Perimenopausal symptom burden: implications for health, work and earlier clinical management

Perimenopausal women often experience symptoms impairing quality of life, yet they receive limited clinical attention. This study aimed to assess symptom burden, health-related quality of life (HRQoL) and work-related outcomes across reproductive aging stages.

Secondary analysis included 1478 women aged 40-54 years from 12 Latin American countries, classified by age and menstrual status into four groups: age 40-44 years with regular cycles (reference), age 45-49 years with regular cycles, age 45-49 years with irregular cycles (perimenopause) and age 50-54 years with absent menses (early postmenopause). Symptoms, HRQoL, work-related outcomes and job satisfaction were assessed using validated instruments Multivariable logistic regression analyses were performed.

Symptom severity increased progressively across stages, with severe symptoms rising from 18.3% (reference group) to 50.6% in postmenopausal women (p < 0.001). Compared with the reference group, women with irregular cycles and those with absent menses had higher odds of severe symptoms (odds ratio [OR] 2.97 and 3.71), lower HRQoL (OR 1.62 and 1.97) and lower job satisfaction (OR 2.01 and 3.07), respectively. Menopausal stage was not independently associated with work-related quality of life.

Symptom burden and its impact on health and job satisfaction emerge before menopause and may inform earlier, stage-specific clinical guidance.