Assessing the burden of menopausal symptoms and their influence on women’s quality of life

OBJECTIVE: Menopause can affect women's quality of life through vasomotor, psychological and urogenital symptoms. This study assessed the prevalence and correlates of impaired quality of life across menopausal stages in Bangladeshi women. METHOD: This cross-sectional study included 3000 women aged 45-55 years attending outpatient gynecology clinics in Dhaka between December 2022 and June 2024. Menopausal stage was classified using Stages of Reproductive Aging Workshop +10 (STRAW +10) criteria. Symptoms and quality of life were assessed using the Menopause Rating Scale (MRS), with impaired quality of life defined as MRS >16. Multivariable logistic regression identified factors associated with impaired quality of life. RESULTS: Overall, 825 women (27.5%) had impaired quality of life. Symptom severity increased across menopausal stages, and hot flush prevalence rose from 22.1% in premenopause to 47.8% in late postmenopause. Hot flushes showed the strongest association with impaired quality of life (adjusted odds ratio [aOR] 10.28, 95% confidence interval [CI]: 8.84-11.95). Psychotropic medication use (odds ratio [OR] 2.00) and vaginal dryness (OR 1.28) were also associated with impairment, whereas sexual activity (OR 0.75), hormone therapy use (OR 0.70) and good self-rated health (OR 0.58) were associated with lower odds. Early postmenopause had the highest risk (aOR 2.14, 95% CI: 1.71-2.69). CONCLUSION: Early postmenopause is a vulnerable period for impaired quality of life among Bangladeshi women. Vasomotor and urogenital symptoms were important correlates of poorer well-being, supporting routine symptom assessment and culturally appropriate menopausal care.