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Multidimensional menopausal symptom burden in Singapore - MARIE work package 2a population analysis
Ieera Madan Aggarwal1, Vindya Pathiraja2, Farah Safdar Husain1
1Department of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore city, Singapore.
Objective:
Menopause is a multidimensional health transition associated with physical, psychological and social consequences. Evidence from Asian settings remains limited, and symptom burden is often examined using single instruments rather than integrated severity measures. This study quantified menopausal symptom burden in Singapore and developed composite indices capturing overall symptom severity and cumulative burden.
Method:
Baseline and follow-up data from the Singapore arm of a multi-site menopause study were analyzed. Participants self-reported menopausal stage and type. Symptoms were assessed using validated psychometric instruments. The Singapore Menopause Symptom Severity Score (SMSS-SG) integrated standardized symptom totals into a single severity metric. A Cumulative Burden Index for Singapore (CBI-SG) combined biological symptom severity (SMSS-SG), psychological burden, socioeconomic disadvantage and health-system barriers on a common scale. Descriptive analyses, non-parametric comparisons and validation assessments were performed.
Results:
Menopausal symptom burden was common and heterogeneous. Musculoskeletal and urogenital symptoms were the most severe, alongside high prevalence of sleep and mood-related symptoms. Overall severity peaked during perimenopause and remained clinically relevant in menopause and postmenopause. Surgical menopause was associated with higher symptom severity and cumulative burden than natural menopause, whereas medically induced menopause showed lower median severity. The SMSS-SG demonstrated good internal consistency and known-group validity, and both indices were inversely associated with health-related quality of life.
Conclusion:
Menopausal symptom burden in Singapore is substantial and multidimensional. Composite severity and cumulative burden indices support epidemiological assessment and may support future symptom-led approaches to epidemiological surveillance, service planning and hypothesis generation within menopause research.
