Menopause symptom burden and management across rural, suburban, and urban settings in a US population

The aim of this study was to compare menopause experience in rural, suburban, and urban-residing women.

A 2019 online survey of US females queried respondents on menopause symptoms, resources, and treatments. Those ≥45 years of age and in late menopause transition or postmenopause were included in the analysis. Late menopause transition and postmenopause subgroups were stratified by rural, suburban, and urban residence, and age-weighted proportions for menopause symptoms and treatments were calculated and compared using chi-square tests.

A total of 1,531 respondents, 45% (n = 686) late menopause transition, mean age of 50.7 (SD 3.9) and 55% (n = 845) postmenopause, and mean age of 65.1 (SD 8.5) were included. More prevalent symptoms in late menopause transition rural residents were as follows: muscle aches and pains (urban: 49%, suburban: 49%, rural: 65%, P = 0.003), and panic attacks (urban: 18%, suburban: 24%, rural: 30%, P = 0.04). More prevalent symptoms in postmenopause rural residents were as follows: mood swings (urban: 18%, suburban: 14%, rural: 23%, P = 0.02), urinary incontinence (urban: 19%, suburban: 14%, rural: 23%, P = 0.02), and vaginal dryness (urban: 22%, suburban: 29%, rural: 37%, P = 0.004). Vasomotor symptom prevalence was high (71% late menopause transition, 20% postmeopause), but current menopause hormone therapy use was low (11% late menopause transition, 11% postmenopause) and did not differ by residence, despite differences in menopausal resources used.

Rural women may experience greater burden of psychological and somatic menopause symptoms but not vasomotor symptoms. Overall low rates of menopause hormone therapy use suggest a need for education regarding hormone therapy, tailored to residential groups who rely on different resources on healthy aging.