Depressed mood symptoms during the menopausal transition: observations from the Seattle Midlife Women's Health Study.

AIM: To describe patterns of depressed mood during the menopausal transition (MT) and to investigate relationships between patterns of depressed mood and MT stages. METHODS: Women during MT and early postmenopause rated depressed mood from 0 to 4 in a 3-day diary. Variables were percentage days with zero ratings, days with ratings of 3 or 4, and slope of ratings over time. Cluster analysis was used. RESULTS: Six distinct clusters were identified for 164 women. The three largest clusters (n = 134) had depressed mood ratings of zero (93% of days, 73%, 50%, respectively). Ratings of 3 or 4 were infrequent for these three clusters (0%, 3%, 9%, respectively). The three smallest clusters (n = 30) had zero ratings for 32% of days, 14% and 8%, respectively. The fourth cluster had 16% rated 3 or 4 with a positive slope. The fifth and sixth clusters had 23% and 6% of days at 3 or 4 with a negative slope. MT stage was not related to depressed mood ratings. Most women did not have depressed mood during the MT. Of those who did, some experienced improvement. IMPLICATIONS: The majority of women for the majority of the time experienced MT without a high severity of depressed mood while a small group of women had mood worsening over time and others improved. Depressed mood that occurs during the MT should not be attributed automatically to menstrual cycle changes or normative changes. Instead, features of a woman's life that contribute to depression should also be considered.

Concordance of retrospective and prospective reporting of menstrual irregularity by women in the menopausal transition.

OBJECTIVES: First, to compare retrospective self-report of irregular and skipped periods by women in the menopausal transition to information recorded concurrently on calendars; and, second, to describe how participants' definitions of irregularity and skipping affected reporting. METHODS: The sample was 161 women who returned both complete menstrual calendars and questionnaires in any year between 1997 and 2002. Irregular and skipped periods documented on menstrual calendars were compared with self-reports. Data were z-score adjusted for repeated observations in women and analyzed using Cohen's kappa. RESULTS: Agreement between calendar and questionnaire reporting of cycle irregularity was weak (kappa = 0.192). Participants' definitions of irregularity and skipping differed markedly from those of the researchers. Agreement about skipping was stronger overall and increased after a definition of skipping was provided to study participants (kappa pre-definition = 0.597; post-definition = 0.765). Counts of skipped cycles led to the greatest differences between researchers and participants. DISCUSSION: Accuracy of self-reports of menstrual cycle irregularity or skipping is not sufficient without explanations about what is meant by those terms. Researchers and clinicians who solicit information from women about menstrual cycle patterns need to define explicitly the phenomenon of interest to insure accurate information.