Menopause Characteristics and Subjective Symptoms in Women with and without Spinal Cord Injury

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Objective: To examine menopause transition characteristics and symptom bother in women with spinal cord injury (SCI). Design: Prospective cohort (4 data collection periods across 4 years). Setting: Community. Participants: Women (n 62) with SCI (injury levels C6–T12, nonambulatory, 36mo postinjury; 86.1% retention) and women without SCI (n 66; 92.9% retention) with intact ovaries,not using hormone therapy, and between the ages of 45 and 60 years volunteered. A total of 505 observations were collected and analyzed. Interventions: None. Main Outcome Measures: Age at final menstrual period (FMP), transitions through menopause status classifications, and menopause symptom bother (vasomotor, somatic, psychologic symptoms). Results: The number of women transitioning through a menopause status classification over the course of the study did not significantly vary by group (P .263), nor did age at FMP (P .643). Women with SCI experienced greater bother of somatic symptoms (a subscale, P .001), bladder infections
(P .001), and diminished sexual arousal (P .012). Women without SCI had significantly greater bother of vasomotor symptoms (P .020). There were no significant group by menopause status interactions; main effects for menopause status were significant only for vasomotor symptoms and vaginal dryness. Conclusions: Results suggested that women with SCI experience greater symptom bother in certain areas, but that patterns of symptom bother across menopause, transition through menopause, and age at FMP are similar to those of their peers.Larger studies are needed to examine menopause outcomes with respect to level of injury and completeness of injury. These findings provide a framework that women with SCI and their health care providers can use to address the menopause transition and highlight the importance of multidisciplinary involvement to maximize health and well being during this transition.

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