Stressful life events during the perimenopause: longitudinal observations from the seattle midlife women's health study

Annette Joan Thomas; Ellen Sullivan Mitchell; Kenneth C Pike; Nancy Fugate Woods

doi:10.1186/s40695-023-00089-y

Stressful life events during the perimenopause: longitudinal observations from the seattle midlife women's health study

Womens Midlife Health. 2023 Sep 5;9(1):6. doi: 10.1186/s40695-023-00089-y.

Authors

Annette Joan Thomas¹, Ellen Sullivan Mitchell², Kenneth C Pike³, Nancy Fugate Woods⁴

Affiliations

¹ College of Nursing, Seattle University, Seattle, WA, USA. thomaann@seattleu.edu.
² Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA.
³ Office of Nursing Research, University of Washington, Seattle, WA, USA.
⁴ Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA.

Abstract

Background: Midlife is a time of increased responsibilities for women who have multiple roles including taking care of children, caring for elderly parents, managing households, and working outside the home. With little time for themselves, women additionally experience stressful life events (SLEs). The purpose of this study was to describe the longitudinal patterns of SLEs of women during midlife and to identify predictors of the SLE longitudinal patterns using baseline data of socio-economic factors and demographic characteristics.

Methods: Women who were part of the Seattle Midlife Women's Health Study (SMWHS), a longitudinal study spanning more than 23 years, who had SLEs measured at baseline and at years 2, 7, and 10 were included in these analyses (N = 380 women at baseline). The Life Event Scale (LES), a 70-item scale based on a yes/no response and a Likert-based scoring system with 0 (no effect) to 4 (large effect), was used to determine the total and impact scores of midlife women. The LES was adapted to midlife women from the Norbeck Scale for younger, pregnant women. Analytic strategies consisted of a group-based trajectory model (GBTM) to examine subgroups of women with similar exposure to SLEs using socio-economic factors (gross family income, education, race/ethnicity, employment), demographic variables (age, marital status, being a parent), and menopausal transition stage to differentiate trajectories over time.

Results: Approximately 86% of women had medium high exposure to undesirable SLEs with a slight decrease (65.5%), or a sharp decrease (20.1%), over 10 years. The majority (approximately 64%) had moderate, sustained impact ratings, while approximately 35% had impact ratings that decreased over time. Most women (approximately 88%) reported desirable life events, which were sustained over the ten years, and which may help to balance or offset the high ratings of undesirable stressful life events. The rated impact of these desirable events decreased slightly over time for 65% of the sample. Socio-economic factors, demographic variables, and menopausal transition stages were not significant predictors of any of the four GBTMs.

Conclusion: Midlife women experience SLEs throughout the menopausal transition. Most of these midlife women had had a large amount of sustained stress over 10 years although all trajectories decreased to some extent over time. Since the menopausal transition stages were not significant predictors of the ratings of SLEs, a more complex set of factors, including social as well as biological, may explain the ratings of the women over the course of this ten-year observational study.

Keywords: Demographic characteristics; Group-based trajectory models; Menopausal transition; Midlife women; Seattle midlife women’s Health Study; Socioeconomic factors; Stressful life events.