Anxiety, aging, and reproductive aging: observations from the Seattle Midlife Women's Health Study

Attention to women's perimenopausal experiences of anxiety has been limited. The purpose of these analyses was to examine the influence of chronological aging and reproductive aging stages on midlife women's reports of anxiety.

Participants aged 35-55 years from the Seattle Midlife Women's Health Study population-based study (N = 508 at baseline) completed an annual health questionnaire and menstrual calendars. In addition, they completed the Symptom Checklist-90 Revised Scales, including anxiety, phobic anxiety, and interpersonal sensitivity, on up to four occasions during the course of the study. Reproductive aging stages were assessed using menstrual calendars and questionnaire data applying Mitchell's (2000) criteria for stages of reproductive aging: late reproductive stages (late reproductive stage 1 [LRS1] and late reproductive stage 2), early menopausal transition stage, late menopausal transition (LMT) stage, and postmenopause (PM). Multilevel modeling using mixed models analysis of linear models (SPSS 28) was employed to examine the effects of age and reproductive aging stages on repeated measures of anxiety, phobic anxiety, and interpersonal sensitivity.

Age was significantly and negatively related to each of the measures: anxiety (beta = -0.015), phobic anxiety (beta = -0.008), and interpersonal sensitivity (beta = -0.016), each decreased significantly with age ( P < 0.001). When accounting for age effects, anxiety scale scores increased as women progressed through reproductive aging stages from LRS1 to the LMT, then decreased from late stage to PM, but changes were not significant. When accounting for age effects, phobic anxiety increased significantly from LRS1 to PM stages (LRS1 vs PM betas -0.139, -0.057, -0.052, -0.010 for LRS1 to LMT, P = 0.018). Interpersonal sensitivity increased from LRS1 to LMT, but changes were not significant.

Aging was significantly and negatively related to anxiety, phobic anxiety, and interpersonal sensitivity, suggesting emotion regulation effects during midlife. When chronological aging was taken into account, reproductive aging was associated significantly with increasing levels of phobic anxiety from the late reproductive stages to PM. Anxiety and interpersonal sensitivity both increased with progression from LRS1 through LMT before decreasing PM, but the changes were not significant.