Table 1 Study characteristics

Bromberger)/ Prospective study of the determinants of age at menopause

To investigate cigarette smoking, reproductive history, and socioeconomic status, among Caucasian and African American women and menopausal age.

Cohort study

Women were 42.5–47.5 years old and premenopausal

US (not specifically mentioned)

Premenopausal women who experienced irregular menstrual cycles, were smokers, were dieting, or were African American were likely to reach menopause earlier than their peers.

Glazer/ The Ohio midlife women’s study

To examine predictors, moderators, and outcome variables associated with the transition to midlife in Caucasian and African American women.

Cohort Study

Community-based sample of healthy midlife (40–60 year old) women

Ohio

Attitude toward menopause and coping effectiveness consistently predicted health promoting activities. However, menopausal status was not determined to be a better predictor of negative health outcomes than stress.

Thurston/ Childhood abuse or neglect is associated with increased vasomotor symptom reporting among midlife women

The aim of the investigation was to examine the association between childhood abuse and vasomotor symptoms (hot flashes, night sweats) over the menopausal transition.

Cohort Study

Women 42 to 52 years, having an intact uterus and at least one ovary and in the previous 3 months at least one menstrual cycle,

without pregnancy, breast-feeding, or reproductive hormone

use.

Pennsylvania

(Pittsburgh) SWAN site only

Childhood abuse and neglect was associated with increased vasomotor symptom reported in adulthood.

Thurston/ Beyond frequency: Who is most bothered by vasomotor symptoms?

The primary aim was to identify correlates of vasomotor symptoms beyond symptom frequency.

Cross Sectional Study

Women 42 to 52 years, having an intact uterus and at least one ovary and in the previous 3 months at least one menstrual cycle,

without pregnancy, breast-feeding, or reproductive hormone

use.

SWAN Study

National Sample; Pittsburgh, Boston, Detroit, Michigan, and Chicago; Los Angeles; Newark, New Jersey; Oakland, California

Mood, symptom sensitivity, symptom duration, sleep problems, age, and race were factors associated with bothersome hot flashes.

Gerber/ Hormone Therapy Use in Women Veterans Accessing Veterans Health Administration Care: A National Cross-Sectional Study

To determine the frequency of HT use among women veterans in the VA and to ascertain whether documented mH conditions were associated with HT use in VA

Cross Sectional Study

Veteran status, at least one VA outpatient visit in FY 2009, and age greater than 45 years.

National sample of female VA users

The prevalence of HT use among women veterans using VA care was more than twice that of the general population.

Thomas/ Changes in sexual function among midlife women: “I’m older… and I’m wiser”

To explore how sexual function changes during midlife/transition to menopause

Qualitative Study

Women 45 to 60 years who had been sexually active with a partner at least once in the prior 12 months.

Pittsburgh, Pennsylvania

The study participants described changes in sexual function during midlife, the age of transition to menopause. When negative changes occurred, women adapted behaviorally and psychologically.

Gibson/ Associations of Intimate Partner Violence, Sexual Assault, and Posttraumatic Stress Disorder with Menopause Symptoms Among Midlife and Older Women

To examine the prevalence of intimate partner violence, sexual assault, and symptoms of PTSD in a large sample of community-dwelling midlife and older women, and evaluate the associations be-tween these exposures and common menopause symptoms.

Cross Sectional Study

Women 40 years of age or older, enrolled in Kaiser Permanente Northern California (KPNC) before age 21, and who had at least half of any childbirth events at a KPNC

facility.

Oakland,

California

Lifetime history of intimate partner violence or sexual assault and current significant symptoms of posttraumatic stress disorder were common and were associated with menopause symptoms.

Palmer/ Onset of natural menopause in African American women

To assess the predictors of the onset of natural menopause in African American women

Cohort Study

Women who reported a natural menopause on the 1997 Black Women’s Health Study questionnaire.

National Study

Earlier onset of natural menopause among African American women was strongly associated with smoking and inversely associated with body mass index and oral contraceptive use.

Woods/ Pathways to depressed mood for midlife women: Observations from the Seattle Midlife Women’s Health Study.

