This study presents Australian normative data for verbal fluency and visual confrontational namin... more This study presents Australian normative data for verbal fluency and visual confrontational naming for midlife women and examines factors that mediate verbal performance in this population. Two hundred and fifty-seven healthy Australian-born women aged 56 -67 years who participated in the Melbourne Women's Midlife Longitudinal Health Project were assessed for verbal fluency and visual confrontational naming. Verbal fluency was assessed using the ''animals'' category fluency task, where participants are asked to name as many animals as they could in 1 min. Confrontational naming was assessed using a modified 30-item version of the Boston Naming Test. The Centre for Epidemiological Studies Depression scale was also administered to assess mood. Verbal fluency and confrontational naming were significantly associated with education level such that women with higher levels of education (512 years) demonstrated stronger verbal performance as compared to women with lower levels of education (512 years). No association was found between verbal performance and age for this sample of Australian women. Mood was unrelated to test performance. Mean fluency and naming scores of women in the present sample tended to be higher than normative values in samples from the United States. The present data provide important comparative information regarding the verbal fluency performance in midlife Australian-born women, which may serve as a reference for more precise clinical decision-making in the Australian context.
The prevalence of osteoarthritis (OA) is greater in women then men. Weight, a factor strongly ass... more The prevalence of osteoarthritis (OA) is greater in women then men. Weight, a factor strongly associated with osteoarthritis, is significantly increased over the menopausal transition. Despite the high prevalence of osteoarthritis, a disabling disease with limited treatment options, there is a paucity of studies in women. The longitudinal phase of the Melbourne Women's Midlife Health Project, is a population-based prospective study of 438 Australian born women who have been followed annually over 11 years. 257 (59%) of these women remained in longitudinal assessment at 11th year of follow-up and 224 of these women agreed to undergo X-rays of their knees and hands. In this study, X-rays were scored for evidence of osteoarthritis using a validated scale, by two investigators who were blinded to questionnaire results. Information on hormone therapy use, physical activity, smoking, BMI and age were obtained by both self-administered and face-to-face questionnaires. Results showed th...
previous studies raised the possibility that adverse health effects associated with elevated bloo... more previous studies raised the possibility that adverse health effects associated with elevated blood pressure (BP) begin at prehypertension levels (BP = 120-139/80-89 mmHg), yet few studies have examined the effects of prehypertension on cognitive functioning. to examine the relationship between BP categories and cognitive functions in middle-aged and older women. two hundred and forty-seven women from the Women's Healthy Ageing Project had their BP measured twice, at mean ages 50 and 60 years. Tests of executive function, processing speed and verbal episodic memory were also administered at follow-up. Analyses of co-variance were performed to evaluate the associations between BP categories and cognitive performance. prehypertensive BP at age 50 years is a significant predictor of reduced processing speed and verbal episodic memory a decade later. Cross-sectional measurements at age 60 years showed that untreated hypertensive women performed significantly worse on verbal episodic ...
To describe the prevalence of risk factors for osteoporosis in a population-based cohort of Austr... more To describe the prevalence of risk factors for osteoporosis in a population-based cohort of Australian-born midlife women; determine the effect of these risk factors on premenopausal and early perimenopausal bone mineral density (BMD); and describe changes in risk factors and any effect of these on bone loss. 4-year longitudinal community-based study. BMD of the lumbar spine (LS) and femoral neck (FN) was measured using dual x-ray absorptiometry (DXA). Melbourne, Australia 224 Australian-born women aged 46-56 years Risk factors for osteoporosis, LS-BMD, FN-BMD, and change in risk factors and BMD. At baseline, 52% reported a calcium intake of less than 800 mg/day and 46% reported a caffeine intake of more than 360 mg/day; 29% exercised less than 1.5 hours/week; 5% had a body mass index (BMI) of less than 20; 14% were current smokers; 23% were past smokers; 10% reported abnormal menstrual histories; and 25% reported a family history of osteoporosis. BMD was positively associated with ...
