Infertility associated with severe menopause symptoms

USA: A recent study published in Menopause has found that women with prior infertility are more likely to have a Menopause Rating Scale (MRS) score above the median and experience sleep problems, irritability, and depressive mood during midlife than women without infertility. 

These findings have implications for the screening of mental health among midlife women," the researchers wrote in their study. 

Not all women experience menopause the same way. The severity of menopause symptoms is influenced by a multitude of behavioural, biological, social, psychological, and demographic factors. The study suggests that infertility may also be a risk factor for some menopause symptoms, including depressive mood, irritability, and sleep problems. 

A woman’s reproductive history has been implicated as a factor in the timing of menopause onset and the prevalence of menopause symptoms. Although the literature on the relation of infertility with the onset of menopause or the severity of menopause symptoms is scarce, there is some indication that women with a history of infertility may experience earlier menopause and greater severity of some menopause symptoms. In addition, infertility has been found to be an equivalent life stressor to a cancer diagnosis, and experiencing stressful life events is associated with reports of more menopause symptoms.

The goal of this new study involving nearly 700 midlife women was to specifically evaluate the effect of a lifetime history of infertility on the experience of menopause symptoms in midlife. Of the study participants, roughly one-third (36.6%) reported ever experiencing infertility. This is higher than the national average of infertility overall that, according to at least one study (The Nurses’ Health Study), was estimated at 27.6%.

Based on the findings, researchers in this new study concluded that women with a history of infertility had greater odds of experiencing sleep problems, depressive mood, and irritability. No association was documented between infertility and other common menopause symptoms such as hot flashes, vaginal dryness, or anxiety.

This is not the first time that infertility has been associated with depression. Prior studies have shown that 30% to 60% of women undergoing evaluation and treatment of infertility screen positive for depression. This is the first study, however, to show that a prior history of infertility is associated with depressive symptoms in midlife and could be considered a flag for increased screening for depressive symptoms in midlife.

Study results are published in the article “Exploring the relationship between history of infertility and the experience of menopausal symptoms.”

“This study shows an association between a history of infertility and increased odds of depression and sleep symptoms in midlife. Women in midlife with a history of infertility may benefit from increased screening for depression,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

Reference:

Fitz, Victoria W. MD, MSCR; Soria-Contreras, Diana C. PhD; Rifas-Shiman, Sheryl L. MPH; Shifren, Jan L. MD, NCMP; Oken, Emily MD, MPH; Chavarro, Jorge E MD, ScD. Exploring the relationship between history of infertility and the experience of menopausal symptoms. Menopause ():10.1097/GME.0000000000002229, August 1, 2023. | DOI: 10.1097/GME.0000000000002229.