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ARTICLE TYPE : RESEARCH ARTICLE

Published on :   14 Oct 2026, Volume - 2
Journal Title :   WebLog Journal of Women’s Health | WebLog J Women's Health | WJWH
Source URL:   weblog icon https://weblogoa.com/articles/wjwh.2026.j1403
Permanent Identifier (DOI) :   doi icon https://doi.org/10.5281/zenodo.23341733

Symptom Burden and Its Determinants Across Premenopause, Perimenopause, and Natural Menopause: A Cross-Sectional Study Using the Menopausal Rating Scale

Sumisti Shakya 1 *
Abha Shrestha 2
Bhawana Shrestha 3
1High-Risk Pregnancy Specialist, MD Obstetrics and Gynecologist, Department of Obstetrics and Gynecology, Dhuilkhel Hospital, Dhulikhel, Kavre, Nepal
2Professor, Senior Consultant and Head of Department of Obstetrics and Gynecology, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal
3Masters in Public Health, Department of Research and Development, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal

Abstract

Background: Menopause represents a major physiological transition, often accompanied by diverse somatic, psychological, and urogenital symptoms. Despite its impact, comparative data across menopausal stages in Nepal remain limited.

Objective: To assess and compare symptom burden across premenopausal, perimenopausal, and postmenopausal women using the Menopausal Rating Scale (MRS), and to identify independent determinants of total and domain specific symptom scores.

Methods: A cross-sectional study was conducted among 348 women aged 40-65 years attending menopause clinic at Dhulikhel Hospital, Nepal (August 2025-February 2026). Sociodemographic, reproductive, and lifestyle data were collected, and menopausal stage classified using STRAW+10 criteria. Symptom burden was assessed with MRS. Multivariable linear regression was applied to identify independent predictors of total and domain specific scores.

Results: The average age at menopause was 47.7±4.70 years. Muscle and joint pain were the most common symptom (75.6%), followed by physical and mental exhaustion (69.0%) and sexual problems (59.2%), while depressive mood was least common (47.4%). Somatic complaints dominated (91.1%), with psychological (85.6%) and urogenital (77.6%) symptoms also prevalent. Total MRS scores rose across menopausal stages, with somatic symptoms peaking at perimenopause, while psychological and urogenital issues escalated sharply in post-menopause. Multivariable analysis confirmed age, menopausal stage, and parity as independent predictors of symptom burden. Somatic symptoms were driven mainly by menopausal stage, psychological symptoms by occupation and physical activity, and urogenital complaints by age, parity, and marital status. Unmarried women reported fewer urogenital problems. Other factors such as BMI, education, residence, smoking, and alcohol showed no significant associations.

Conclusion: Symptom burden intensifies across menopausal stages, with distinct determinants for somatic, psychological, and urogenital domains. These findings underscore the need for stage and domain specific counselling and interventions tailored to Nepali women’s.

Keywords: Pre-Menopause; Perimenopause; Menopause; Menopausal Rating Scale; Somatic Symptoms; Psychological Symptoms; Urogenital Symptoms

Citation

Shakya S, Shrestha A, Shrestha B. Symptom Burden and Its Determinants Across Premenopause, Perimenopause, and Natural Menopause: A Cross-Sectional Study Using the Menopausal Rating Scale. WebLog J Women's Health. wjwh.2026. j1403. https://doi.org/10.5281/zenodo.23341733
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