The menopausal transition and healthy ageing and wellbeing

The menopause is a key period in a woman?s life. It marks the end of her reproduction and is often associated with changes in heart disease risk factors, bone density and how much muscle and fat mass she has. This time period is also one when women frequently change their role in the family and may change occupation or employment status. Research has shown that some women feel positive about the menopause, because it marks the end to concerns about contraception and increased freedom to pursue some of their own interests and occupations. Others feel negatively towards the menopause because it marks the loss of youth and the ability to reproduce and because of some of the adverse symptoms associated with it. Few studies have examined in detail how all of these changes interact with each other and how risk factors in earlier life and genetic factors impact on the changes that occur as women go through the menopause. We plan to study biological, medical, social and economic characteristics, as well as body image, sexual health and family relationships as women go through the menopause. We will also study how earlier reproductive health, lifestyles and genetic factors affect these changes. We will undertake this study in a group of 2800 women who will go through the menopausal transition over the next 5 years. We already have a lot of data on these women and this further study will enable us to fully understand how changes that occur as women go through the menopause affect their health and wellbeing. Thus, our research represents good value for money.

Unlike most physiological systems in humans, which age slowly and continue to function to some extent until death, in women reproductive function is lost abruptly and completely in middle-age. The menopause is a clear marker of the end of reproduction and has important biological, health and social implications for healthy ageing. Our hypotheses are that (i) the menopausal transition (MT) will be importantly related to changes in health, social and economic characteristics; (ii) some of these changes will be temporary and some will be beneficial to long term health and well-being and others detrimental to it; (iii) health related changes will be influenced by lifestyle changes, menopausal hormonal changes and the influence of menopausal hormonal changes on DNA methylation and (iv) that lifestyle, social, economic and health related changes over the MT will influence body image, family relations, employment and income, and vice versa. Because of the complex interplay of lifestyle, molecular genetic, hormonal, health, social and economic outcomes that are likely to influence how the MT influences healthy ageing and wellbeing it is essential that a multidisciplinary and large-scale approach is used to address our hypotheses. Our proposal is unique in that it will be the largest study to date to explore changes over the MT (2800 women will be studied) and will be the only study with a wealth of previously collected (over 20 years) early adulthood data on reproductive health, general health and lifestyle before the menopause, existence of genome wide data and prospectively collected data on offspring and partners. Our research will clarify the relationship between MT changes and healthy ageing and wellbeing in women and how these relate to health and wellbeing in their partners and children.