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The association of menopause status with physical function: the Study of Women’s Health Across the Nation

Tseng, Lisa A. BA1; El Khoudary, Samar R. PhD, MPH2; Young, Elizabeth A. MPH2; Farhat, Ghada N. PhD3; Sowers, MaryFran PhD4†; Sutton-Tyrrell, Kim DrPH2; Newman, Anne B. MD, MPH2

Menopause: The Journal of The North American Menopause Society: November 2012 - Volume 19 - Issue 11 - p 1186–1192
doi: 10.1097/gme.0b013e3182565740
Original Articles

Objective The aim of this study was to determine whether postmenopause status is associated with self-reported limitations in physical function.

Methods The Study of Women’s Health Across the Nation is a multisite, multiethnic, longitudinal study of midlife women. Women aged 45 to 57 years (N = 2,566) completed the physical function scale of the Medical Outcomes Study Short-Form 36 on visit 4 (2000-2001). Scores created a three-category variable of physical function limitations: none (86-100), moderate (51-85), and substantial (0-50). In the Study of Women’s Health Across the Nation, menopause status is a five-category list variable based on menstrual bleeding patterns and gynecological surgery. Premenopausal and perimenopausal women using hormones (n = 284) or missing physical function scores (n = 46) were excluded. Multinomial logistic regression was used to relate physical function and menopause status after adjustment for age, ethnicity, site, education, body mass index (BMI), and self-reported diabetes, hypertension, arthritis, depressive symptoms, smoking, and hormone use among postmenopausal women.

Results Of 2,236 women, 8% were premenopausal, 51% were early perimenopausal, 12% were late perimenopausal, 24% were naturally postmenopausal, and 5% were surgically postmenopausal. In the full model, substantial limitations in physical function were higher in postmenopausal women, whether naturally postmenopausal (odds ratio, 3.82; 95% CI, 1.46-10.0) or surgically postmenopausal (odds ratio, 3.54; 95% CI, 1.15-10.84), than in premenopausal women. These associations were attenuated by higher BMI and depressive symptoms but remained significant. Moderate limitations in physical function were not significantly related to menopause status.

Conclusions Women experiencing surgical or naturally occurring postmenopause report greater limitations in physical function compared with premenopausal women, independent of age and only partly explained by higher BMI and depressive symptoms. This suggests that physiological changes in menopause could contribute directly to limitations in physical function.

From the 1Clinical Scientist Training Program, School of Medicine, and 2Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA; 3Faculty of Health Sciences, University of Balamand, Beirut, Lebanon; and 4Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI.

Received January 20, 2012; revised and accepted March 19, 2012.


Funding/support: Lisa A. Tseng was supported by a Clinical Research Fellowship from the Doris Duke Charitable Foundation via the University of Pittsburgh School of Medicine and by Pittsburgh Training in Geriatrics and Gerontology grant T32 AG021885. Anne B. Newman was supported by grant R01-AG-023629 and University of Pittsburgh Claude D. Pepper Older American Independent Center grant P30-AG-024827.

The Study of Women’s Health Across the Nation received grant supportfrom the National Institutes of Health (NIH), Department of Health andHuman Services, through the National Institute on Aging, the NationalInstitute of Nursing Research, and the NIH Office of Research on Women’s Health (grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, and AG012495).

Financial disclosure/conflicts of interest: None reported.

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging, the National Institute of Nursing Research, the Office of Research on Women’s Health, or the NIH.

Address correspondence to: Lisa A. Tseng, BA, Room 467, 130 North Bellefield Avenue, Pittsburgh, PA 15213. E-mail:

©2012The North American Menopause Society