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

Disclosures
In This Article

Discussion

This study of middle-aged women found them to be remarkably positive in their appraisal of life as shown by their responses to the statements in the life satisfaction measures, indicating that middle age is not a time to be feared with regard to quality of life. These findings are not what one would predict on the basis of common negative community-held stereotypes of the middle-aged woman.

We did not find any relation between the measures of life satisfaction used and any phase of the menopausal transition. Life satisfaction was not related to hormone levels, HRT use, or induced menopause. We have also reported that negative mood[16] and positive mood are unrelated to menopausal status.[19] Taken together, these findings mean that subjective well-being (comprising positive and negative affect and life satisfaction) is unrelated to the menopausal transition.

O'Dea and colleagues[20] also found that menopausal status was not significantly related to life satisfaction on the basis of a postal survey of 189 men and women ages between 49 and 55 years, who were registered with a London general practice. In that study, only employment status was associated with life satisfaction. We found no association between employment status and either measure of life satisfaction, but both of our life satisfaction scales were significantly correlated with satisfaction with work and daily activities.

The authors' study found that attitudes to aging and menopause measured earlier in the study predicted later life satisfaction, suggesting that life satisfaction is based on stable cognitive frameworks. The other most important variables associated with higher life satisfaction were those of positive feelings for partner, lack of daily hassles or interpersonal stress, and healthy lifestyles, which included exercise and not smoking. The only symptom group that negatively and significantly affected life satisfaction were dysphoric symptoms and those associated with negative affect. This is in keeping with the finding that the validated mood subscale

used to measure negative affect was also significantly related to life satisfaction. Of interest is that there was no effect of vasomotor symptoms, confirming that menopause itself had no effect on life satisfaction. Other variables, including those of self-rated health and the different components of sexual functioning, were also associated with life satisfaction on univariate analysis but were not retained in the stepwise multivariate model, indicating that these variables were not independently significant in their relation to life satisfaction. We have previously reported that negative mood was affected by a similar constellation of variables.[16] However, negative mood was affected by self-rated health and a range of bothersome symptoms, including hot flushes, and had an interaction with menopausal status[16] not found in the current study of life satisfaction. This suggests that life satisfaction measures and mood measures are tapping into different dimensions of subjective well-being.

The findings in the literature with regard to the relation between self-rated health and life satisfaction in this age group are contradictory. George and Landerman[21] found that for persons between the ages of 35 and 59 years, the relation between health and life satisfaction was not significant. Willits and Crider[22] found that self-rated health in men and women ages 50-55 years was a significant correlate of their 4 questions on satisfaction with present job, way of life in the community, present marriage, and life as a whole. Differing results may reflect the measure of life satisfaction used or the variables or analytic techniques selected.

Our study found a high correlation between the 2 measures of life satisfaction (r = 0.70) and convergence with other measures of subjective well-being (positive and negative mood subscales and questions on work satisfaction and satisfaction with daily living). Using student samples, Diener and colleagues[11] found a convergence for the SWLS and other measures of well-being. Pavot and colleagues[1] studied a wider age range and also found high convergence of self-reported and peer-reported measures of subjective well-being. These investigators[1] also compared a number of measures in a group of 16 men and 23 women older than 52 years of age. Measures included the SWLS and the LSI-A, the 20-item measure from which the LSI-Z was developed. A mood adjective checklist and a single-item question about degree of satisfaction with the day were also used. The correlation was 0.81 between the SWLS and the LSI-A and 0.65 between SWLS and the single-item measure of daily satisfaction. The correlation between LSI-A and the daily satisfaction measure was 0.64. Convergence with the daily affect balance scale was also found (0.76 for the SWLS and 0.77 for the LSI-A). Furthermore, in a student sample of 84 women and 46 men, Pavot and coworkers[1] found correlations between the SWLS and affect balance (0.58), negative affect (-0.30), and positive affect (0.62), with good convergent validity. Taken together, these findings confirm the close relations between the cognitive and affective components of subjective well-being and support the concept that subjective well-being is a relatively stable phenomenon.[1]

There are some limitations in study design. Volunteers for the longitudinal phase of the study differed at baseline from nonparticipants on certain variables9 (self-rated health, education level, paid work, exercise participation) found to be associated with life satisfaction. The effects of HRT on life satisfaction are difficult to judge from annual measures as symptom relief may have occurred between measures.

In conclusion, this study found life satisfaction to be closely related to measures of mood, that both were predicted by earlier held attitudes toward aging and toward menopause, and that both were affected by feelings toward the partner, presence of stress, and lifestyle factors. Negative mood was also affected by self-rated health and by a range of bothersome symptoms, including hot flushes, and had an interaction with menopausal status. Stage of menopausal transition, hormone levels, and HRT use were not related to life satisfaction. These findings suggest that although mood and life satisfaction are closely related variables that contribute to subjective well-being, they measure different dimensions.

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