Menopause dynamics: From symptoms to quality of life, unraveling the complexities of the hormonal shift

Simerjeet Singh Bagga; Surekha Tayade; Nilesh  Lohiya; Archana Tyagi; Aditya Chauhan

doi:10.31893/multirev.2025057

Keywords:

Abstract

The article delves deeply into the nature and process of menopause through which women undergo, which comprises profound transitions that occur during all menopausal stages. These findings emphasize the critical importance of comprehending and effectively addressing the diverse array of menopausal symptoms. The profound decline in progesterone and estrogen levels has been identified as the catalyst for triggering a spectrum of symptoms, which include but are not limited to hot flashes, mood swings, sleep disturbances, and genitourinary issues. These symptoms are noted to have a tangible impact on the daily functioning and overall well-being of women. This article underscores the pivotal role played by hormonal shifts in the manifestation of these symptoms and highlights the pressing need for the development of robust management strategies. Furthermore, hormone replacement therapy (HRT) is a well-researched treatment option, albeit with the caveat that its potential risks necessitate a personalized and nuanced approach. It also emphasizes the importance of lifestyle modifications, such as engaging in regular physical activity, adopting a balanced diet, and considering cognitive behavioral therapy, as pivotal elements in mitigating certain menopausal symptoms while concurrently enhancing overall health. The article also underscores the importance of addressing sexual health through therapeutic interventions, acknowledging their potential to significantly ameliorate vaginal symptoms and enhance sexual function, thereby fostering greater intimacy and relational satisfaction. Additionally, it highlights the profound psychosocial adjustments that women undergo during menopause, which are intrinsically intertwined with sociocultural factors. A holistic approach to menopause management is advised, which encompasses psychological support, medical treatments, and social interventions, underscoring their collective importance in effectively supporting women through this important life transition.
References
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2. Albrecht, G. L. (1994). Advances in Medical Sociology: Quality of Life in Health Care 1994 (R. Fitzpatrick, Ed.).
3. Alexander, J. L., Neylan, T., Kotz, K., Dennerstein, L., Richardson, G., & Rosenbaum, R. (2007). Assessment and treatment for insomnia and fatigue in the symptomatic menopausal woman with psychiatric comorbidity. Expert Review of Neurotherapeutics, 7(11 Suppl), S139–S155. https://doi.org/10.1586/14737175.7.11s.S139
4. Avis, N. E., Ory, M., Matthews, K. A., Schocken, M., Bromberger, J., & Colvin, A. (2003). Health-related quality of life in a multiethnic sample of middle-aged women: Study of Women’s Health Across the Nation (SWAN). Medical Care, 41(11), 1262–1276. https://doi.org/10.1097/01.MLR.0000093479.39115.AF
5. Cho, L., Kaunitz, A. M., Faubion, S. S., Hayes, S. N., Lau, E. S., Pristera, N., Scott, N., Shifren, J. L., Shufelt, C. L., Stuenkel, C. A., & Lindley, K. J. (2023). Rethinking menopausal hormone therapy: For whom, what, when, and how long? Circulation, 147(7), 597–610. https://doi.org/10.1161/CIRCULATIONAHA.122.061559
6. Col, N. F., Guthrie, J. R., Politi, M., & Dennerstein, L. (2009). Duration of vasomotor symptoms in middle-aged women: A longitudinal study. Menopause (New York, N.Y.), 16(3), 453–457. https://doi.org/10.1097/gme.0b013e31818d414e
7. Daly, E., Gray, A., Barlow, D., McPherson, K., Roche, M., & Vessey, M. (1993). Measuring the impact of menopausal symptoms on quality of life. BMJ (Clinical Research Ed.), 307(6908), 836–840. https://doi.org/10.1136/bmj.307.6908.836
8. Dj, B., & Sm, M. (1989). A prospective study of factors affecting age at menopause. Journal of Clinical Epidemiology, 42(11). https://doi.org/10.1016/0895-4356(89)90044-9
9. Ew, F., Md, S., H, L., & Db, N. (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression. Archives of General Psychiatry, 63(4). https://doi.org/10.1001/archpsyc.63.4.375
10. Freeman, E. W., Sammel, M. D., Lin, H., Gracia, C. R., Pien, G. W., Nelson, D. B., & Sheng, L. (2007). Symptoms associated with menopausal transition and reproductive hormones in midlife women. Obstetrics and Gynecology, 110(2 Pt 1), 230–240. https://doi.org/10.1097/01.AOG.0000270153.59102.40
11. Greene, J. G., & Cooke, D. J. (1980). Life stress and symptoms at the climacterium. The British Journal of Psychiatry: The Journal of Mental Science, 136, 486–491. https://doi.org/10.1192/bjp.136.5.486
12. Harlow, S. D., Gass, M., Hall, J. E., Lobo, R., Maki, P., Rebar, R. W., Sherman, S., Sluss, P. M., de Villiers, T. J., & STRAW 10 Collaborative Group. (2012). Executive summary of the Stages of Reproductive Aging Workshop + 10: Addressing the unfinished agenda of staging reproductive aging. Menopause (New York, N.Y.), 19(4), 387–395. https://doi.org/10.1097/gme.0b013e31824d8f40