Skeletal fragility and falls are the 2 most potent factors leading to osteoporotic fractures. The... more Skeletal fragility and falls are the 2 most potent factors leading to osteoporotic fractures. The aim of this article is to review factors associated with women's risk of developing skeletal fragility and subsequent osteoporosis. Many factors have been implicated, but the evidence for some is unsubstantial. Low premenopausal bone mineral density (BMD), a decrease in BMD, and an increase in bone fragility -- which occur as a result of both aging and the menopause -- are major determinants of subsequent risk for osteoporotic fracture. In addition, low body mass index (BMI), low calcium intake, low physical activity, and smoking can affect BMD. The relative importance of the effects these physical and lifestyle factors have on BMD in midlife women is not fully established. The impact of gynecologic history (parity, lactation, oral contraceptive use, age of menarche) on BMD is uncertain.
To describe Australian-born women's experience of symptoms during the natural menopause trans... more To describe Australian-born women's experience of symptoms during the natural menopause transition and the relative contribution of menopausal and health status, social factors and lifestyle behaviours. A community based cross-sectional survey by telephone interview was carried out on a randomly derived sample of Melbourne women. The participants were 2000 Australian-born women, aged between 45 and 55 years. A list of 22 symptoms was used. Explanatory variables were: sociodemographic variables; menopausal and health status; lifestyle behaviours; attitudes to ageing and to menopause. A 70% response rate was achieved for eligible women who could be contacted during the study. Premenopausal women were the least symptomatic and perimenopausal women the most symptomatic. Factor analysis found seven common factors from the 22 symptoms studied. Menopausal status based on menstrual history was significantly related to two groups of symptoms: vasomotor symptoms, which increased through t...
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 2001
To investigate: (i) the incidence of impaired fasting glycaemia (IFG) developed over 5 y in a pop... more To investigate: (i) the incidence of impaired fasting glycaemia (IFG) developed over 5 y in a population-based sample of Australian-born women; (ii) prospectively the factors which are associated with the development of IFG; (iii) the association of the menopausal transition with the onset of IFG and an increase in serum insulin concentrations. A total of 265 women (110 pre-, 138 peri-, 17 postmenopausal) participants in the longitudinal phase of the Melbourne Women's Midlife Health Project, aged 46-57 and with normal fasting plasma glucose concentrations at the time of the initial measure, were interviewed, had physical measurements and blood taken annually over a 5 y follow-up period. During the study period 43 women (16%) recorded a fasting glucose concentration of > or =6.1 mmol/l (IFG). Women who recorded IFG prospectively had, at the time of the initial measure when fasting glucose concentrations were normal: higher body mass index (BMI), trunk skinfold thicknesses, wai...
Correlates of self-rated health among a randomly selected sample of 1863 Australian-born women 45... more Correlates of self-rated health among a randomly selected sample of 1863 Australian-born women 45-55 years of age were examined in two logistic regression analyses: one comparing a self-rated health of worse than one's peers with a self-rated health the same as one's peers; and, one comparing a self-rated health of better than one's peers with a self-rated health the same as one's peers. The final model for worse health was largely a reflection of the physical experience of ill health while that for better health was a more complex construct including not only the absence of illness but also markers of sociodemographic advantage and self-image. The two models had only three variables in common. Notably, the relationship between the outcome measures and one common variable, body mass index, differed markedly.
Two hundred and twenty-four women (74 pre-, 90 peri-, 60 post-menopausal), aged 46-59 years, from... more Two hundred and twenty-four women (74 pre-, 90 peri-, 60 post-menopausal), aged 46-59 years, from a population-based cohort participated in a longitudinal study of bone mineral density (BMD). BMD was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femoral neck and the time between bone scans was on average 25 (range 14-41) months. The aim of the study was to assess changes in BMD in relation to changes in normal menopausal status. During the study period women who were between 3 and 12 months past their last menstrual period (n = 22, late perimenopausal) at the time of the second bone scan had a mean (SE) annual change in BMD of 70.9% (0.4%) at the lumbar spine and 70.7% (0.6%) at the femoral neck (both p50.05 compared with women who remained premenopausal). In the women who became postmenopausal (n = 42) the mean annual changes in BMD were 72.5% (0.2%) at the lumbar spine and 71.7% (0.2%) at the femoral neck (both p50.0005), and in the women who remained postmenopausal (n = 60) they were 70.7% (0.2%) per year and 70.5% (0.3%) per year respectively (both p50.05), compared with women who remained premenopausal. In the 1-3 years after the final menstrual period (FMP) there was greater bone loss from the lumbar spine than the femoral neck (p50.05). In women who were menstruating at the time of the second bone scan and whose FMP could be dated prospectively (n = 35), higher baseline oestradiol levels were associated with less lumbar spine bone loss (p50.005). In the women who remained postmenopausal there was an association between baseline body mass index (BMI) and percentage change per year in femoral neck BMD (p50.05), such that women with higher BMI had less bone loss. In conclusion, during the time of transition from peri-to post-menopause, women had accelerated BMD loss at both the hip and spine.
