Habitual physical activity is a meaningful predictor of well-being in mid-life women: a longitudinal analysis.

OBJECTIVES: To examine whether physical-activity patterns over a period of 4 years are associated with well-being. DESIGN: A sample of 399 women aged 50-60 years participated in the study. Measures included rate of physical activity and other life style behaviors, well-being, health status, and interpersonal stress. Sufficient and insufficient exercisers were identified, and the association of this dichotomy with well-being, along with the contribution of the other variables, was examined. RESULTS: The distribution of physical-activity patterns remained stable over the 4 years of the study, with 40% of the women exercising leisurely and 15-20% exercising vigorously four to seven times a week. Approximately 50% of the women were considered sufficiently active in terms of public recommendations. Random effects regression analysis revealed that sufficient exercise along with a low frequency of daily hassles, relatively few menopausal symptoms, and a low level of interpersonal stress significantly contributed to the variability of well-being. CONCLUSIONS: These data evoke the need for a better understanding of exercise behavior and its promising potential contribution to the well-being of middle-aged women.

The menopausal transition: a 9-year prospective population-based study. The Melbourne Women's Midlife Health Project.

OBJECTIVES: To describe the natural history of the menopause in Australian-born women. To determine the hormonal changes relating to the menopausal transition (MT) and how these affect quality of life, bone mineral density, body composition, cardiovascular disease (CVD) risk and memory. DESIGN: A 9-year prospective, observational study of a population-based sample of 438 Australian-born women aged 45-55 years at baseline. By the 9th year, the retention rate was 88%. Interviews, blood sampling, menstrual calendars, quality of life and physical measures were taken annually, and bone mineral density was measured bi-annually. RESULTS: The late MT coincides with changes in estradiol, follicle stimulating hormone, and free testosterone index, decreases in bone density and mastalgia, and increases in central adiposity, vasomotor symptoms, insomnia and vaginal dryness. Levels of total testosterone and dehydroepiandrosterone sulfate are unchanged by the MT. An increase in CVD risk was associated with increases in weight and free testosterone index and a decrease in estradiol. Depressed mood is increased by symptoms and by stressors occurring in the MT. Sexual functioning significantly deteriorates with the MT and aging, but relational factors have major effects. Menstrual cycles became more variable and longer closer to the final menstrual period. CONCLUSIONS: As hormonal changes during the MT directly or indirectly adversely affect quality of life, body composition and CVD risk, maintenance of health parameters in the premenopausal years is crucial for a healthy postmenopause.

Health care-seeking for menopausal problems.

OBJECTIVES: To determine the rate and timing of medical consultations for menopausal problems during the menopausal transition and to identify baseline and prospective variables associated with these consultations. METHODS: This was a 9-year community-based study with annual interviews of 438 Australian-born women who at baseline were aged 45-55 years, had menstruated in the previous 3 months and were not using hormone therapy. RESULTS: In total, 387 women completed the 9-year study, of whom 86% consulted a doctor about menopausal problems, with an annual mean of 31%. Of the women, 212 experienced a natural menopause. The prevalence of consultations regarding menopausal problems was a maximum about 2.5 years before the final menstrual period (FMP). The time of greatest prevalence of reporting bothersome hot flushes was 2.1 years after the FMP. There was no significant relationship between number of symptoms reported and time to/from the FMP. Multiple regression analysis found that an increased number of consultations for menopausal problems was associated with the baseline variables: vasomotor symptoms (p < 0.005), rating one's health as 'worse than most' (p < 0.005) and taking two or more non-prescription medications (p < 0.05); and the follow-up variables: dysphoric symptoms (p < 0.05), vasomotor symptoms (p < 0.005) and hormone therapy use (p < 0.001). CONCLUSION: Nearly one-third of women will consult a doctor annually during the years of the menopausal transition. Those who are more symptomatic with mood or vasomotor symptoms consult doctors more often and are more likely to use hormone replacement therapy.