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Perimenopause Research

Our published papers and presented posters from the Women Living Better perimenopause research collaborative
PEER-REVIEWED RESEARCH PAPERS
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“Not feeling like myself” in perimenopause — what does it mean? Observations from the Women Living Better survey
Coslov, Nina MBA1; Richardson, Marcie K. MD2; Woods, Nancy Fugate PhD, RN3. “Not feeling like myself” in perimenopause — what does it mean? Observations from the Women Living Better survey. Menopause ():10.1097/GME.0000000000002339, March 25, 2024. | DOI: 10.1097/GME.0000000000002339
In this analysis we set out to better understand what symptoms are most associated with the phrase “I don’t feel like myself”. This phrase is used frequently by those on the path to menopause and many health care providers who care for midlife women also report hearing it. Overall, sixty-three percent (63.3%) of participants reported feeling not like themselves (NFLM) 50% of the time or more over the previous 3 months. To see which symptoms were most correlated with NFLM, you can read access the paper here.

Open Access. Made possible by contributions to a GoFundMe campaign.

It was published online ahead of print on March 26, 2024, and will be published in Volume 31, Issue 5 of Menopause, the journal of The Menopause Society.

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Anticipated age of perimenopausal experiences, stress, satisfaction, and health and well-being: Observations from The Women Living Better Survey
Woods NF, Coslov N, Richardson M. Anticipated age of perimenopausal experiences, stress, satisfaction, and health and well-being: observations from the Women Living Better Survey. Menopause. 2023 Aug 1;30(8):807-816. doi: 10.1097/GME.0000000000002206. Epub 2023 Jun 6. PMID: 37279510.
In this research, we hypothesized that being "off-time" that is having perimenopause-related menstrual cycle changes or symptoms sooner than you expect them, would lead to more health stress, lower satisfaction with life roles and activities, and poorer perceived health. However, "off-time" was only associated with worse perceived health. An interesting finding was that those who were "off-time" and experiencing more bothersome volatile mood symptoms reported greater health stress, lower satisfaction with life roles and activities, and poorer perceived health. Perhaps because volatile mood symptoms which include new irritability, sudden anger/rage and mood swings aren't expected, they are more a cause of concern.

It was published online ahead of print on June 6, 2023, and in the August 2023 issue of Menopause, the journal of the Menopause Society.

This paper is not open access. Only the abstract is available.

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Seeking Health Care for Perimenopausal Symptoms: Observations from The Women Living Better Survey
Richardson MK, Coslov N, Woods NF. Seeking Health Care for Perimenopausal Symptoms: Observations from The Women Living Better Survey. J Womens Health (Larchmt). 2023 Apr;32(4):434-444. doi: 10.1089/jwh.2022.0230. Epub 2023 Jan 12. PMID: 36656145; PMCID: PMC10079240.
This paper explores the factors that contribute to making perimenopausal health care interactions either satisfying or unsatisfying for the patient. We analyzed responses to an open-ended question about how a healthcare interaction for a bothersome symptom went. Our analysis revealed themes that led to either satisfying or unsatisfying interactions which in turn present opportunities for improved care.

It was published online ahead of print on January 12, 2023 and in the April 2023 issue of The Journal of Women’s Health.

Open access: made possible by generous contributions by the Women Living Better Community

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See the full paper
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Symptom experience during the late reproductive stage versus the menopausal transition in the Spanish-language Women Living Better survey
Cortés YI, Coslov N, Richardson MK, Woods NF. Symptom experience during the late reproductive stage versus the menopausal transition in the Spanish-language Women Living Better survey. Menopause. 2023 Mar 1;30(3):260-266. doi: 10.1097/GME.0000000000002132. Epub 2023 Jan 10. PMID: 36630255; PMCID: PMC9974803.
This research analyzed the data from the Spanish language Women Living Better Survey. I compared the symptom experience of those in the late reproductive stage with those in the menopausal transition. For 8 of 18 symptom groups the LRS and MT experiences were similar. These findings support anticipatory guidance about menopause and further research about symptoms experienced among Spanish-speaking women in order to offer more personalized midlife health care.

It was published online ahead of print on January 10, 2023, and will be published in the March 2023 issue of Menopause, the Journal of the North American Menopause Society.

It will become open access on March 1. 2024.

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See the full paper
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Effects of bothersome symptoms during the late reproductive stage and menopausal transition: observations from the Women Living Better Survey
Woods, Nancy Fugate BSN, Ph.D., FAAN, FGSA1; Coslov, Nina MBA2; Richardson, Marcie K. MD, FACOG3. Effects of bothersome symptoms during the late reproductive stage and menopausal transition: observations from the Women Living Better Survey. Menopause 30(1):p 45-55, January 2023. | DOI: 10.1097/GME.0000000000002090
This research documents how bothersome symptoms interfere with our daily activities and relationships and contribute to “not feeling like ourselves”. Interestingly, not feeling like myself” was not associated with vasomotor symptoms (hot flashes and night sweats). We wonder if this is because these are symptoms well known to be associated with the path to menopause. Whereas a new experience of other symptoms (brain fog, volatile mood, fatigue and pain and anxiety/vigilance) is less well known to be possibly associated with the path to menopause and therefore hard to attribute, and possibly of more concern. This is why we think it’s so important to have accurate expectations about the range of experiences that are part of the path to menopause. When we know what to expect, it can lessen surprise, concern and suffering.

It was published online ahead of print on November 2, 2022, and in the Jan 2023 issue of Menopause, the Journal of the North American Menopause Society.