Objective: To determine the question that best predicts radiographic evidence of non-axial osteoa... more Objective: To determine the question that best predicts radiographic evidence of non-axial osteoarthritis (OA).
To identify symptoms that change in prevalence and severity during midlife and evaluate their rel... more To identify symptoms that change in prevalence and severity during midlife and evaluate their relationships to menopausal status, hormonal levels, and other factors. In a longitudinal, population-based study of 438 Australian-born women observed for 7 years with an 89% retention rate, 172 advanced from premenopause to perimenopause or postmenopause. Annual measures included a 33-item symptom check list; psychosocial, lifestyle, and health-related factors; menstrual status; hormone usage; and blood levels of follicle-stimulating hormone and estradiol (E2). Increasing from early to late perimenopause were the number of women who reported five or more symptoms (+14%), hot flushes (+27%), night sweats (+17%) and vaginal dryness (+17%) (all P <.05). Breast soreness-tenderness decreased with the menopausal transition (-21%). Trouble sleeping increased by +6%. The major change in prevalence was from early to late perimenopause, except for insomnia, which showed a gradual increase. Those variables most related to onset of hot flushes were number of symptoms at early perimenopause (P <.05), having an unskilled or no occupation (P <.05), more than 10 pack-years of smoking (P <.01), and decreased E2 (P <.01). The onset of night sweats increased with the change in E2 (P <.05). The onset of vaginal dryness decreased with more years of education (P <.05). Trouble sleeping was predicted by prior lower well-being (P <.01), belief at baseline that women with many interests hardly notice menopause (P <.01), and hot flushes (P <.01). Although middle-aged women are highly symptomatic, the symptoms that appear to be specifically related to hormonal changes of menopausal transition are vasomotor symptoms, vaginal dryness, and breast tenderness. Insomnia reflected bothersome hot flushes and psychosocial factors.
Objective: To determine the frequency of hot flushes in a population sample of 453 pre-, peri-, a... more Objective: To determine the frequency of hot flushes in a population sample of 453 pre-, peri-, and postmenopausal w o m e n (aged 48-59 years), and to investigate the relationship of hot-flush reporting with menstrual status, serum levels of estradiol (E2), inhibin, and FSH, history of premenstrual complaints, and physical and life-style factors. Methods: We used a population-based sample. Interviews were conducted in the w o m e n ' s homes. Results: Frequency of hot-flush reporting was associated with menstrual status (P < .001). Twenty-nine percent of w o m e n who had more than 3 and less than 12 months of amenorrhea, and 37% of postmenopausal w o m e n experienced hot flushes several times a day. In total, 13% of premenopausal women, 37% of perimenopausal women, 62% of postmenopausal women, and 15% of w o m e n on hormone therapy reported having had at least one hot flush in the previous 2 weeks. Follicle-stimulating hormone levels were higher in w o m e n w h o experienced hot flushes at least once a day or more (P < .001); E2 levels were higher in w o m e n experiencing one or no hot flushes per w e e k (P < .001). The w o m e n in the perimenopausal group w h o experienced hot flushes had higher FSH levels (P = .008) and were more likely to have reported premenstrual complaints at the first interview 3 years earlier (P = .03). In the postmenopausal group, there was no significant difference with any of the variables studied between the w o m e n w h o were experiencing hot flushes and those w h o were not.
