Although perimenopausal status is defined based on changes in menstrual cycles in women of appropriate age, research has suggested that the characteristic symptoms of perimenopause, including sleep disruption and hot flashes, often begin before the reduction of menstrual frequency, at a time known as the late reproductive stage (LRS).
As of 2018, an online website (https://womenlivingbetter.org) has encouraged women ages 35 to 55 to complete a survey about symptoms.
Among respondents, 945 met criteria for LRS (≥3 menses in the previous 3 months, but with subtle menstrual changes) and 491 for perimenopause (<3 menses in the previous 3 months).
The mean age of LRS and perimenopausal respondents was 46.1 years and 49.8 years, respectively. Overall, >70% had a bachelor’s degree or had attended graduate school, 69% were white, 5% Hispanic, 3% black, and 2% Asian.
Similar proportions of women in the LRS and perimenopause groups reported most of the 61 symptoms assessed, including sleep disturbances, mood changes, headaches, mental confusion and dizziness.
Perimenopausal women reported that hot flashes, cold/night sweats, palpitations, and mood symptoms occurred significantly more frequently than LRS women. The only symptom rated as significantly more bothersome by perimenopausal women than LRS women was hot flashes.
Aim: The aim of this study was to examine the occurrence of a variety of symptoms, their frequency, annoyance, burden and interference in the lives of women in the late reproductive stage (LRS) and to compare their experiences with those of women in the menopausal transition. . (MT). Women ages 35 to 55 responded to an 82-question online survey offered by Women Living Better. Participants reported current menstrual patterns, recent changes, and frequency of symptoms, discomfort, and interference. The women’s cycles were classified as LRS or MT using the Stages of Reproductive Aging Workshop +10 criteria. Of 2,406 respondents, 946 met criteria for LRS and 583 for MT. Participants included 30% from outside the United States, 31% from diverse racial/ethnic groups, and 18% reported having difficulty paying for basics. A similar proportion of women in the LRS and MT+ groups reported each of the symptoms: there was a difference of less than 10% for 54 of the 61 symptoms. Of the mean discomfort ratings for all symptoms, only hot flashes differed significantly between the LRS and MT groups. LRS women experienced similar levels of symptom-related interference with personal relationships and daily life as those in the MT stage, but did not anticipate these symptoms to occur until age 50. Conclusions: Women in the late reproductive stage (LRS) experience symptoms strikingly similar to those often associated with MT. Women do not expect these changes until age 50 or older and are surprised by such symptoms before cycle irregularity. Research on the epidemiology and treatment of LRS symptoms, advance counseling for women, and education of physicians caring for them deserve further attention. |
