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Health symptoms during midlife in relation to menopausal transition: British prospective cohort study

BMJ 2012; 344 doi: (Published 08 February 2012) Cite this as: BMJ 2012;344:e402

Re: Health symptoms during midlife in relation to menopausal transition: British prospective cohort study

In the context of the Health for all, a goal to be achieved by 2020 AD, it is important to widen the scope of reproductive health to women beyond reproductive years as well as, at twilight of reproductive life (i.e. midlife). This age group assumes importance as longevity is constantly increasing leading to expansion of this age- group. While talking about this age group one has to specifically ask about symptoms/problems indicative of morbidities related to Genito-urinary system in these women (of perimenopausal, menopausal and post-menopausal age group).

In a study conducted in a convenience sample of 200 healthy women aged 45 to 55 years, drawn from the state-wide population of women residing in Australia, it was revealed that Perimenopause was marked by more than hot flushes and night sweats. Most frequently occurring symptoms were forgetfulness, lack of energy, irritability and weight gain. The most distressing symptoms included weight gain, heavy bleeding, poor concentration, leaking of urine, and feeling as though life is not worth living1.
A longitudinal cohort of the Study of Women's Health Across the Nation, a prospective, multiethnic, multisite study of the natural history of menopausal transition was used to document prevalence of mild, moderate and severe urinary incontinence among ethnically diverse perimenopausal women in USA. The result showed mean age of subjects was 46.4 years. Incontinence prevalence was 57%. Nonwhite groups had lower risk2.

Four thousand women were recruited on a random basis from Civil Registration System, in one rural nad one urban county in Denmark and were asked to fill in a self-administered, validated questionnaire on lower urinary tract symptoms (LUTS). Results revealed that women aged 40-60 years frequently (27.8%) reported lower urinary tract symptoms and 16.1% had urinary incontinence. Age but not the place of residence was an important factor associated with the occurrence of lower urinary tract symptoms in perimenopausal women. LUTS occurring more than once weekly seem to be the most appropriate single measure of LUTS3.


1. McVeigh C. Peimenopause: more than hot flushes and night sweats for some Australian women. J Obstet Gynecol Neonatal Nurs. 2005; 34(1): 21-7.
2. Sampselle CM, Harlow SD, Skurnick J, Brubaker L, Bondaenko I. Urinary
incontinence predictors and life impact in ethnically diverse perimenopausal women.
Obstet Gynecol. 2002; 100(6): 1230-8.
3. Moller LA, Lose G, Jorgensen T. The prevalence and bothersomeness of lower
urinary tract symptoms in women 40-60 years of age. Acta Obstet Gynecol Scand.
2000; 79(4): 298-305.

Competing interests: No competing interests

20 February 2012
Neeru Gupta
Scientist E
Indian Council of Medical Research
V. Ramalingaswamy Bhawan, Ansari Nagar, New Delhi-110029