Gonadal hormones may influence cognitive function. Postmenopausal midlife women in the population... more Gonadal hormones may influence cognitive function. Postmenopausal midlife women in the population-based Melbourne Women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Midlife Health Project cohort were administered a comprehensive battery of neuropsychological tests on two occasions 2 years apart. Participants (n = 148, mean age 60 years) had undergone natural menopause and were not using hormone therapy. Estrone, total and free estradiol, and total and free testosterone levels were measured at time of the first testing. Principal-component analysis identified four cognitive factors. In multiple linear regression analyses, better semantic memory performance was associated with higher total (p = 0.02) and free (p = 0.03) estradiol levels and a lower ratio of testosterone to estradiol (p = 0.007). There were trends for associations between better verbal episodic memory and lower total testosterone (p = 0.08) and lower testosterone/estradiol ratio (p = 0.06). Lower free testosterone levels were associated with greater 2-year improvement on verbal episodic memory (p = 0.04); higher testosterone/estradiol predicted greater semantic memory improvement (p = 0.03). In postmenopausal midlife women, endogenous estradiol and testosterone levels and the testosterone/estradiol ratio are associated with semantic memory and verbal episodic memory abilities.
Several studies have indicated that perimenopausal women typically report a wide range of symptom... more Several studies have indicated that perimenopausal women typically report a wide range of symptoms. Typically these include loss of positive well-being, unstable emotional and behavioural coping abilities, cognitive dysfunctions and pronounced physical discomforts. As this cluster of reported changes appears to be very similar to those of premenstrual syndrome (PMS), an important question for examination is whether a prior history of menstrualrelated problems is a significant predictive marker for a more troubled menopause transition. Approximately 438 midaged urban women who entered the longitudinal phase of the Melbourne Women's Midlife Health Study in 1991 have been evaluated annually for at least three consecutive years. Those who reported a self-defined history of PMS-type problems were compared to others who did not on a range of issues. These include number and type of complaints during menopause transition, help seeking, treatment use, general health and well-being and demographic characteristics. Results are presented that examine the possible relationship between problematic premenstrual and perimenopausal experiences. The issue of whether 'vulnerability' can be identified and will determine a more troubled menopause will be discussed.
This study presents Australian normative data for verbal fluency and visual confrontational namin... more This study presents Australian normative data for verbal fluency and visual confrontational naming for midlife women and examines factors that mediate verbal performance in this population. Two hundred and fifty-seven healthy Australian-born women aged 56 -67 years who participated in the Melbourne Women's Midlife Longitudinal Health Project were assessed for verbal fluency and visual confrontational naming. Verbal fluency was assessed using the ''animals'' category fluency task, where participants are asked to name as many animals as they could in 1 min. Confrontational naming was assessed using a modified 30-item version of the Boston Naming Test. The Centre for Epidemiological Studies Depression scale was also administered to assess mood. Verbal fluency and confrontational naming were significantly associated with education level such that women with higher levels of education (512 years) demonstrated stronger verbal performance as compared to women with lower levels of education (512 years). No association was found between verbal performance and age for this sample of Australian women. Mood was unrelated to test performance. Mean fluency and naming scores of women in the present sample tended to be higher than normative values in samples from the United States. The present data provide important comparative information regarding the verbal fluency performance in midlife Australian-born women, which may serve as a reference for more precise clinical decision-making in the Australian context.
The prevalence of osteoarthritis (OA) is greater in women then men. Weight, a factor strongly ass... more The prevalence of osteoarthritis (OA) is greater in women then men. Weight, a factor strongly associated with osteoarthritis, is significantly increased over the menopausal transition. Despite the high prevalence of osteoarthritis, a disabling disease with limited treatment options, there is a paucity of studies in women. The longitudinal phase of the Melbourne Women's Midlife Health Project, is a population-based prospective study of 438 Australian born women who have been followed annually over 11 years. 257 (59%) of these women remained in longitudinal assessment at 11th year of follow-up and 224 of these women agreed to undergo X-rays of their knees and hands. In this study, X-rays were scored for evidence of osteoarthritis using a validated scale, by two investigators who were blinded to questionnaire results. Information on hormone therapy use, physical activity, smoking, BMI and age were obtained by both self-administered and face-to-face questionnaires. Results showed th...
previous studies raised the possibility that adverse health effects associated with elevated bloo... more previous studies raised the possibility that adverse health effects associated with elevated blood pressure (BP) begin at prehypertension levels (BP = 120-139/80-89 mmHg), yet few studies have examined the effects of prehypertension on cognitive functioning. to examine the relationship between BP categories and cognitive functions in middle-aged and older women. two hundred and forty-seven women from the Women's Healthy Ageing Project had their BP measured twice, at mean ages 50 and 60 years. Tests of executive function, processing speed and verbal episodic memory were also administered at follow-up. Analyses of co-variance were performed to evaluate the associations between BP categories and cognitive performance. prehypertensive BP at age 50 years is a significant predictor of reduced processing speed and verbal episodic memory a decade later. Cross-sectional measurements at age 60 years showed that untreated hypertensive women performed significantly worse on verbal episodic ...
