The impact of menopause on sexual health a cross-sectional study using data from women living in Northern Greece

 Corresponding author: Panagiota D Dourou Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. The impact of menopause on sexual health a cross-sectional study using data from women living in Northern Greece Aikaterini E Sousamli and Panagiota D Dourou * Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, 12243 Athens, Greece. World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 Publication history: Received on 28 April 2025; revised on 31 May 2025; accepted on 03 June 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.26.3.2176 Abstract Menopause represents a significant life transition for women, often accompanied by physical, psychological, and sexual health challenges. With the increasing life expectancy in women, a considerable part of their life will be spent in the postmenopausal period. The decline in estrogen levels leads to vasomotor symptoms, such as hot flashes and night sweats, as well as psychological symptoms, including anxiety, depression, and irritability. Sexual dysfunction is another key concern, with many menopausal women experiencing reduced libido, vaginal dryness, and pain during intercourse. This study aimed to evaluate the impact of menopause on sexual health. The study sample consisted of 100 menopausal and 101 non-menopausal women aged 45-55. An anonymous questionnaire included sociodemographic questions, the Female Sexual Function Index (FSFI), the DASS-21 index, MENQOL index, Pittsburgh Sleep Quality Index, SF-12 questionnaire, and the Hot Flash-Related Daily Interference Scale (HFRS). The results showed that menopausal women had significantly lower sexual desire, arousal, lubrication, orgasm, and satisfaction, with higher levels of sexual discomfort and pain (P<0.001). Increased sexual and vasomotor symptoms were associated with poorer sexual function, while psychological distress (anxiety, depression, and stress) compounded the challenges of sexual dysfunction. Poor sleep quality also had adverse effects on sexual health. Menopause is strongly associated with declines in sexual function, highlighting the need for healthcare providers to offer guidance and treatment options tailored to women's health history and preferences. Lifestyle changes, like regular physical exercise and a healthy diet, alongside psychological and medical interventions, can play a role in the improvement of sexual health and quality of life. Keywords: Menopause; Sexual dysfunction; Sexual health; Vasomotor symptoms; Psychosocial health; Quality of life; Hormone therapy; Hot flashes 1. Introduction Menopause marks a significant life transition for women [1]. It is estimated that approximately 6,000 women in the United States enter menopause each day, and with increasing life expectancy, they will spend nearly 40% of their lives in the postmenopausal stage [2]. The onset of menstruation (menarche) and menopause, both fundamental aspects of female reproductive function, serve as critical milestones in a woman’s life cycle, significantly influencing sexual health and function [3]. While some women perceive this change positively, it is often associated with aging and negative connotations, particularly in Western cultures [1]. The menopausal transition is characterized by a decrease in ovarian function, leading to reduced estrogen levels and various physical, psychological, and social changes [4]. These changes can result in common symptoms, including hot flashes, mood swings, sleep disturbances, sexual dysfunction and increased risks for osteoporosis and cardiovascular diseases [5]. The symptoms have a direct impact on women’s quality of life, including sexual health, which tends to decline during this period [6]. Despite the growing body of research on menopausal symptoms, there remain gaps in understanding their frequency, severity, and the overall impact on women’s well-being. World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 527 1.1. Menopause and Sexual Health Sexuality in women is a relatively new field of biomedical research [3]. In premenopausal women, the vaginal wall is thick, well-vascularized, and lubricated. However, during menopause, as estrogen levels decline, the vaginal wall becomes thinner and paler. This can lead to atrophic vaginitis, an inflammation of the vaginal tissue that may result in brown or yellow discoloration. Additionally, the vagina loses elasticity, narrows, and shrinks, causing discomfort. These