Anticipated age of perimenopausal experiences, stress, satisfaction, and health and well-being: observations from the Women Living Better Survey.

Abstract

People's expectations about the timing of developmental events, specifically the ages at which they will occur, are influenced by social and cultural contexts. When expected timing and lived experience are divergent, events such as menopause may be associated with greater stress or distress. We hypothesized that being "off-time," that is, experiencing perimenopause-related menstrual cycle changes or symptoms in a timeframe before a person expects them, would lead to worse ratings on measures of stress, satisfaction, and health. Participants responded to the online Women Living Better Survey during March to August 2020; 1,262 met the eligibility criteria for inclusion in hypothesis testing. Being "off-time" referred to experiencing changes related to perimenopause at a younger age than that at which participants anticipated experiencing such changes. Using a one-way analysis of variance (ANOVA), we examined differences in being "off-time" versus "on-time" on seven participant-rated measures: stress (overall and health-related stress), satisfaction with life roles and activities, and well-being and health ratings (interference with daily activities, interference with relationships, "not feeling like myself," and perceived health). Using 2-way ANOVA, we then tested hypothesized differences between being "off-time" and on-time and experiencing perimenopause-related menstrual cycle changes, vasomotor/sleep symptoms, or volatile mood symptoms on the same seven measures. Those who were "off-time" versus "on-time" reported significantly poorer health ratings in a one-way ANOVA. Experiencing more noticeable perimenopause-related menstrual cycle changes was significantly related to greater health stress, overall stress, satisfaction with life roles and activities, interference with daily activities, interference with relationships, and "not feeling like myself" (all P < 0.05), but not to health ratings. Experiencing more bothersome vasomotor symptoms was significantly related to health stress, overall stress, interference with daily activities, interference with relationships, and "not feeling like myself" more of the time and to poorer perceived health (all P < 0.05). There were no significant interaction effects of being "off-time" and experiencing perimenopause-related menstrual cycle changes or vasomotor symptoms. In contrast, having more bothersome volatile mood symptoms significantly affected health stress, overall stress, satisfaction with life roles and activities, interference with daily activities, interference with relationships, "not feeling like myself" more of the time, and perceived health. Finally, there was a significant interaction effect of being "off-time" and volatile mood symptoms on health stress, satisfaction with life roles and activities, and perceived health (all P < 0.05). Being "off-time" alone had little effect on studied measures with the exception of poorer perceived health. Experiencing more noticeable perimenopause-related menstrual cycle changes or having more bothersome vasomotor symptoms influenced several measures, but there were no interactive effects with being "off-time." In contrast, those who were "off-time" and experiencing more bothersome volatile mood symptoms reported greater health stress, lower satisfaction with life roles and activities, and poorer perceived health. These interactive effects of being "off-time" and experiencing volatile mood suggest a need for greater attention to the link between volatile mood and perimenopause. Furthermore, anticipatory guidance for those on the path to menopause should include the possibility of volatile mood symptoms.