Climacteric complaints in the community

At the onset of the climacteric, healthy middle-aged women present with a variety of complaints, especially in general practice. In these first years of entering the menopause, vaginal blood loss alters from irregular periods to complete amenorrhoea. According to these different menstrual patterns, we can distinguish a pre-, peri- and postmenopausal phase. It could be useful to know whether specific climacteric complaints are related to these different phases.

The aim of this study was to investigate the relationship between climacteric complaints and the menstrual pattern during the menopausal transition in a population-based cross-sectional survey of healthy middle-aged women.

All women aged 47-54 years, living in the city of Eindhoven, were invited to participate in the Eindhoven Osteoporosis Study (EPOS); 6648 (78%) agreed to participate. All women completed a questionnaire concerning climacteric complaints. Climacteric status was defined by menstrual history. Odds ratios (ORs) were obtained for the relationship between climacteric status and climacteric complaints. Multiple logistic regression analysis was carried out, with climacteric status as the dependent variable.

Of the 27 items in the questionnaire concerning climacteric complaints, seven were significantly different between all three climacteric phases (P: < 0.1). After multiple logistic regression analysis, comparing peri- and premenopause, only flushing (OR 5.9) was significantly different. Between post- and perimenopause, seven symptoms appeared to be different: three urogenital complaints [vaginal dryness (OR 1.6), vaginal discharge (OR 0.4) and pain during intercourse (OR 1.9)], three vasomotor symptoms [daytime sweating (OR 1.4), night-time sweating (OR 0.7) and flushing (OR 1.9)] and, finally, insomnia (OR 1.3). When comparing post- and premenopause, flushing (OR 13.4), insomnia (OR 2.1) and depressed mood (OR 0.6) were significantly different, in addition to three urogenital symptoms: vaginal dryness (OR 2.6), vaginal discharge (OR 0.3) and pain during intercourse (OR 2.1).

The major findings of the study are that flushing is strongly associated with the transition from pre- to perimenopause, while urogenital complaints, daytime sweating and insomnia are more prominent in the transition from peri- to postmenopause.