Singaporean cohort study: Menopausal women now more symptomatic

Menopause occurs at about 50 years of age for Singaporean women, and almost two out of three of them experience moderate-to-severe symptoms, as shown in a study presented at RCOG 2023.

“In terms of symptom prevalence, joint/muscle discomfort was top (33 percent). This was followed by sleep problems (28 percent), physical and mental exhaustion (20 percent), vaginal dryness (20 percent), and hot flashes (19 percent),” reported lead study author Dr Susan Logan from National University of Singapore, Singapore.

On further analysis, joint/muscle discomfort and sleep problems affected one out of three and one out of four women, respectively, across all age groups. Exhaustion and hot flashes were more common among women below 55 years of age, but occurred in one in six 55-to-64-year-olds and one in 10 ≥65-year-olds. [RCOG 2023, abstract OP.0009]

Ethnicity also factored in, Logan noted, such that Indians had the highest prevalence of three out of the top five symptoms.

In multivariable logistic regression models, higher total scores (>6) on Menopause Rating Scale (MRS) were associated with menstrual irregularity at 25 years (adjusted odds ratio [aOR], 1.58, 95 percent confidence interval [CI], 1.04–2.40), poorer self-rated health status (aOR, 2.32, 95 percent CI, 1.70–3.18), moderate-to-severe disability (aOR, 10.90, 95 percent CI, 3.21–37.02), and slower performance on repeated chair-stand test (aOR, 2.14, 95 percent CI, 1.22–3.75).

In contrast, lower total scores on MRS were associated with lower education (aOR, 0.45, 95 percent CI, 0.26–0.76).

The rankings of moderate-to-severe symptoms in the present cohort were similar to that in 2001 data, but the prevalence of these symptoms was about three times greater in the present cohort, according to Logan.

“This study, the largest in a multiethnic, midlife, Asian population with natural menopause, is the first, in 15 years, to reassess menopausal age and symptoms in Singapore … [and provides] an up-to-date picture of the most common symptoms and correlates for midlife Singaporean women,” she said.

In light of the findings, Logan pointed out that the prevalence of moderate-to-severe menopausal symptoms differs by ethnicity and that women today are possibly more symptomatic.

“The results suggest the need to take a life course approach to menstrual abnormalities and the need to explore menopausal symptoms in older women and those with poorer self-reported health, disability, and reduced physical performance,” she added.

Taken together, the data add to limited research in Asia and raise the profile of this important and prevalent area of health, according to Logan. It can also “advise healthcare professionals, government ministries, women, and their families on what to expect and [factors] that may reduce/exacerbate symptoms.”