Comparison of Symptoms Between Midlife Women in Peri-menopause and Post-menopause Using Network Comparison Test

Introduction: Midlife women in peri-menopause and post-menopause experience a complex array of symptoms. However, there are conflicting results on how their symptom experience differs by menopausal stage. Current studies have not examined the interconnected relationship among menopausal symptoms and understood how this relationship may differ based on the menopausal stage. Purpose. This study aims to examine and compare the symptom network structure and key symptoms between midlife women in peri-menopause and post-menopause. Method. This is a secondary data analysis using cross-sectional data (visit 5) from the Study of Women’s Health Across the Nation. Network analysis was used to visualize the network structure and to identify key symptoms. Then, network comparison test was conducted to compare the symptom network properties. Propensity score matching was used to match participants in terms of their covariates. Result. In midlife women in peri-menopause, frequent mood change was the key symptom with the highest strength (1.59) and closeness (1.28). In midlife women in post-menopause, night sweat was the key symptom with the highest strength (1.35) and betweenness (1.82). The symptom networks were not significantly different between the two groups in terms of global strength (S = 0.01, p = 0.974), network structure (M = 0.10, p = 0.461), and specific centrality measure (C=-0.10, p = 0.083). Conclusion. While the symptom networks were not invariant, the key symptoms were different between the two groups. This indicates a potential need for different symptom management approach in midlife women in peri-menopause and post-menopause. With this new knowledge, clinicians should offer targeted key symptom assessment and management in clinical settings.