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Maturitas. 2000 Aug 31;36(2):93-112.

Self-defined menopausal status in a multi-ethnic sample of midlife women.

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1
Department of Epidemiology, University of Michigan, 109 Observatory St., Ann Arbor, MI 48109-2029, USA. harlow@umich.edu

Abstract

OBJECTIVES:

This study aimed to identify factors associated with women's perceived menopausal status and to evaluate agreement between women's self-designation and a menstrually-based classification in a multi-ethnic sample of women.

METHODS:

A cross-sectional survey was conducted as part of a large, seven-site, multi-ethnic study, the Study of Women's Health Across the Nation (SWAN). All variables were assessed by self-report in 13952 women aged 40-55 years. Multiple linear regression was used to assess determinants of self-defined menopausal status, stratifying by race/ethnicity within three anatomical/hormone use strata. Kappa statistics were used to evaluate agreement between the self-defined and menstrually-based classifications.

RESULTS:

For women with an intact uterus, at least one ovary and not using hormones, menstrual patterns explained about half the variance in self-defined menopause status with older women classifying themselves later in the transition. Disagreement between menstrually-based and self-defined menopausal status was 39, 38, 36, 32 and 29% for Hispanic, African-American, Japanese, Caucasian, and Chinese women, respectively (kappa statistics=0.46, 0.41, 0.40, 0.53 and 0.58). Women with vasomotor symptoms tended to self-designate themselves as being in transition regardless of their menstrual patterns. Age and 12 months of amenorrhea explained about 40% of the variance in self-categorization among women using hormones with an intact uterus. Bilateral oophorectomy, age and time since surgery explained about 20% of the variance among post-surgical women.

CONCLUSIONS:

Menstrual characteristics are strong predictors of women's self-perceived menopausal status. However, additional factors, including symptoms and cultural differences in the meaning of specific bleeding patterns, are also relevant and require further investigation.

PMID:
11006497
[Indexed for MEDLINE]
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