To develop a test and a multidimensional model of depressed mood experienced by women during midlife.

Cohort Study

Women who had a menstrual period within the past year and were 35–55 years old, not pregnant or lactating, had a uterus and at least one ovary

Seattle, Washington

The stressful life context pathway was most influential in accounting for depressed mood. Health status had a direct effect on depressed mood and an indirect effect through stress.

Avis)/ Is there a menopausal syndrome? Menopausal status and symptoms across racial/ethnic groups

The specific research questions addressed were: (1) How does the factor structure of symptoms among mid-aged women compare across racial/ethnic groups? (2) Is symptom reporting related to race/ethnicity or menopausal status? and (3) Does the relationship between menopausal status and symptoms vary across racial/ethnic groups?

Cross Sectional Study

Women 42 to 52 years, having an intact uterus and at least one ovary and in the previous 3 months at least one menstrual cycle,

without pregnancy, breast-feeding, or reproductive hormone

use.

SWAN Studies

National Sample; Pittsburgh, Boston, Detroit, Michigan, and Chicago; Los Angeles; Newark, New Jersey; Oakland, California

Controlling for age, education, health, and economic strain, Caucasian women reported significantly more psychosomatic symptoms than other racial/ethnic groups. African-American women reported significantly more vasomotor symptoms.

Bromberger/ Psychologic distress and natural menopause: a multiethnic community study

To examine the association between psychological distress and natural menopause in a community sample of African American, White, Chinese, Hispanic, and Japanese women participating in a national women’s health study.

Cross Sectional Study

Women 42 to 52 years, having an intact uterus and at least one ovary and in the previous 3 months at least one menstrual cycle,

without pregnancy, breast-feeding, or reproductive hormone

use.

SWAN Studies

National Sample; Pittsburgh, Boston, Detroit, Michigan, and Chicago; Los Angeles; Newark, New Jersey; Oakland, California

Psychologic distress is associated with irregular menses in midlife.

Sharps/ Knowledge, attitudes, perceptions and practices of African American women toward menopausal health.

To identify the knowledge, attitudes, perceptions and practices of African American women toward menopausal health.

Cohort Study

African American women from diverse SES levels, between 40 to 65 years of age.

N/A

Among this group of women there were significant differences in use of HRT

and health promotion behaviors. Most women sought information from printed materials.

* HRT usage was a proxy for menopausal symptoms

Hudson/ Symptom experience and self-care strategies among healthy, midlife African American women.

To describe symptom prevalence, symptom distress, and the self-care management strategies of midlife African American women during the late pre-menopausal and early peri-menopausal transition.

Cohort Study

African American Women age 40–52

 N/A;

Prevalent or severe symptoms included fatigue, headaches, cramps, night sweats, and depression. Most self-care strategies were “passive” strategies, such as “faith,” “think,” “accept,” or “value/believe/forgive self”.

Nosek/ The effects of perceived stress and attitudes toward menopause and aging on symptoms of menopause.

To explore the association of women’s pre-existing attitudes toward menopause, aging, and perception of stress with subsequent intensity of vasomotor symptoms often associated with menopausal transition (hot flashes, night sweats, day sweats, and vaginal dryness).

Cohort Study

Women ages 40–50 began the study while pre-menopausal

Northern California

A lower income, higher perceived stress, a more negative attitude toward aging, and a more positive attitude toward menopause influenced menopausal symptom experience.

DeMello/ Menopausal symptoms in the Southwest United States: A cross-sectional survey of women from areas with different socioeconomic resources

To understand self-reported menopausal symptoms of women from areas of differing socioeconomic makeup: women who are uninsured or experiencing homelessness in downtown Phoenix and insured women living in socially advantaged areas in the neighboring community of Scottsdale.

Cross Sectional Study

Women aged 40–65 years

Phoenix, Arizona

In a group of women living in Arizona from distinct socioeconomic areas, significant differences were demonstrated in menopausal symptom bother specifically with higher psychological and somatic symptoms in women who were uninsured or experiencing homelessness independent of age, race, menopause stage and HT use.