Life Satisfaction, Symptoms, and the Menopausal Transition

Lorraine Dennerstein, AO, MBBS, PhD, FRANZCP, DPM; Emma Dudley, BSc, Grad Dip Epidemiol; Janet Guthrie, MSc, PhD, Dip Ed; and Elizabeth Barrett-Connor, MD

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Abstract and Introduction

Objective: The aims of this study were to examine the relation between life satisfaction and the menopausal transition, identify factors predictive or associated with life satisfaction, and determine the relation between life satisfaction and other health outcomes.
Research design and methods: This is a prospective population-based study of 438 middle-aged Australian-born women followed for 6 years after baseline measures. Retention rate at 6 years was 90% (n = 395). Two self-reported measures of life satisfaction (Life Satisfaction Index-Z scale [LSI-Z] and Satisfaction with Life Scale [SWLS]) were used in year 6. Positive and negative affect scales and questions about satisfaction with work and daily living were also used. Sociodemographic variables were measured at baseline, and attitudes toward menopause and aging were documented at years 2 and 5, respectively. Other explanatory variables, including symptoms, health, stress, life events, sexual functioning, and lifestyle were measured in year 6.
Results: Women overwhelmingly endorsed positive responses to life satisfaction questions. The LSI-Z and the SWLS were highly correlated with each other (r = 0.70), with the mood scales, and with responses to questions about satisfaction with work and daily living. The LSI-Z and SWLS were not related to menopausal status, hormone levels (follicle-stimulating hormone, estradiol), age, body mass index, hot flushes, hormone replacement therapy, sexual interest, employment status, type of profession, children at home, alcohol, chronic conditions, surgery, premenstrual complaints, life events (major or secondary), and social support. Stepwise multiple regression found that life satisfaction was predicted by earlier attitudes and was positively associated with feelings for partner and exercise and negatively associated with daily hassles, interpersonal stress, dysphoric symptoms, and current smoking.
Conclusions: Life satisfaction was closely related to mood, predicted by earlier attitudes, and affected by relationship to partner, stress, and lifestyle. Life satisfaction was unrelated to menopause status, hormone levels, or hormone replacement therapy.

Life satisfaction is considered to be the cognitive or judgmental component of subjective well-being. The other component of subjective well-being is the measure of emotions consisting of positive and negative affect.[1] Measures of the affective component include those of affect balance such as that developed by Bradburn[2] and Kammann and Flett.[3] Life satisfaction can be assessed globally or by specific domain area, such as satisfaction with work, marriage, and health. Single-item scales are more likely to have psychometric problems.[4] Life satisfaction questionnaires focus on the individual's internal frame of reference.[5]

Most research on life satisfaction has focused on the correlates of life satisfaction for persons ages 65 and older. Health was identified as being the most strongly related factor to this aspect of subjective well-being.[6] There have been very few studies of factors related to life satisfaction in a middle-aged population. Yet women in this age group are going through menopause, and the menopausal transition is associated with a marked increase in symptom reporting.[7]

The present study employs data from 6 years of longitudinal follow-up of a population-based sample of middle-aged Australian-born women to examine the relation between the menopausal transition and life satisfaction. The study uses longitudinal analysis to identify baseline and other predictor factors of life satisfaction measured subsequently at the 6-year follow-up. In addition, the study evaluates the relation between life satisfaction and other factors, including health outcomes (well-being, sexuality, self-rated health) measured cross-sectionally at year 6.

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