Although women experience clusters of symptoms during the menopausal transition, most research focuses on individual symptoms such as hot flashes. The proposed study shifts the paradigm from focusing on individual symptoms to symptom clusters (SCs). Re-analyzing data on symptoms and genetic polymorphisms, endocrine biomarkers, symptom vulnerability factors and sociobehavioral risk factors from over 500 participants in the Seattle Midlife Women's Health Study (P50 NR02323, R01 NR04141, P30 NR04001, P30 ES07033) with longitudinal follow-up spanning up to 19 years will allow us to achieve these aims: 1) identify prevalent symptom clusters during the late reproductive stage, early and late menopausal transition stages, and early postmenopause using latent class analysis;2) determine the consistency of symptom clusters as women change from one menopausal transition stage to the next;3) test models linking genetic polymorphisms, endocrine biomarkers, symptom vulnerability factors, social-behavioral risk factors and menopause-related factors to symptom clusters, and outcomes of well-being and symptom interference;4) conduct a systematic review of controlled clinical trials to identify symptoms as secondary treatment effects and adverse effects that will inform us about therapies for symptom clusters and 5) synthesize results of the empirical analyses and systematic review to develop novel symptom cluster management protocols to be tested in future feasibility studies. An interdisciplinary scientific advisory board including National Institute on Aging-funded MS-FLASH clinical trials investigators will provide our research team an opportunity for immediate sharing of our results in order to inform design of symptom cluster management approaches as well as their ongoing studies, including the generation of ancillary studies of symptom clusters and related mechanisms.

Public Health Relevance

The results of this study will help clinicians and women, themselves, identify symptoms that cluster together and that may have different causes. Knowing which cluster of symptoms a woman has may help her clinician recommend the treatment or treatments that are most likely to work best for her. Using some of the genetic and hormone tests, as well as information about the woman's history, such as stressful experiences she has had, may help understand what causes some of her symptoms and may help her and her clinician decide on the best treatment available for her.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21NR012218-01
Application #
7952735
Study Section
Nursing Science: Adults and Older Adults Study Section (NSAA)
Program Officer
Tigno, Xenia
Project Start
2010-09-15
Project End
2012-07-31
Budget Start
2010-09-15
Budget End
2011-07-31
Support Year
1
Fiscal Year
2010
Total Cost
$234,000
Indirect Cost
Name
University of Washington
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Woods, Nancy Fugate; Cray, Lori A; Mitchell, Ellen Sullivan et al. (2018) Polymorphisms in Estrogen Synthesis Genes and Symptom Clusters During the Menopausal Transition and Early Postmenopause: Observations From the Seattle Midlife Women's Health Study. Biol Res Nurs 20:153-160
Ismail, Rita; Linder, Lauri A; MacPherson, Catherine Fiona et al. (2016) Feasibility of an iPad application for studying menopause-related symptom clusters and women's heuristics. Inform Health Soc Care 41:247-66
Ismail, R; Taylor-Swanson, L; Thomas, A et al. (2015) Effects of herbal preparations on symptom clusters during the menopausal transition. Climacteric 18:11-28
Woods, Nancy Fugate; Ismail, Rita; Linder, Lauri A et al. (2015) Midlife women's symptom cluster heuristics: evaluation of an iPad application for data collection. Menopause 22:1058-66
Taylor-Swanson, L; Thomas, A; Ismail, R et al. (2015) Effects of traditional Chinese medicine on symptom clusters during the menopausal transition. Climacteric 18:142-56
Woods, Nancy Fugate; Cray, Lori; Mitchell, Ellen Sullivan et al. (2014) Endocrine biomarkers and symptom clusters during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study. Menopause 21:646-52
Woods, N F; Mitchell, E S; Schnall, J G et al. (2014) Effects of mind-body therapies on symptom clusters during the menopausal transition. Climacteric 17:10-22
Thomas, Annette J; Ismail, Rita; Taylor-Swanson, Lisa et al. (2014) Effects of isoflavones and amino acid therapies for hot flashes and co-occurring symptoms during the menopausal transition and early postmenopause: a systematic review. Maturitas 78:263-76
Cray, L A; Woods, N F; Mitchell, E S (2013) Identifying symptom clusters during the menopausal transition: observations from the Seattle Midlife Women's Health Study. Climacteric 16:539-49
Cray, Lori A; Woods, Nancy Fugate; Herting, Jerald R et al. (2012) Symptom clusters during the late reproductive stage through the early postmenopause: observations from the Seattle Midlife Women's Health Study. Menopause 19:864-9

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