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Premenstrual symptoms in fertile age are associated with impaired quality of life, but not hot flashes, in recently postmenopausal women

Hautamäki, Hanna MD1; Haapalahti, Petri MD, PhD2; Savolainen-Peltonen, Hanna MD, PhD1,3; Tuomikoski, Pauliina MD, PhD1; Ylikorkala, Olavi MD, PhD1; Mikkola, Tomi S. MD, PhD1,3

doi: 10.1097/GME.0000000000000247
Original Articles

Objective Because premenstrual symptoms in fertile age resemble menopausal symptoms, many women with premenstrual symptoms fear that they have an increased risk for developing vasomotor symptoms in menopause. We investigated the impact of premenstrual symptoms on the occurrence and severity of menopausal vasomotor symptoms and quality of life.

Methods One hundred fifty recently postmenopausal healthy women recorded hot flashes prospectively (23, none; 34, mild; 30, moderate; 63, severe), and their quality of life was assessed using the Women’s Health Questionnaire. We measured the occurrence of premenstrual symptoms in fertile age using the Premenstrual Symptoms Screening Tool and calculated a premenstrual score reflecting symptom severity.

Results One hundred seven women (89.2%) reported premenstrual symptoms (median score, 7.0; range, 0-38), which had impaired work efficiency or social relations in 64 women (53.3%). The occurrence of premenstrual symptoms was similar in women with and without hot flashes of different magnitudes, as the mean (SEM) premenstrual score was 7.8 (1.4) for no hot flashes, 5.0 (1.0) for mild hot flashes, 7.7 (1.3) for moderate hot flashes, and 9.4 (1.2) for severe hot flashes (P = 0.10). The severity of premenstrual symptoms failed to correlate with the severity of postmenopausal hot flashes (r = 0.087, P = 0.346). A history of premenstrual symptoms was associated with impaired memory and concentration capacity (r = −0.448, P < 0.001), depressive mood (r = −0.263, P = 0.02), sleep problems (r = −0.282, P = 0.01), and feeling less attractive (r = −0.260, P = 0.02) during the first menopausal years.

Conclusions The occurrence of premenstrual symptoms in fertile age is associated with impaired quality of life, but not hot flashes, in recently postmenopausal women.

From the 1Department of Obstetrics and Gynecology and 2HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland; and 3Folkhälsan Research Institute, Helsinki, Finland.

Received January 22, 2014; revised and accepted March 5, 2014.

Funding/support: This study was supported by a special government grant for health science research and by grants from the Orion-Farmos Research Foundation and the Finnish Menopause Society. The funding sources were not involved in the conduct of the research or in the preparation of this article.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Tomi S. Mikkola, MD, PhD, Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Haartmaninkatu 2, PO Box 140, Helsinki FIN-00029 HUS, Finland. E-mail:

© 2014 by The North American Menopause Society.