Menopause Symptoms in Women with Diabetes: Glucose Control is an Important Correlate of Severity

Rouen, Patricia, Sarah Krein, Joyce Roberts, and Nancy Reame

Title:  Menopause Symptoms in Women with Diabetes: Glucose Control is an Important Correlate of Severity

Objective:  The menopause symptom experience of healthy women is well documented but little is known as to how menopause symptoms present in women with diabetes mellitus (DM).  The purpose of this cross-sectional, correlational study was to describe the menopause symptom experience of women with type 2 DM and determine the influence of glucose control on menopause symptom severity.

Design:  By comparative group design, we examined the menopause symptom experience of three groups of postmenopausal women veterans (age 45-60 yrs) receiving care in the Veterans Affairs (VA) healthcare system: women without DM (n=90), women with controlled DM (n =135; HbA1c < 7%) and women with poorly controlled DM (n=102; HbA1c >7%). Primary data (reproductive and diabetes status, menopause symptom prevalence and severity) were collected by self-administered survey.  With consent, secondary data were obtained from VA national laboratory files to characterize glycemic control. Symptom prevalence was compared by Chi Square with Fisher exact test; symptom severity scores were compared by t test and ANOVA with post-hoc analyses. Relationships among the variables were assessed with multivariate analyses.

Results:  The women veterans were obese, physically inactive, of low income with more than one chronic illness.  Most respondents (53.1%) had experienced a surgical menopause at an early age (mean 39.1 + 0.6 yrs). Despite higher BMI and increased co-morbidities, diabetic women experienced menopause at the same age and reported similar menopause symptoms as the non-diabetic cohort.  By ANOVA, women with poor glucose control demonstrated higher menopause symptom severity scores than non-diabetic women and their controlled peers of comparable body size, years postmenopause and psychological status.  By multivariate analysis, glucose control was a significant correlate of menopause symptom severity among women with DM, independent of obesity, surgical menopause and non-European ethnicity. In the diabetic cohort, both menopause symptom severity and glucose control were significant correlates of perceived physical health independent of age, BMI, ethnicity and mood status    

Conclusion: Women veterans with DM have a similar menopause experience as non-diabetic women. Glucose control rather than diabetes status is a key clinical feature associated with menopause symptom severity. These findings substantiate the importance of addressing menopause health issues in the clinical management of women with diabetes and suggest interventions targeting glucose control may improve the menopause symptom experience.