Menopausal symptoms in average-age menopause and premature ovarian insufficiency

There is limited data on the prevalence and severity of menopausal symptoms among the Canadian population. This study aims to characterize and compare the prevalence and severity of menopausal symptoms among Canadian women experiencing menopause around the average age and those with premature ovarian insufficiency.

This cross-sectional observational study included women attending specialized menopause and premature ovarian insufficiency clinics at an academic center in Toronto, Canada. Participants completed a standardized intake questionnaire and the Menopause Rating Scale, a validated instrument assessing psychological, somato-vegetative, and urogenital symptoms. Symptom prevalence and severity were compared between cohorts using nonparametric and categorical statistical tests.

The study included 374 women experiencing menopause at an average age (median age 53 y) and 149 women with premature ovarian insufficiency (median age 34 y). Menopausal symptoms were common in both groups, with most women reporting symptoms in at least one domain. Urogenital symptoms were the most prevalent and severe across cohorts. Total Menopause Rating Scale scores were higher among women with menopause compared with premature ovarian insufficiency (P=0.003), driven by greater somato-vegetative symptom burden (P=0.002); psychological and urogenital symptom scores did not differ significantly between groups.

Menopausal symptoms are common and frequently severe for both average-age menopause and premature ovarian insufficiency. Younger age in premature ovarian insufficiency may not confer protection against psychological or urogenital symptoms, given similar symptom burden with average-age menopause. This underscores the need for proactive, comprehensive symptom assessment and management-particularly for urogenital and sexual health-in all individuals experiencing estrogen deficiency.