Menopausal status at the age of 46: Its association with depressive and anxiety symptoms and morbidity in women—A northern Finland birth cohort 1966 study

Abstract

INTRODUCTION: The incidence of several morbidities increases during the menopausal transition. However, studies of the association between early-onset menopause and psychiatric symptoms and morbidity are scarce. We aimed to investigate how climacteric status at age 46 was associated with depressive and anxiety symptoms. MATERIAL AND METHODS: This prospective cohort study included 2632 female participants from the Northern Finland Birth Cohort 1966 who participated in the 46-year follow-up. Among these, 356 participants (13%) were classified as climacteric. Data regarding the participants' backgrounds as well as anxiety and depressive symptoms (measured by the Hopkins Symptom Checklist-25 and the Beck Depression Inventory) were analyzed. Information on psychiatric medication purchases was retrieved from a national registry. The association between climacteric status at age 46 and the presence of psychiatric symptoms or medication purchases was evaluated using binary logistic regression. RESULTS: Climacteric women exhibited a higher prevalence of significant anxiety symptoms compared with preclimacteric women (22.6% vs. 16.0%, p = 0.002) with an odds ratio of 1.53 (95% confidence interval: 1.16-2.02), as measured by the Hopkins Symptom Checklist-25 questionnaire. This association remained statistically significant after adjusting for smoking, alcohol consumption, body mass index, and education (odds ratio 1.44; 95% confidence interval: 1.04-2.00). The climacteric women also reported depression symptoms more frequently than the preclimacteric women (30.1% vs. 24.6%, p = 0.032), and the association persisted after adjustment for covariates (odds ratio 1.39; 95% confidence interval: 1.03-1.85). The Beck Depression Inventory-21 indicated higher rates of depression among climacteric women (17.7% vs. 13.6%, p = 0.046); however, no independent association was observed following adjustment. Purchases of antidepressants (48% vs. 41%, p = 0.012) and benzodiazepine derivatives (18.3% vs. 13.3%, p = 0.012) between the ages 40 and 57 were more frequent among climacteric women aged 40-57, yet no independent association was identified between advanced climacteric status and medication purchases in the multivariate model. CONCLUSIONS: Advanced menopausal status at age 46 was linked to a higher risk of anxiety and depressive symptoms. It is crucial to support the mental health and well-being of women during and after menopause, especially for those experiencing early-onset menopause.