To describe the prevalence of risk factors for osteoporosis in a population-based cohort of Austr... more To describe the prevalence of risk factors for osteoporosis in a population-based cohort of Australian-born midlife women; determine the effect of these risk factors on premenopausal and early perimenopausal bone mineral density (BMD); and describe changes in risk factors and any effect of these on bone loss. 4-year longitudinal community-based study. BMD of the lumbar spine (LS) and femoral neck (FN) was measured using dual x-ray absorptiometry (DXA). Melbourne, Australia 224 Australian-born women aged 46-56 years Risk factors for osteoporosis, LS-BMD, FN-BMD, and change in risk factors and BMD. At baseline, 52% reported a calcium intake of less than 800 mg/day and 46% reported a caffeine intake of more than 360 mg/day; 29% exercised less than 1.5 hours/week; 5% had a body mass index (BMI) of less than 20; 14% were current smokers; 23% were past smokers; 10% reported abnormal menstrual histories; and 25% reported a family history of osteoporosis. BMD was positively associated with ...
Skeletal fragility and falls are the 2 most potent factors leading to osteoporotic fractures. The... more Skeletal fragility and falls are the 2 most potent factors leading to osteoporotic fractures. The aim of this article is to review factors associated with women's risk of developing skeletal fragility and subsequent osteoporosis. Many factors have been implicated, but the evidence for some is unsubstantial. Low premenopausal bone mineral density (BMD), a decrease in BMD, and an increase in bone fragility -- which occur as a result of both aging and the menopause -- are major determinants of subsequent risk for osteoporotic fracture. In addition, low body mass index (BMI), low calcium intake, low physical activity, and smoking can affect BMD. The relative importance of the effects these physical and lifestyle factors have on BMD in midlife women is not fully established. The impact of gynecologic history (parity, lactation, oral contraceptive use, age of menarche) on BMD is uncertain.
To describe Australian-born women's experience of symptoms during the natural menopause trans... more To describe Australian-born women's experience of symptoms during the natural menopause transition and the relative contribution of menopausal and health status, social factors and lifestyle behaviours. A community based cross-sectional survey by telephone interview was carried out on a randomly derived sample of Melbourne women. The participants were 2000 Australian-born women, aged between 45 and 55 years. A list of 22 symptoms was used. Explanatory variables were: sociodemographic variables; menopausal and health status; lifestyle behaviours; attitudes to ageing and to menopause. A 70% response rate was achieved for eligible women who could be contacted during the study. Premenopausal women were the least symptomatic and perimenopausal women the most symptomatic. Factor analysis found seven common factors from the 22 symptoms studied. Menopausal status based on menstrual history was significantly related to two groups of symptoms: vasomotor symptoms, which increased through t...
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 2001
To investigate: (i) the incidence of impaired fasting glycaemia (IFG) developed over 5 y in a pop... more To investigate: (i) the incidence of impaired fasting glycaemia (IFG) developed over 5 y in a population-based sample of Australian-born women; (ii) prospectively the factors which are associated with the development of IFG; (iii) the association of the menopausal transition with the onset of IFG and an increase in serum insulin concentrations. A total of 265 women (110 pre-, 138 peri-, 17 postmenopausal) participants in the longitudinal phase of the Melbourne Women's Midlife Health Project, aged 46-57 and with normal fasting plasma glucose concentrations at the time of the initial measure, were interviewed, had physical measurements and blood taken annually over a 5 y follow-up period. During the study period 43 women (16%) recorded a fasting glucose concentration of > or =6.1 mmol/l (IFG). Women who recorded IFG prospectively had, at the time of the initial measure when fasting glucose concentrations were normal: higher body mass index (BMI), trunk skinfold thicknesses, wai...
