Symptom prevalence during menopause and factors associated with symptoms and menopausal age. Results from the Norwegian Hordaland Women's Cohort study
Section snippets
Background
Symptoms most consistently connected to changes in hormonal status during the menopause are the vasomotor symptoms (hot flushes and sweats/nights sweats) and vaginal dryness, and to some extent sleep disturbances [1], [2], [3], [4]. Studies published the last decade substantiating side effects of hormone therapy (HT) have profoundly changed the attitudes to HT during and after the menopause [5], [6], [7]. Since 2002 the Norwegian volume of purchased HT has been more than halved [8]. Because
Study population
The Hordaland County Health Survey (HUSK) was a joint epidemiological research project carried out by the National Health Screening System of Norway (now: Norwegian Institute of Public Health) and the University of Bergen. It consists of a baseline registration obtained in 1997–1999, including all inhabitants in the county born 1953–57. Baseline measurements from HUSK included body height and weight, and blood pressure. A non-fasting blood sample was also collected. The self-administrated
Frequency and burden of symptoms: hot flushes, cold sweats/night sweats, vaginal soreness/dryness
When the women went through the midlife age, the prevalence of hot flushes showed a gradual increase both in terms of frequency and symptom burden (Table 2, Fig. 1, Fig. 2). The proportion of women who experienced daily hot flushes increased from 2% in the 41–42 years age group, to 22% in the 53–54 years age group, with a slight decrease to 20% in age group 55–57 years. The prevalence of cold sweats/night sweats followed a similar pattern, whereas the proportion of women who reported daily
Sample size
The Hordaland Women's Cohort (HWC) is community based, includes a large number of randomly selected participants, and the attrition rate was low, all factors strengthening the external validity of the study results. Compared to the US SWAN study, the women in the Cohort had a lower prevalence of surgically induced menopause. In SWAN, the overall incidence of surgically induced menopause (bilateral oopherectomy and/or hysterectomy) was 20.8% as compared to 8% in our population [1]. This probably
Conclusion
Our study shows that about one third of Norwegian women report frequent and bothersome vasomotor symptoms during the menopausal transition, while a somewhat lower proportion do not experience any (or very few) symptoms at all. Smoking is significantly associated with more symptoms and an earlier menopausal age, while other life style factors, like BMI or physical activity before menopause, have no significant correlation with the prevalence or the burden of menopausal symptoms.
Contributors
Bjørn Gjelsvik declares that he has written the first draft of the text and has done the main part of the statistical analyses.
Elin O. Rosvold declares that he has participated in the data analysis, interpretation and discussion of results, and discussion and revision of the paper, and has seen and approved the final version.
Jørund Straand declares that he has participated in the data analysis, interpretation and discussion of results, and discussion and revision of the paper, and has seen and
Competing interests
Authors declare no conflict of interest.
Funding
The Hordaland Women's Cohort as a sub-study of the Hordaland Health Study was performed in collaboration with the Norwegian National Health Screening Service and the University of Bergen. The Cohort was partly funded by the Norwegian Research Council. Funding for the present substudy was obtained from Norwegian Medical Association's Funds for Research in General Practice, and the University of Oslo.
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