Comparison of Symptoms Between Midlife Women in Perimenopause and Postmenopause Using Network Comparison Test

Midlife women in perimenopause and postmenopause experience a complex array of symptoms. However, there is conflicting evidence on how their symptom experiences differ 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. 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, a network comparison test was conducted to compare the symptom network properties. Propensity score matching was used to match participants in terms of their covariates. In midlife women in perimenopause, frequent mood change was the key symptom with the highest strength (1.59), closeness (1.27), and expected influence (1.62). In midlife women in postmenopause, anxiety was the key symptom with the highest closeness (0.95) and expected influence (1.48). The symptom networks were not significantly different between the 2 groups in terms of global strength (global strength = 0.01, P = .974), network structure (network structure = 0.10, P = .461), and specific centrality measure (centrality = -0.10, P = .083). While the symptom networks were not invariant, the key symptoms were different between the 2 groups. Our study findings indicate a potential need for different symptom management approaches for midlife women in perimenopause and postmenopause. With this new knowledge, clinicians should offer targeted key symptom assessment and management.