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Perimenopause Meets Life: Observations from the Women Living Better Survey
Woods NF, Coslov N, Richardson MK. Perimenopause meets life: observations from the Women Living Better Survey. Menopause. 2022 Oct 3. doi: 10.1097/GME.0000000000002072. Epub ahead of print. PMID: 36194844.
This perimenopause research based on data from the WLB survey verifies that midlife stress comes from our many roles and relationships — no big surprise here! But, these sources of stress in turn have an impact on symptom bother. So, we might be able to lessen symptom bother by being proactive in identifying sources of stress from roles and relationships and doing what we can to manage this stress. In addition, this analysis demonstrated that being satisfied with the mix of life roles and activities — both paid and unpaid — seems to lessen role and relationship stressors and lessen the bother associated with some midlife symptoms.

It was published online ahead of print on October 3, 2022 and in the December 2022 issue of Menopause, the Journal of the North American Menopause Society.

See key findings
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Symptom Experience during the Late Reproductive Stage and the Menopausal Transition: Observations from the Women Living Better Survey
Coslov, Nina MBA; Richardson, Marcie K. MD, FACOG; Woods, Nancy Fugate PhD, RN, FAAN. Symptom experience during the late reproductive stage and the menopausal transition: observations from the Women Living Better survey, Menopause: September 2021 – Volume 28 – Issue 9 – p 1012-1025. doi: 10.1097/GME.0000000000001805
This paper shares data from the 2020 Women Living Better Survey. This is among the few studies that have analyzed the symptom experience during the Late Reproductive Stage (LRS), while periods are still coming monthly, but with subtle changes to the length of cycle, amount of flow or days of flow and compared it with the Menopause Transition (MT), when cycles have become noticeably irregular.

It was published in the September 2021 issue of Menopause, the Journal of the North American Menopause Society. Through support from a GoFundMe campaign, it was made open access on October 28, 2021.

Open Access.

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See the full paper
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Transitioning to the menopausal transition: a scoping review of research on the late reproductive stage in reproductive aging.
Woods NF, Mitchell ES, Coslov N, Richardson MK. Transitioning to the menopausal transition: a scoping review of research on the late reproductive stage in reproductive aging. Menopause. 2021 Jan 15;28(4):447-466. doi: 10.1097/GME.0000000000001707. PMID: 33470754.
We were curious about people’s experience with symptoms while periods were still regular — before noticeable menstrual cycle changes. This is referred to as the Late Reproductive Stage in the research literature. Our collaborator, Dr. Woods suggested a “scoping paper” to determine what previous research had been done about this stage. This involved searching many scientific literature databases from 2000 to the present. What we found were only 9 research papers mentioning the Late Reproductive stage. Other research studied women of Late Reproductive age. In most research, the Late Reproductive Stage was used as a baseline or comparator stage for changes that came later on the path to menopause. We felt there was value in looking at this stage on its own and this scoping review further confirmed this as little was known from previous research.

Open Access.

See the full paper
PRESENTED POSTERS HIGHLIGHTING PERIMENOPAUSE RESEARCH
The Meaning of “Not Feeling Like Myself” During Perimenopause: Observations from the Women Living Better Study
By Nina Coslov, Marcie Richardson, Nancy Fugate Woods; Presented at The Menopause Society Annual Meeting, September 2023, Philadelphia, PA
This poster elucidates the meaning of the often-used phrase “Not Feeling Like Myself” in midlife respondents by presenting which symptoms had the strongest correlation for those who endorsed this sentiment.
Effects of Anticipated Age of Perimenopausal Experiences on Health, Stress and Well-Being: Observations from the Women Living Better Survey
By Nancy Fugate Woods, Nina Coslov, Marcie Richardson; Presented at The Menopause Society Annual Meeting, September 2023, Philadelphia, PA
This poster shares an analysis about the association of being “off-time”, that is experiencing symptoms associated with perimenopause before they are expected.
Effects of Bothersome Symptoms during the LRS and MT: Observations from the Women Living Better Survey
By Marcie Richardson, Nina Coslov, Nancy Fugate Woods; Presented at The North American Menopause Society, October 2022, Atlanta, GA
This poster shares data about how bothersome symptoms affect 4 outcomes: 1. self-ratings of health, 2. interference with everyday activities, 3. interference with relationships, and 4. “Not feeling like myself”.
Seeking Healthcare for Perimenopausal Symptoms: Findings from the Women Living Better Survey
By Marcie Richardson, Nina Coslov, Nancy Fugate Woods; Presented at The North American Menopause Society, September 2021, Washington, DC
This poster shares data from a qualitative analysis of survey respondents’ responses when asked about how interactions with healthcare providers for bothersome perimenopausal symptoms went. There are important implications for behavioral changes for both patients and providers for improved interactions.
Perimenopause Meets Life: Observations from the Women Living Better Survey
By Nancy Fugate Woods, Nina Coslov, Marcie Richardson; Presented at The North American Menopause Society, September 2021, Washington, DC
This poster shares an analysis about the association of different variables (i.e. educational attainment, stage of menopause transition, health behaviors, roles and relationships, overall stress, stress associated with roles and relationships) with symptom bother on the path to menopause.
Poster Prize Winner! Women’s Experience of The Late Reproductive Stage: Findings from the Women Living Better Survey
By Marcie Richardson, Nina Coslov, Ellen Sullivan Mitchell, Nancy Fugate Woods; Presented at The North American Menopause Society, October 2020, Virtual
This poster shares early analysis from the Women Living Better Survey from respondents ages 35-55 about their experience on the path to menopause.

Recognition: NAMS Poster Prize Winner!