vaginal and vulvar changes can lead to various symptoms that negatively impact quality of life and sexual function [2]. Studies indicate that the majority of women remain sexually active during menopause. However, a significant proportion (approximately 60%) report sexual dysfunction, primarily characterized by a decrease in sexual desire or an avoidance of sexual intercourse [4]. According to the American Psychiatric Association’s DSM-IV classification, common sexual dysfunctions observed during perimenopause include disorders or lack of sexual desire, difficulties in sexual arousal, inability to achieve orgasm and pain during sexual intercourse (dyspareunia) [4]. Dyspareunia, in particular, is a leading factor contributing to loss of interest in sex for many women [1]. Psychological, social, and environmental factors play a critical role in shaping sexual function and behavior. A comprehensive approach to women’s sexuality must extend beyond the biological process and consider emotional, psychological, and societal influences [3]. Research suggests that women feel more comfortable discussing sexual concerns when the healthcare provider initiates the conversation. However, such issues are rarely addressed in clinical practice [1]. Both the natural decline in estrogen levels during natural menopause and the reduction of androgens due to aging or surgical menopause contribute to sexual symptoms, such as reduced sexual desire, impaired arousal, painful intercourse (dyspareunia), decreased orgasm intensity and lower overall sexual satisfaction [3]. Additionally, menopause affects emotional and cognitive aspects of sexuality through hormonal changes in reproductive function. However, the extent of this impact varies among women, depending on individual history and psychological factors [3]. 2. Material and methods 2.1. Study Design and Participants This study utilized a cross-sectional design with a sample of 201 women aged 45-55, divided into two groups, the menopausal group (n=100), women who had not menstruated for at least 12 consecutive months and the premenopausal group (n=101), women with regular menstrual cycles. The purpose of this study was to evaluate the menopausal symptoms and to investigate their effect in women’s quality of life. This research was conducted in Gynecological Clinics of Health Centers in Drama and Serres. Women who came for a gynecological examination were asked about their participation in the study and those who agreed to participate were included in it. The survey was conducted from June to October 2023. 2.2. Measurements The measurement tools are a self-administered questionnaire that, in addition to socio-demographic questions, includes the following validated instruments in order to evaluate various dimensions of health, such were the Female Sexual Function Index (FSFI) which evaluates sexual dysfunction, including desire, arousal, and satisfaction [7], the Depression, Anxiety, and Stress Scale (DASS-21) which measures depression, anxiety and stress [8], the Menopause-Specific Quality of Life (MENQOL) which assesses the impact of menopausal symptoms on her quality of life [9], the Pittsburgh Sleep Quality Index (PSQI) which evaluates sleep disturbances and overall sleep quality [10], the SF-12 Health Survey therein measures physical and mental health-related to quality of life [11]and lastly the Hot Flash-Related Daily Interference Scale (HFRS) which quantifies the frequency and impact of hot flashes on quality of life [12]. World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 528 2.3. Statistical Analysis Data were analyzed using SPSS 22.0, with comparisons made between menopausal and premenopausal groups using ttests and correlation analyses. Linear regression analysis using the stepwise method and logarithmic transformations, where necessary, were used to find independent factors related to the depression, sexual functioning and quality of life scales, from which dependence coefficients and their standard errors (SE) were obtained. To find independent factors related to the sleep quality scale, logistic regression analysis using the stepwise method was performed and Odds ratios with their 95% confidence intervals (95% CI) were obtained. Statistical significance was set at p < 0.05. 