Correlates of self-rated health among a randomly selected sample of 1863 Australian-born women 45... more Correlates of self-rated health among a randomly selected sample of 1863 Australian-born women 45-55 years of age were examined in two logistic regression analyses: one comparing a self-rated health of worse than one's peers with a self-rated health the same as one's peers; and, one comparing a self-rated health of better than one's peers with a self-rated health the same as one's peers. The final model for worse health was largely a reflection of the physical experience of ill health while that for better health was a more complex construct including not only the absence of illness but also markers of sociodemographic advantage and self-image. The two models had only three variables in common. Notably, the relationship between the outcome measures and one common variable, body mass index, differed markedly.
Two hundred and twenty-four women (74 pre-, 90 peri-, 60 post-menopausal), aged 46-59 years, from... more Two hundred and twenty-four women (74 pre-, 90 peri-, 60 post-menopausal), aged 46-59 years, from a population-based cohort participated in a longitudinal study of bone mineral density (BMD). BMD was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femoral neck and the time between bone scans was on average 25 (range 14-41) months. The aim of the study was to assess changes in BMD in relation to changes in normal menopausal status. During the study period women who were between 3 and 12 months past their last menstrual period (n = 22, late perimenopausal) at the time of the second bone scan had a mean (SE) annual change in BMD of 70.9% (0.4%) at the lumbar spine and 70.7% (0.6%) at the femoral neck (both p50.05 compared with women who remained premenopausal). In the women who became postmenopausal (n = 42) the mean annual changes in BMD were 72.5% (0.2%) at the lumbar spine and 71.7% (0.2%) at the femoral neck (both p50.0005), and in the women who remained postmenopausal (n = 60) they were 70.7% (0.2%) per year and 70.5% (0.3%) per year respectively (both p50.05), compared with women who remained premenopausal. In the 1-3 years after the final menstrual period (FMP) there was greater bone loss from the lumbar spine than the femoral neck (p50.05). In women who were menstruating at the time of the second bone scan and whose FMP could be dated prospectively (n = 35), higher baseline oestradiol levels were associated with less lumbar spine bone loss (p50.005). In the women who remained postmenopausal there was an association between baseline body mass index (BMI) and percentage change per year in femoral neck BMD (p50.05), such that women with higher BMI had less bone loss. In conclusion, during the time of transition from peri-to post-menopause, women had accelerated BMD loss at both the hip and spine.
Objective: To determine the question that best predicts radiographic evidence of non-axial osteoa... more Objective: To determine the question that best predicts radiographic evidence of non-axial osteoarthritis (OA).
To identify symptoms that change in prevalence and severity during midlife and evaluate their rel... more To identify symptoms that change in prevalence and severity during midlife and evaluate their relationships to menopausal status, hormonal levels, and other factors. In a longitudinal, population-based study of 438 Australian-born women observed for 7 years with an 89% retention rate, 172 advanced from premenopause to perimenopause or postmenopause. Annual measures included a 33-item symptom check list; psychosocial, lifestyle, and health-related factors; menstrual status; hormone usage; and blood levels of follicle-stimulating hormone and estradiol (E2). Increasing from early to late perimenopause were the number of women who reported five or more symptoms (+14%), hot flushes (+27%), night sweats (+17%) and vaginal dryness (+17%) (all P &amp;amp;amp;amp;lt;.05). Breast soreness-tenderness decreased with the menopausal transition (-21%). Trouble sleeping increased by +6%. The major change in prevalence was from early to late perimenopause, except for insomnia, which showed a gradual increase. Those variables most related to onset of hot flushes were number of symptoms at early perimenopause (P &amp;amp;amp;amp;lt;.05), having an unskilled or no occupation (P &amp;amp;amp;amp;lt;.05), more than 10 pack-years of smoking (P &amp;amp;amp;amp;lt;.01), and decreased E2 (P &amp;amp;amp;amp;lt;.01). The onset of night sweats increased with the change in E2 (P &amp;amp;amp;amp;lt;.05). The onset of vaginal dryness decreased with more years of education (P &amp;amp;amp;amp;lt;.05). Trouble sleeping was predicted by prior lower well-being (P &amp;amp;amp;amp;lt;.01), belief at baseline that women with many interests hardly notice menopause (P &amp;amp;amp;amp;lt;.01), and hot flushes (P &amp;amp;amp;amp;lt;.01). Although middle-aged women are highly symptomatic, the symptoms that appear to be specifically related to hormonal changes of menopausal transition are vasomotor symptoms, vaginal dryness, and breast tenderness. Insomnia reflected bothersome hot flushes and psychosocial factors.