13. Jungari, S., & Chauhan, B. (2017). Prevalence and determinants of premature menopause among Indian women: Issues and challenges ahead. Health & Social Work, 42, 1–8. https://doi.org/10.1093/hsw/hlx010
14. Kalmbach, D. A., Cheng, P., Arnedt, J. T., Anderson, J. R., Roth, T., Fellman-Couture, C., Williams, R. A., & Drake, C. L. (2019). Treating insomnia improves depression, maladaptive thinking, and hyperarousal in postmenopausal women: Comparing cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy, and sleep hygiene education. Sleep Medicine, 55, 124–134. https://doi.org/10.1016/j.sleep.2018.11.019
15. M, T., S, A., G, O., A, E., & N, K. (2018). Strategies to improve menopausal quality of life: A systematic review. Journal of Education and Health Promotion, 7. https://doi.org/10.4103/jehp.jehp_137_17
16. Manber, R., & Armitage, R. (1999). Sex, steroids, and sleep: A review. Sleep, 22(5), 540–555.
17. Mann, E., Smith, M. J., Hellier, J., Balabanovic, J. A., Hamed, H., Grunfeld, E. A., & Hunter, M. S. (2012). Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): A randomised controlled trial. The Lancet. Oncology, 13(3), 309–318. https://doi.org/10.1016/S1470-2045(11)70364-3
18. Manson, J. E., Chlebowski, R. T., Stefanick, M. L., Aragaki, A. K., Rossouw, J. E., Prentice, R. L., Anderson, G., Howard, B. V., Thomson, C. A., LaCroix, A. Z., Wactawski-Wende, J., Jackson, R. D., Limacher, M., Margolis, K. L., Wassertheil-Smoller, S., Beresford, S. A., Cauley, J. A., Eaton, C. B., Gass, M., & Wallace, R. B. (2013). Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA, 310(13), 1353–1368. https://doi.org/10.1001/jama.2013.278040
19. Messina, M. (2014). Soy foods, isoflavones, and the health of postmenopausal women. The American Journal of Clinical Nutrition, 100(Suppl 1), 423S–430S. https://doi.org/10.3945/ajcn.113.071464
20. National Collaborating Centre for Women’s and Children’s Health (UK). (2015). Menopause: Full Guideline. National Institute for Health and Care Excellence (UK). http://www.ncbi.nlm.nih.gov/books/NBK327156/
21. Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., Macera, C. A., & Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39(8), 1435–1445. https://doi.org/10.1249/mss.0b013e3180616aa2
22. Paramsothy, P., Harlow, S. D., Nan, B., Greendale, G. A., Santoro, N., Crawford, S. L., Gold, E. B., Tepper, P. G., & Randolph, J. F. (2017). Duration of the menopausal transition is longer in women with young age at onset: The multiethnic Study of Women’s Health Across the Nation. Menopause (New York, N.Y.), 24(2), 142–149. https://doi.org/10.1097/GME.0000000000000736
23. Praveena, S. M., Asha, G., Sunita, M., Anju, J., & Ratna, B. (2018). Yoga offers cardiovascular protection in early postmenopausal women. International Journal of Yoga, 11(1), 37–43. https://doi.org/10.4103/ijoy.IJOY_69_16
24. Proceedings from the NIH State-of-the-Science Conference on Management of Menopause-Related Symptoms, March 21-23, 2005, Bethesda, Maryland, USA. (2005). The American Journal of Medicine, 118(Suppl 12B), 1–171. https://doi.org/10.1016/j.amjmed.2005.09.030
25. Santoro, N., & Johnson, J. (2019). Diagnosing the onset of menopause. JAMA, 322(8), 775–776. https://doi.org/10.1001/jama.2019.6250
26. Santoro, N., & Komi, J. (2009). Prevalence and impact of vaginal symptoms among postmenopausal women. The Journal of Sexual Medicine, 6(8), 2133–2142. https://doi.org/10.1111/j.1743-6109.2009.01335.x
27. Santoro, N., Epperson, C. N., & Mathews, S. B. (2015). Menopausal symptoms and their management. Endocrinology and Metabolism Clinics of North America, 44(3), 497–515. https://doi.org/10.1016/j.ecl.2015.05.001
28. Schmidt, P. J., Steinberg, E. M., Negro, P. P., Haq, N., Gibson, C., & Rubinow, D. R. (2009). Pharmacologically induced hypogonadism and sexual function in healthy young women and men. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 34(3), 565–576. https://doi.org/10.1038/npp.2008.24
29. Simon, J. A. (2011). Identifying and treating sexual dysfunction in postmenopausal women: The role of estrogen. Journal of Women’s Health (2002), 20(10), 1453–1465. https://doi.org/10.1089/jwh.2010.2151
30. Syamala, T. S., & Sivakami, M. (2005). Menopause: An emerging issue in India. Economic and Political Weekly, 40(47), 4923–4930. https://www.jstor.org/stable/4417427
31. Talaulikar, V. (2022). Menopause transition: Physiology and symptoms. Best Practice & Research Clinical Obstetrics & Gynaecology, 81, 3–7. https://doi.org/10.1016/j.bpobgyn.2022.03.003
32. Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health-related quality of life: A conceptual model of patient outcomes. JAMA, 273(1), 59–65.
33. Zheng, H., Harlow, S. D., Kravitz, H. M., Bromberger, J., Buysse, D. J., Matthews, K. A., Gold, E. B., Owens, J. F., & Hall, M. (2015). Actigraphy-defined measures of sleep and movement across the menstrual cycle in midlife menstruating women: Study of Women’s Health Across the Nation Sleep Study. Menopause (New York, N.Y.), 22(1), 66–74. https://doi.org/10.1097/GME.0000000000000249