3. Results 3.1. Participant characteristics The study sample consisted of 201 women, of whom 100 (49.8%) were postmenopausal. Table 1 presents the demographic characteristics of the participants, both for the entire sample and separated by menopausal status. Table 1 Sociodemographic Characteristics of the Women in the Sample Total Sample Pre-Menopausal Post-Menopausal P P Pearson’s x2 test N (%) N (%) N (%) Ethnicity Greek 192(95.5) 99(98) 93(93) 0.101+ Other 9(4.5) 2(2) 7(7) If other, specify Albanian 6(3) 2(2) 4(4) - Russian 3(1.5) 0(0) 3(3) Age, Mean (SD) 50(2.7) 49.7(2.6) 50.3(2.9) 0.114++ BMI, Mean (SD) 26,8 (3.5) 26.6(3.5) 26.9(3.5) 0.471++ BMI Categories Normal weight 63(31.3) 30(29.7) 33(33) 0.322 Overweight 108(53.7) 59(58.4) 49(49) Obese 30(14.9) 12(11.9) 18(18) Employment Status No 90(44.8) 45(44.6) 45(45) 0.949 Yes 111(55.2) 56(55.4) 55(55) If yes, occupation Public Sector Employee 37(33.3) 18(32.1) 19(34.5) 0.792 Self-employed 21(18.9) 12(21.4) 9(16.4) Private Sector Employee 53(47.7) 26(46.4) 27(49.1) Educational Level Primary School 11(5.5) 1(1) 10(10) 0.031+ Middle School 38(18.9) 15(14.9) 23(23) High School 115(57.2) 64(63.4) 51(51) Technical Institute (TEI) 22(10.9) 12(11.9) 10(10) University (AEI) 8(4) 4(4) 4(4) Master’s Degree 5(2.5) 3(3) 2(2) Doctorate 2(1) 2(2) 0(0) Married 20(10) 13(12.9) 7(7) Married with children 127(63.2) 59(58.4) 68(68) Divorced 16(8) 6(5.9) 10(10) World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 529 Marital Status In a Relationship 29(14.4) 18(17.8) 11(11) 0.264 Single 9(4.5) 5(5) 4(4) Annual Household Income (in euros) 0-5.000 11(5.5) 6(5.9) 5(5) 5.000-12.000 58(28.9) 15(14,9) 43(43) <0.001 12.000-20.000 107(53.2) 66(65,3) 41(41) >20.000 25(12.4) 14(13,9) 11(11) +Fisher’s exact test ++Student’s t-test The majority of participants (95.5%) were Greek, with an average age of 50 years (SD = 2.7), 53.7% were overweight, and 55.2% were employed, with 47.7% working in the private sector. Educationally, 57.2% had completed high school, and a higher proportion of postmenopausal women had finished primary or secondary school compared to their premenopausal counterparts. Regarding marital status, 63.2% were married with children, and 53.2% reported an annual household income of €12,000-20,000, with postmenopausal women reporting higher incomes in the €5,00012,000 range. Among women who still had menstruation, 48.5% were in the perimenopausal stage. For those who were postmenopausal, the average time since their last period was 1.9 years (SD = 0.9). Only one postmenopausal participant reported using hormone replacement therapy. 3.2. Levels of sexual functioning Participants who were not in menopause had better sexual functioning in every domain as well as overall compared to menopausal participants. It was observed that women who were not in menopause exhibited a stronger sexual desire compared to those who were in menopause (table 2). Table 2 Comparison of Sexual Functionality Levels Between Menopausal and Non-Menopausal Women Menopausal Non-Menopausal P MannWhitney test Mean (SD) Median (Range) Mean (SD) Median (Range) Sexual Desire 3(1.5) 2.4(1.8-3.6) 4.1(1.4) 4.8(3.6-4.8) <0.001 Arousal 3.1(1.9) 3.6(1.7-4.8) 4.1(1.7) 4.8(3.6-4.8) <0.001 Lubrication 3.3(1.8) 3.6(2.4-4.8) 4.2(1.7) 4.8(3.6-4.8) <0.001 Orgasm 3.4(1.9) 3.6(2.2-4.8) 4.2(1.7) 4.8(3.6-5.2) <0.001 Satisfaction 3.4(1.8) 3.6(1.6-4.8) 4.2(1.5) 4.8(3.6-4.8) <0.001 Pain 3.5(1.2) 4(2.8-4.2) 4.2(1) 4.4(3.6-5.2) <0.001 Total Score 19.7(9) 20.9(12.3-27) 25(8.2) 28(20.8-29.6) <0.001 3.3. Levels of vasomotor, psychosocial, physical, and sexual symptoms The scores in all dimensions were significantly higher in women who were in menopause. Consequently, they experienced more vasomotor, psychosocial, physical, and sexual symptoms compared to women who were not in menopause (table 3). Table 3 Comparison of Menopausal Symptoms Between Menopausal and Non-Menopausal Women Menopausal Non-Menopausal P MannWhitney test Mean (SD) Median (Range) Mean (SD) Median (Range) Vasomotor Symptoms 5(1.7) 5(3.7-6.3) 3.3(1.5) 2.3(2.3-4) <0.001 Psychosocial Symptoms 3.5(1.7) 3.3(2.2-4.8) 2.1(1.5) 1.4(1-2.9) <0.001 Physical Symptoms 3.6(1.4) 3.6(2.6-4.5) 2(1.4) 1.2(1-2.7) <0.001 Sexual Symptoms 4.3(2.2) 4.3(2.3-6.2) 1.8(1.8) 1(1-1) <0.001 World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 530 Spearman's correlation coefficients of anxiety/ depression/ stress scales, quality of life, and sexual functioning in menopausal women in relation to the menopausal symptoms scale In the correlation between sweating/ hot flashes and menopausal symptoms in menopausal women with quality of life, sleep quality, sexual functioning, and symptoms of anxiety, depression, and stress, the study found that more psychosocial, sexual, physical, and