Climacteric complaints in the community

Background. At the onset of the climacteric, healthy middle-aged women pres ent with a variety of complaints, especially in general practice. In these first years of entering the menopause, vaginal blood loss alters from irreg ular periods to complete amenorrhoea. According to these different menstrua l patterns, we can distinguish a pre-, peri- and postmenopausal phase. It c ould be useful to know whether specific climacteric complaints are related to these different phases. Objective. The aim of this study was to investigate the relationship betwee n climacteric complaints and the menstrual pattern during the menopausal tr ansition in a population-based cross-sectional survey of healthy middle-age d women. Methods. All women aged 47-54 years, living in the city of Eindhoven, were invited to participate in the Eindhoven Osteoporosis Study (EPOS); 6648 (78 %) agreed to participate. All women completed a questionnaire concerning cl imacteric complaints. Climacteric status was defined by menstrual history. Odds ratios (ORs) were obtained for the relationship between climacteric st atus and climacteric complaints. Multiple logistic regression analysis was carried out, with climacteric status as the dependent variable. Results. Of the 27 items in the questionnaire concerning climacteric compla ints, seven were significantly different between all three climacteric phas es (P < 0.1). After multiple logistic regression analysis, comparing peri- and premenopause, only flushing (OR 5.9) was significantly different. Betwe en post- and perimenopause, seven symptoms appeared to be different: three urogenital complaints [vaginal dryness (OR 1.6), vaginal discharge (OR 0.4) and pain during intercourse (OR 1.9)], three vasomotor symptoms [daytime s weating (OR 1.4), night-time sweating (OR 0.7) and flushing (OR 1.9)] and, finally, insomnia (OR 1.3). When comparing post- and premenopause, flushing (OR 13.4), insomnia (OR 2.1) and depressed mood (OR 0.6) were significantl y different, in addition to three urogenital symptoms: vaginal dryness (OR 2.6), vaginal discharge (OR 0.3) and pain during intercourse (OR 2.1). Conclusion. The major findings of the study are that flushing is strongly a ssociated with the transition from pre- to perimenopause, while urogenital complaints, daytime sweating and insomnia are more prominent in the transit ion from peri- to postmenopause.