PSYCHOLOGICAL, SOMATOVEGETATIVE, AND UROGENITAL SYMPTOMS DURING THE MENOPAUSAL TRANSITION: A CROSS-SECTIONAL ANALYSIS OF WOMEN IN PRIMARY HEALTH CARE

Abstract

The menopausal transition is a complex biological and psychosocial process that marks the end of a woman's reproductive function, typically occurring between the ages of 45 and 55. This period is characterized by significant hormonal changes that affect a wide range of somatic, psychological, and urogenital functions. Particular attention in the literature is given to perimenopause, a phase sensitive to the development of psychiatric disorders and cognitive dysfunctions. Nevertheless, previous research has often neglected to analyze the intensity of symptoms across different age groups, which is the focus of this study.
Research Objectives: The aim of this study was to determine the prevalence of psychological, somatovegetative, and urogenital symptoms during the menopausal transition in women attending primary health care services.
Methods: A prospective cross-sectional study was conducted from July 1, 2024, to July 1, 2025, at the Department of Gynecology, Primary Health Center Cazin (Bosnia and Herzegovina). A total of 417 women aged 45 and older were included in the study. None of the participants were using hormone replacement therapy or had been diagnosed with psychiatric disorders. The validated Menopause Rating Scale (MRS) was used to assess three dimensions of symptoms: psychological, somatovegetative, and urogenital. Statistical analysis was performed using IBM SPSS Statistics (version 27), and differences between age groups were analyzed using Pearson’s chi-square test (p < 0.05).
Results and Discussion: The mean age of participants was 56.63 ± 4.64 years. Psychological symptoms were present in 63.5% of women, with the highest prevalence of severe symptoms observed in the 55–59 age group (20.1%). However, the differences between age groups were not statistically significant (p = 0.463). Somatovegetative symptoms were reported in 68.1% of participants, with the most pronounced symptoms in the 50–54 and 55–59 age groups. A statistically significant association was found between age and symptom intensity (p = 0.019). Urogenital symptoms were present in 66.2% of women, with the highest frequency of severe symptoms recorded in the 65+ age group (31.0%), also showing a statistically significant difference between age groups (p = 0.033).
Conclusions: The findings indicate a high prevalence of all three symptom categories associated with the menopausal transition, with somatovegetative and urogenital symptoms being more prominent in older age groups. Psychological symptoms were present across all age groups, but without significant intergroup differences. These results highlight the need for an individualized, multidisciplinary approach to managing menopausal symptoms, with special emphasis on age-specific characteristics and psychological support. Furthermore, the results may serve as a foundation for future research focused on the prevention and treatment of menopausal disorders within primary health care settings.
Recommendations: Physicians and healthcare professionals should adopt a personalized approach in assessing and managing menopausal transition symptoms, considering the woman's age, symptom intensity, and overall health status. Further research is needed to explore the long-term outcomes of menopausal symptoms and the effectiveness of various therapeutic approaches, particularly within local populations.