has more than halved, and use beyond age 60 years is not recommended. Whether many women were unnecessarily treated in the past or whether a considerable proportion of women are now highly symptomatic and without treatment is not known.
Therefore, we have investigated the current prevalence of menopausal symptoms, using a validated questionnaire, in women aged 40 to 65 years and randomly recruited from the Australian community. The questionnaire used in this study allowed us to evaluate a range of menopausal symptoms and the degree to which women were bothered by these symptoms. We have also documented the current use of hormonal and nonhormonal prescription therapy for management of menopausal symptoms.
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