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How to cite

Bagga, S. S., Tayade, S., Lohiya, N., Tyagi, A., & Chauhan, A. (2024). Menopause dynamics: From symptoms to quality of life, unraveling the complexities of the hormonal shift. Multidisciplinary Reviews, 8(2), 2025057. https://doi.org/10.31893/multirev.2025057

[1] ACOG Practice Bulletin No. 141: Management of menopausal symptoms. (2014). Obstetrics and Gynecology, 123(1), 202–216. https://doi.org/10.1097/01.AOG.0000441353.20693.78

[2] Albrecht, G. L. (1994). Advances in Medical Sociology: Quality of Life in Health Care 1994 (R. Fitzpatrick, Ed.).

[3] Alexander, J. L., Neylan, T., Kotz, K., Dennerstein, L., Richardson, G., & Rosenbaum, R. (2007). Assessment and treatment for insomnia and fatigue in the symptomatic menopausal woman with psychiatric comorbidity. Expert Review of Neurotherapeutics, 7(11 Suppl), S139–S155. https://doi.org/10.1586/14737175.7.11s.S139

[4] Avis, N. E., Ory, M., Matthews, K. A., Schocken, M., Bromberger, J., & Colvin, A. (2003). Health-related quality of life in a multiethnic sample of middle-aged women: Study of Women’s Health Across the Nation (SWAN). Medical Care, 41(11), 1262–1276. https://doi.org/10.1097/01.MLR.0000093479.39115.AF

