The menopausal transition is accompanied by a wide variety of symptoms, including physical symptoms (hot flashes and night sweats or vasomotor symptoms; VMS), cognitive symptoms, (trouble concentrating, and mood disruptions), and an increase in experience of depressive symptoms. The menopausal transition is marked by decreasing levels of estrogen, which may be partially responsible for the experience of menopausal symptoms. However, the role estrogen exposure plays in menopausal symptom experience has not been entirely determined. PURPOSE: The purpose of this study was to determine whether 2 different estimates of prior estrogen exposure are associated with menopausal symptom experience. METHODS: A questionnaire was sent via Qualtrics to 82 women (age=54±6 yrs; height=165±6 cm; weight= 64.1±11.5 kg). Women were asked about their menstrual history, obstetrical history, contraceptive use, and menopausal symptom experience. Two estimates of estrogen exposure were constructed. The first index of lifetime estrogen load, referred to as the Reproductive Years Index (RYI), was constructed by subtracting the age at the final menstrual period or current age if final menstrual period has not yet occurred from the age at first menses. The second lifetime estrogen load index, referred to as the Comprehensive Estrogen Measurement Index (CEMI), was constructed by adding estrogen based contraceptive usage in years and time pregnant in years to the RYI and subtracting bouts of amenorrhea in years. Global physical symptom experience was calculated by adding the number of physical symptoms each participant reported experiencing. Pearson correlations were used to evaluate the relationship between RYI and CEMI and participant characteristics. Multiple regression models for CEMI and RYI were constructed using reverse stepwise methods, and age was always included in the model. Independent t-tests were used to determine whether CEMI or RYI differed based on VMS experience. A 2×3 ANOVA was run to determine whether CEMI or RYI differed by menopausal status. RESULTS: There was no statistical significance depicted for either index’s association with global physical symptom experience (all P>0.05). However, CEMI was significantly correlated with physical activity (r=0.253, P=0.022) and BMI (r=-0.247, P=0.025). Mean RYI scores were significantly higher for those who experience VMS (t=2.876, df=80, P=0.005), and there was a trend toward a greater CEMI score in those reporting VMS (t=1.878, df=80, P=0.064). ANOVA analysis determined that menopausal status influences RYI (P=0.027), but VMS experience did not. Additionally, ANOVA analysis determined that VMS symptoms influence CEMI (P=0.035), but menopausal status did not (P=0.814). CONCLUSIONS: These two methods of estimated lifetime estrogen load were not associated with global physical symptom experience, suggesting that lifetime estrogen load does not play a significant role in overall symptom experience. However, RYI is significantly higher in women who experience VMS symptoms, suggesting that VMS may be more associated with higher estrogen exposure than other menopausal symptoms. Future research should be conducted to evaluate the role of lifetime estrogen exposure on VMS. Further, the role of follicle stimulating hormone, another major reproductive hormone, on menopausal symptom experience should be investigated. A poster deriving from special studies with Dr. Sarah Witkowski, Associate Professor of Exercise & Sport Studies.
by Elizabeth Lee ‘21