Classifying menopause stage by menstrual calendars and annual interviews: need for improved questionnaires

Area of Science:

• Reproductive Endocrinology
• Women's Health Research
• Menopause Studies

Background:

• Accurate staging of the menopausal transition is crucial for understanding women's health.
• Current methods, including annual interviews and follicle-stimulating hormone (FSH) levels, may not align with detailed menstrual cycle tracking.

Purpose of the Study:

• To evaluate the concordance between menopausal transition stages determined by annual interviews or FSH levels and those determined by monthly menstrual calendars.
• To identify factors contributing to discrepancies in menopausal transition staging.

Main Methods:

• Analysis of daily self-recorded menstrual calendar data (1996-2006) from 379 women across four US sites.
• Comparison of menstrual calendar data with annual interview and FSH level data.
• Calculation of Cohen's κ statistics and logistic regression to assess agreement and identify discordant factors.

Main Results:

• Poor agreement was observed between annual interview data and menstrual calendars for early (κ = -0.13) and late (κ = -0.18) menopausal transition.
• Significant discordance was noted for Chinese, African-American women, and those with lower educational attainment.
• Poor agreement also found between annual FSH levels and menstrual calendars for early (κ = -0.44) and late (κ = -0.32) menopausal transition.

Conclusions:

• Existing methods for staging the menopausal transition using annual interviews or FSH levels demonstrate poor agreement with detailed menstrual cycle data.
• Current assessment tools may inaccurately identify the onset and progression of the menopausal transition.
• Development and evaluation of novel interview questions are recommended for improved accuracy in multiethnic populations with diverse educational backgrounds.