The association of menopause and physical functioning in women at midlife

OBJECTIVES: To determine whether the characteristics of menstrual bleeding and the menopausal transition are associated with physical functioning in w omen age 40 to 55, after considering ethnicity, ability to pay for basics, body size, and age. DESIGN: Cross-sectional study. SETTING: Seven geographically dispersed community samples in the United Sta tes. PARTICIPANTS: The 14,427 respondents were Caucasians (46.9%), African Ameri cans (28.7%), Chinese (4.0%), Japanese (5.3%), and Hispanics (12.6%) from t he Study of Women's Health Across the Nation (SWAN) Cross-sectional Study, a study of the menopausal transition, including surgical menopause. MEASUREMENTS: The dependent variable was a three-category variable based on the physical functioning scale of the Medical Outcomes Study. Explanatory variables included menstrual and menopausal status. RESULTS: Eighty percent (80.8%) of women reported no limitation in physical functioning, whereas 10% of women had some limitation, and 9.2% of women i ndicated having substantial limitation. Women with substantial limitation i n physical functioning had double the prevalence odds ratio (POR = 2.02; 95 % confidence interval (CI) = 1.64-2.49) of having surgical menopause and 76 % greater odds (POR = 1.76; 95% CI = 1.38-2.24)) of using hormones, compare d with women with no limitation. Compared with those without limitation, wo men with substantial limitation in physical functioning had 56% greater odd s (POR = 1.56; 95% Cl = 1.23-1.97)) of being naturally postmenopausal and a 41% greater odds (POR = 1.41; 95% Cl = 1.17-1.70) of being perimenopausal, relative to being premenopausal and after adjusting for other variables. CONCLUSION: Even at the relatively early age of 40 to 55, approximately 20% of women self-reported limitation in physical functioning. Surgical menopa use and the use of hormones were more frequently observed in women with som e and substantial physical limitation than in women with no limitation, eve n after adjusting for economic status, age, body mass index, and race/ethni city.