Study of Women Veterans in Menopause.

Abstract

In healthy women, menopause symptoms have been associated with decreased quality of life, limitations in physical functioning and perceived declines in health status. Most menopause research is limited to the study of healthy women and little is known as to how menopause symptoms manifest themselves in women with type 2 diabetes. This study employed a comparative group design to examine the menopause symptom experience of three groups of women veterans receiving care in the Veteran Affairs Healthcare system: women without diabetes (n = 90), women with controlled diabetes (hemoglobin A1c [HbA1c] < 7%; n = 135) and women with poorly controlled diabetes (HbA1c > 7%; n = 102). Participants were recruited from an ethnically diverse postmenopausal sample (n = 536) who responded to a national mailed survey (n = 900) and consented to clinical data access. As a group, the women were obese, of low income with more than one chronic illness. On average, menopause symptom prevalence rates were higher compared to those observed in previous community-based investigations of ethnically diverse non-veteran cohorts. However, despite higher BMI and increased disease-related co-morbidities, diabetic participants experienced menopause at the same age and reported similar menopause symptoms as the non-diabetic cohort. Among respondents with diabetes, glucose control was an important clinical correlate of menopause symptom severity, independent of obesity, surgical menopause, and non-European ethnicity. With the exception of vasomotor symptoms, women veterans with poor glucose control demonstrated higher menopause symptom severity scores (total score, psychological and somatic factor scores) than their controlled peers of comparable body size, years postmenopause and psychological status. Further, both menopause symptom severity and glucose control were significant correlates of perceived physical health in the diabetic cohort. These findings substantiate the importance of addressing menopause health issues in the clinical management of women veterans with diabetes using services in the VA healthcare system. For this group already in poor health, interventions targeting glucose control may also improve their menopause symptom experience. Future studies are warranted to better understand the relationship between military service and the menopause experience of women veterans, and confirm these findings in non-veteran diabetic populations.