[5] Cho, L., Kaunitz, A. M., Faubion, S. S., Hayes, S. N., Lau, E. S., Pristera, N., Scott, N., Shifren, J. L., Shufelt, C. L., Stuenkel, C. A., & Lindley, K. J. (2023). Rethinking menopausal hormone therapy: For whom, what, when, and how long? Circulation, 147(7), 597–610. https://doi.org/10.1161/CIRCULATIONAHA.122.061559

[6] Col, N. F., Guthrie, J. R., Politi, M., & Dennerstein, L. (2009). Duration of vasomotor symptoms in middle-aged women: A longitudinal study. Menopause (New York, N.Y.), 16(3), 453–457. https://doi.org/10.1097/gme.0b013e31818d414e

[7] Daly, E., Gray, A., Barlow, D., McPherson, K., Roche, M., & Vessey, M. (1993). Measuring the impact of menopausal symptoms on quality of life. BMJ (Clinical Research Ed.), 307(6908), 836–840. https://doi.org/10.1136/bmj.307.6908.836

[8] Dj, B., & Sm, M. (1989). A prospective study of factors affecting age at menopause. Journal of Clinical Epidemiology, 42(11). https://doi.org/10.1016/0895-4356(89)90044-9

[9] Ew, F., Md, S., H, L., & Db, N. (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression. Archives of General Psychiatry, 63(4). https://doi.org/10.1001/archpsyc.63.4.375

[10] Freeman, E. W., Sammel, M. D., Lin, H., Gracia, C. R., Pien, G. W., Nelson, D. B., & Sheng, L. (2007). Symptoms associated with menopausal transition and reproductive hormones in midlife women. Obstetrics and Gynecology, 110(2 Pt 1), 230–240. https://doi.org/10.1097/01.AOG.0000270153.59102.40

[11] Greene, J. G., & Cooke, D. J. (1980). Life stress and symptoms at the climacterium. The British Journal of Psychiatry: The Journal of Mental Science, 136, 486–491. https://doi.org/10.1192/bjp.136.5.486

[12] Harlow, S. D., Gass, M., Hall, J. E., Lobo, R., Maki, P., Rebar, R. W., Sherman, S., Sluss, P. M., de Villiers, T. J., & STRAW 10 Collaborative Group. (2012). Executive summary of the Stages of Reproductive Aging Workshop + 10: Addressing the unfinished agenda of staging reproductive aging. Menopause (New York, N.Y.), 19(4), 387–395. https://doi.org/10.1097/gme.0b013e31824d8f40

[13] Jungari, S., & Chauhan, B. (2017). Prevalence and determinants of premature menopause among Indian women: Issues and challenges ahead. Health & Social Work, 42, 1–8. https://doi.org/10.1093/hsw/hlx010

[14] Kalmbach, D. A., Cheng, P., Arnedt, J. T., Anderson, J. R., Roth, T., Fellman-Couture, C., Williams, R. A., & Drake, C. L. (2019). Treating insomnia improves depression, maladaptive thinking, and hyperarousal in postmenopausal women: Comparing cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy, and sleep hygiene education. Sleep Medicine, 55, 124–134. https://doi.org/10.1016/j.sleep.2018.11.019

[15] M, T., S, A., G, O., A, E., & N, K. (2018). Strategies to improve menopausal quality of life: A systematic review. Journal of Education and Health Promotion, 7. https://doi.org/10.4103/jehp.jehp_137_17

[16] Manber, R., & Armitage, R. (1999). Sex, steroids, and sleep: A review. Sleep, 22(5), 540–555.

[17] Mann, E., Smith, M. J., Hellier, J., Balabanovic, J. A., Hamed, H., Grunfeld, E. A., & Hunter, M. S. (2012). Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): A randomised controlled trial. The Lancet. Oncology, 13(3), 309–318. https://doi.org/10.1016/S1470-2045(11)70364-3

[18] Manson, J. E., Chlebowski, R. T., Stefanick, M. L., Aragaki, A. K., Rossouw, J. E., Prentice, R. L., Anderson, G., Howard, B. V., Thomson, C. A., LaCroix, A. Z., Wactawski-Wende, J., Jackson, R. D., Limacher, M., Margolis, K. L., Wassertheil-Smoller, S., Beresford, S. A., Cauley, J. A., Eaton, C. B., Gass, M., & Wallace, R. B. (2013). Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA, 310(13), 1353–1368. https://doi.org/10.1001/jama.2013.278040

