Exploring symptom clusters across the menopausal stages - systematic review and meta-analysis

This study aimed to identify and compare symptom clusters and their severity among perimenopausal and postmenopausal women using a systematic literature review on publications from 1996 to 2023 across PubMed, Medline, Cochrane Library, and APA PsycINFO. The meta-analysis followed the PRISMA guideline, initially screening 425 articles, with 14 articles meeting the criteria of relevance, scientific rigor, and a focus on symptom clustering in climacteric women. Data from the 14 selected studies (n = 14,760) were extracted, including study characteristics, participant demographics, methods for identifying symptom clusters, specific symptoms within each cluster, and associations with lifestyle factors, genetics, or psychosocial elements. The findings were synthesized to quantify relationships between different symptom clusters, identifying four distinct groups: somatic, vasomotor, psychological, and sexual symptoms. The overall standardized mean difference (SMD) of -0.89 [95 % CI = -1.70, -0.07] was found for somatic symptom clusters, indicating significant differences. However, no conclusive distinctions were observed in vasomotor, sexual, and psychological symptoms, highlighting variability in symptom presentation. Despite this heterogeneity, the overall effect for somatic symptoms remained statistically significant (Z = 2.14, P = 0.03). The findings emphasize the complexity of symptomatology in climacteric women and underscore the need for tailored person-centered interventions and longitudinal studies.