Objective: To determine the frequency of hot flushes in a population sample of 453 pre-, peri-, a... more Objective: To determine the frequency of hot flushes in a population sample of 453 pre-, peri-, and postmenopausal w o m e n (aged 48-59 years), and to investigate the relationship of hot-flush reporting with menstrual status, serum levels of estradiol (E2), inhibin, and FSH, history of premenstrual complaints, and physical and life-style factors. Methods: We used a population-based sample. Interviews were conducted in the w o m e n ' s homes. Results: Frequency of hot-flush reporting was associated with menstrual status (P < .001). Twenty-nine percent of w o m e n who had more than 3 and less than 12 months of amenorrhea, and 37% of postmenopausal w o m e n experienced hot flushes several times a day. In total, 13% of premenopausal women, 37% of perimenopausal women, 62% of postmenopausal women, and 15% of w o m e n on hormone therapy reported having had at least one hot flush in the previous 2 weeks. Follicle-stimulating hormone levels were higher in w o m e n w h o experienced hot flushes at least once a day or more (P < .001); E2 levels were higher in w o m e n experiencing one or no hot flushes per w e e k (P < .001). The w o m e n in the perimenopausal group w h o experienced hot flushes had higher FSH levels (P = .008) and were more likely to have reported premenstrual complaints at the first interview 3 years earlier (P = .03). In the postmenopausal group, there was no significant difference with any of the variables studied between the w o m e n w h o were experiencing hot flushes and those w h o were not.
Gonadal hormones may influence cognitive function. Postmenopausal midlife women in the population... more Gonadal hormones may influence cognitive function. Postmenopausal midlife women in the population-based Melbourne Women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Midlife Health Project cohort were administered a comprehensive battery of neuropsychological tests on two occasions 2 years apart. Participants (n = 148, mean age 60 years) had undergone natural menopause and were not using hormone therapy. Estrone, total and free estradiol, and total and free testosterone levels were measured at time of the first testing. Principal-component analysis identified four cognitive factors. In multiple linear regression analyses, better semantic memory performance was associated with higher total (p = 0.02) and free (p = 0.03) estradiol levels and a lower ratio of testosterone to estradiol (p = 0.007). There were trends for associations between better verbal episodic memory and lower total testosterone (p = 0.08) and lower testosterone/estradiol ratio (p = 0.06). Lower free testosterone levels were associated with greater 2-year improvement on verbal episodic memory (p = 0.04); higher testosterone/estradiol predicted greater semantic memory improvement (p = 0.03). In postmenopausal midlife women, endogenous estradiol and testosterone levels and the testosterone/estradiol ratio are associated with semantic memory and verbal episodic memory abilities.
Several studies have indicated that perimenopausal women typically report a wide range of symptom... more Several studies have indicated that perimenopausal women typically report a wide range of symptoms. Typically these include loss of positive well-being, unstable emotional and behavioural coping abilities, cognitive dysfunctions and pronounced physical discomforts. As this cluster of reported changes appears to be very similar to those of premenstrual syndrome (PMS), an important question for examination is whether a prior history of menstrualrelated problems is a significant predictive marker for a more troubled menopause transition. Approximately 438 midaged urban women who entered the longitudinal phase of the Melbourne Women's Midlife Health Study in 1991 have been evaluated annually for at least three consecutive years. Those who reported a self-defined history of PMS-type problems were compared to others who did not on a range of issues. These include number and type of complaints during menopause transition, help seeking, treatment use, general health and well-being and demographic characteristics. Results are presented that examine the possible relationship between problematic premenstrual and perimenopausal experiences. The issue of whether 'vulnerability' can be identified and will determine a more troubled menopause will be discussed.
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Papers by L. Dennerstein