[19] Messina, M. (2014). Soy foods, isoflavones, and the health of postmenopausal women. The American Journal of Clinical Nutrition, 100(Suppl 1), 423S–430S. https://doi.org/10.3945/ajcn.113.071464

[20] National Collaborating Centre for Women’s and Children’s Health (UK). (2015). Menopause: Full Guideline. National Institute for Health and Care Excellence (UK). http://www.ncbi.nlm.nih.gov/books/NBK327156/

[21] Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., Macera, C. A., & Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39(8), 1435–1445. https://doi.org/10.1249/mss.0b013e3180616aa2

[22] Paramsothy, P., Harlow, S. D., Nan, B., Greendale, G. A., Santoro, N., Crawford, S. L., Gold, E. B., Tepper, P. G., & Randolph, J. F. (2017). Duration of the menopausal transition is longer in women with young age at onset: The multiethnic Study of Women’s Health Across the Nation. Menopause (New York, N.Y.), 24(2), 142–149. https://doi.org/10.1097/GME.0000000000000736

[23] Praveena, S. M., Asha, G., Sunita, M., Anju, J., & Ratna, B. (2018). Yoga offers cardiovascular protection in early postmenopausal women. International Journal of Yoga, 11(1), 37–43. https://doi.org/10.4103/ijoy.IJOY_69_16

[24] Proceedings from the NIH State-of-the-Science Conference on Management of Menopause-Related Symptoms, March 21-23, 2005, Bethesda, Maryland, USA. (2005). The American Journal of Medicine, 118(Suppl 12B), 1–171. https://doi.org/10.1016/j.amjmed.2005.09.030

[25] Santoro, N., & Johnson, J. (2019). Diagnosing the onset of menopause. JAMA, 322(8), 775–776. https://doi.org/10.1001/jama.2019.6250

[26] Santoro, N., & Komi, J. (2009). Prevalence and impact of vaginal symptoms among postmenopausal women. The Journal of Sexual Medicine, 6(8), 2133–2142. https://doi.org/10.1111/j.1743-6109.2009.01335.x

[27] Santoro, N., Epperson, C. N., & Mathews, S. B. (2015). Menopausal symptoms and their management. Endocrinology and Metabolism Clinics of North America, 44(3), 497–515. https://doi.org/10.1016/j.ecl.2015.05.001

[28] Schmidt, P. J., Steinberg, E. M., Negro, P. P., Haq, N., Gibson, C., & Rubinow, D. R. (2009). Pharmacologically induced hypogonadism and sexual function in healthy young women and men. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 34(3), 565–576. https://doi.org/10.1038/npp.2008.24

[29] Simon, J. A. (2011). Identifying and treating sexual dysfunction in postmenopausal women: The role of estrogen. Journal of Women’s Health (2002), 20(10), 1453–1465. https://doi.org/10.1089/jwh.2010.2151

[30] Syamala, T. S., & Sivakami, M. (2005). Menopause: An emerging issue in India. Economic and Political Weekly, 40(47), 4923–4930. https://www.jstor.org/stable/4417427

[31] Talaulikar, V. (2022). Menopause transition: Physiology and symptoms. Best Practice & Research Clinical Obstetrics & Gynaecology, 81, 3–7. https://doi.org/10.1016/j.bpobgyn.2022.03.003

[32] Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health-related quality of life: A conceptual model of patient outcomes. JAMA, 273(1), 59–65.

[33] Zheng, H., Harlow, S. D., Kravitz, H. M., Bromberger, J., Buysse, D. J., Matthews, K. A., Gold, E. B., Owens, J. F., & Hall, M. (2015). Actigraphy-defined measures of sleep and movement across the menstrual cycle in midlife menstruating women: Study of Women’s Health Across the Nation Sleep Study. Menopause (New York, N.Y.), 22(1), 66–74. https://doi.org/10.1097/GME.0000000000000249

Abstract

References

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