vasomotor symptoms were associated with higher levels of depression, anxiety, and stress. Just as the frequency of hot flashes/ sweating increased per week, participants' levels of anxiety and depression also rose. Additionally, higher levels of stress and depression were associated with greater problems related to these hot flashes/ sweating. Conversely, participants who managed and controlled these symptoms more effectively experienced fewer symptoms of depression. The more frequently participants experienced hot flashes/ sweating on a weekly basis, the worse their mental health was (table 4). Table 4 Spearman Correlation Coefficients of Anxiety/Depression/Stress Scales, Quality of Life, and Sexual Functionality in Menopausal Women in Relation to the Menopausal Symptoms Scale Menopausal Symptoms Scale (MENQOL) Vasomotor Psychosocial Psychosocial Sexual Anxiety. Depression. Stress Scale (DASS-21) Depression Score r 0.27 0.73 0.34 0.34 P 0.007 <0.001 0.001 <0.001 Anxiety Score r 0.20 0.67 0.44 0.39 P 0.050 <0.001 <0.001 <0.001 Stress Score r 0.24 0.82 0.52 0.35 P 0.016 <0.001 <0.001 <0.001 Total DASS-21 Score r 0.25 0.83 0.48 0.41 P 0.011 <0.001 <0.001 <0.001 Quality of Life (SF-12) Physical Health Summary Scale r -0.29 -0.36 -0.62 -0.23 P 0.004 <0.001 <0.001 0.023 Mental Health Summary Scale r -0.32 -0.69 -0.34 -0.28 P 0.001 <0.001 0.001 0.005 Female Sexual Function Index (FSFI) Sexual Desire r -0.40 -0.21 -0.39 -0.72 P <0.001 0.036 <0.001 <0.001 Arousal r -0.46 -0.26 -0.42 -0.71 P <0.001 0.009 <0.001 <0.001 Lubrication r -0.40 -0.26 -0.40 -0.74 P <0.001 0.010 <0.001 <0.001 Orgasm r -0.42 -0.26 -0.41 -0.71 P <0.001 0.008 <0.001 <0.001 Satisfaction r -0.43 -0.29 -0.43 -0.72 P <0.001 0.004 <0.001 <0.001 Pain r -0.26 -0.39 -0.33 -0.40 P 0.009 <0.001 0.001 <0.001 Total FSFI Score r -0.43 -0.28 -0.43 -0.74 P <0.001 0.005 <0.001 <0.001 World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 531 3.4. Spearman's correlation coefficients of anxiety, depression, stress, quality of life, and sexual functioning scales in menopausal women in relation to the sweating/ hot flashes scale Additionally, the more problems they had related to potential hot flashes/ sweating and the less they controlled/ managed them, the worse both their physical and mental health were overall. Finally, frequent hot flashes/ sweating and more problems related to them were linked to worse sexual functionality in all areas. On the other hand, better management and control of these symptoms were associated with improved sexual functionality in all dimensions except for pain (table 5). Table 5 Spearman Correlation Coefficients of Anxiety, Depression, Stress, Quality of Life, and Sexual Function Scales in Menopausal Women in Relation to the Hot Flush Rating Scale Hot Flush Rating Scale (HFRS) Frequency of Hot Flushes/Sweating per Week Control/ Management Problems Anxiety. Depression. and Stress Scale (DASS21) Depression Score r 0.23 -0.26 0.28 P 0.019 0.008 0.005 Anxiety Score r 0.21 -0.18 0.17 P 0.041 0.074 0.100 Stress Score r 0.16 -0.16 0.22 P 0.117 0.109 0.027 Total DASS-21 Score r 0.21 -0.22 0.24 P 0.038 0.031 0.016 Quality of Life (SF12) Physical Health Summary Score r -0.10 0.20 -0.24 P 0.308 0.042 0.016 Mental Health Summary Score r -0.25 0.33 -0.34 P 0.013 0.001 0.001 Female Sexual Function Index (FSFI) Sexual Desire r -0.29 0.39 -0.45 P 0.004 <0.001 <0.001 Arousal r -0.35 0.45 -0.51 P <0.001 <0.001 <0.001 Lubrication r -0.35 0.42 -0.46 P <0.001 <0.001 <0.001 Orgasm r -0,36 0,451 -0,487 P <0.001 <0.001 <0.001 Satisfaction r -0.34 0.42 -0.48 P 0.001 <0.001 <0.001 Pain r -0.24 0.10 -0.23 P 0.016 0.319 0.023 Total FSFI Score r -0.34 0.42 -0.49 P <0.001 <0.001 <0.001 World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 532 3.5. The impact of various psychosocial and sexual menopausal symptoms Multivariate linear regressions were conducted on menopausal women, with dependent variables being the dimensions and overall score of anxiety, depression, stress scales, and independent variables being their sociodemographic characteristics, hot flashes, and menopausal symptoms. Only psychosocial menopausal symptoms were found to be significantly associated with the score in the "Depression" dimension. Findings showed that the more psychosocial menopausal symptoms participants had, the higher their levels of depression. Also, more psychosocial symptoms were associated with higher levels of anxiety. Participants with an annual household income above €20,000 experienced less anxiety compared to those with