Menopausal stage transitions and associations with overall and domain-specific perceived stress in middle-aged Korean women

Yoonyoung Jang ¹, Yoosoo Chang ², Sang Won Jeon ³, Junhee Park ⁴, Byungtae Seo ⁵, Jeonggyu Kang ⁴, Ria Kwon ¹, Ga-Young Lim ¹, Kye-Hyun Kim ⁶, Hoon Kim ⁷, Yun Soo Hong ⁸, Jihwan Park ⁹, Di Zhao ⁹, Juhee Cho ¹⁰, Eliseo Guallar ¹¹, Seungho Ryu ¹²

• PMID: 40639230
• DOI: 10.1016/j.maturitas.2025.108660

Abstract

Background: The menopausal transition, closely linked to later-life health, involves substantial physiological and psychological changes, potentially increasing perceived stress. However, longitudinal studies have reported inconsistent results, with limited data for Asian women, despite the potential for perceived stress to vary with both race and socioeconomic status. Therefore, this study investigated the longitudinal association between menopausal transition and perceived stress among middle-aged Korean women.

Materials and methods: We conducted a longitudinal study on 4619 women aged 42-52 who provided written consent in person at the Kangbuk Samsung Hospital Total Healthcare Center between 2014 and 2018. Participants were followed until August 2023, with a median follow-up of 6.6 years (interquartile range: 5.1-7.7), with 2 to 8 repeated comprehensive health screenings. We examined associations between menopausal transition and total scores and domain sub-scores (anger, tension, and depression) on the Perceived Stress Inventory using a linear mixed-effects model.

Results: Overall Perceived Stress Inventory and anger scores significantly increased during the late transition stage compared with the pre-menopause stage; however, they decreased during post-menopause. Tension scores showed a similar trend, although the results were not significant. Depression scores significantly increased during the early transition, late transition, and post-menopause stages compared with the pre-menopause stage.

Conclusion: Middle-aged Korean women's perceived stress significantly increased during the menopausal transition independent of age, marital status, education, and other confounders. Further research is needed to explore the implications of heightened stress and to assess the potential benefits of targeted interventions for women's health during this period.

Keywords: Menopausal transition; Menopause; Middle-aged Korean women; Perceived stress inventory; Straw+10.