an income of up to €12.000. In addition, the more vasomotor and psychosocial menopausal symptoms participants had, the higher their stress levels. The more problems related to hot flashes/ sweats participants experienced, the more stress they reported. Furthermore, the more menopausal symptoms participants had, the higher their levels of anxiety, stress, and depression. The study examined the impact of various psychosocial and sexual menopausal symptoms, as well as factors like income and education, on different dimensions of sexual health. Using logarithmic transformations and the stepwise method, the results presented in the following tables (table 6-12) were obtained. Table 6 Multivariate linear regression of menopausal women with the dependent variable being the dimension of sexual desire and independent variables including their socio-demographic characteristics, sweating/ hot flashes, and menopausal symptoms Dependency coefficient Standard error of the coefficient t Pvalue Psychosocial symptoms -0.024 0.008 0.002 Sexual symptoms -0.050 0.006 <0.001 Problems from hot flashes/sweating -0.018 0.004 <0.001 (reference: ≤12.000€) Annual household income (€) 12-20.000 0.067 0.024 0.006 Obviously, higher psychosocial and sexual symptoms, as well as more problems from hot flashes/ sweating, are associated with lower sexual desire. Women with an annual income between €12,000 and €20,000 show significantly higher sexual desire compared to those earning ≤€12.000 (table 6). Table 7 Multivariate linear regression of menopausal women with the dependent variable being the arousal dimension and independent variables including their socio-demographic characteristics, sweating/hot flashes, and menopausal symptoms Dependency coefficient Standard error of the coefficient t P-value Problems from hot flashes/sweating -0.057 0.014 <0.001 Sexual symptoms -0.073 0.010 <0.001 Psychosocial symptoms -0.035 0.013 0.011 Vasomotor symptoms -0.053 0.024 0.027 Clearly, increased vasomotor, psychosocial, and sexual menopausal symptoms, as well as problems with hot flashes/ sweats, were linked to lower arousal during sexual intercourse (table 7). World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 533 Table 8 Multivariate Linear Regression of Menopausal Women with the dependent variable being the lubrication dimension and independent variables including their socio-demographic characteristics, sweating/ hot flashes, and menopausal symptoms Dependency coefficient Standard error of the coefficient t Pvalue Sexual symptoms -0.072 0.011 <0.001 Control/ Management of hot flashes/ sweating 0.028 0.009 0.002 Psychosocial symptoms -0.032 0.014 0.032 ⁺More sexual symptoms and psychosocial symptoms are significantly associated with lower lubrication levels. Conversely better control/management of hot flashes/ sweating is significantly associated with higher lubrication levels (table 8). Table 9 Multivariate linear regression of menopausal women with the dependent variable being the orgasm dimension and independent variables including their socio-demographic characteristics, sweating/ hot flashes, and menopausal symptoms Dependency coefficient Standard error of the coefficient t Pvalue Sexual symptoms -0.064 0.010 <0.001 Control/Management of hot flashes/ sweating 0.024 0.009 0.007 Indubitably, more sexual symptoms are associated with lower orgasm function in menopausal women. Better control/management of hot flashes/sweating is significantly associated with better orgasm function (table 9). Table 10 Multivariate linear regression of menopausal women with the dependent variable being the satisfaction dimension and independent variables including their socio-demographic characteristics, sweating/ hot flashes, and menopausal symptoms Dependency coefficient Standard error of the coefficient t P-value Sexual symptoms -0.049 0.007 <0.001 Problems due to hot flashes/sweating -0.022 0.005 <0.001 Reference: ≤12.000€ Annual household income (€) 12-20.000 0.078 0.029 0.009 >20.000 0.030 0.05 0.555 Reference: Primary/Junior High School Educational level High School 0.091 0.030 0.003 Technical University/ University/ Postgraduate 0.106 0.045 0.020 More sexual symptoms and problems due to hot flashes/ sweating were significantly associated with lower satisfaction. Participants with higher annual income (12.000 - 20.000€) was associated with higher satisfaction. Also, higher education levels were significantly associated with greater satisfaction, with high school and university/ postgraduate education showing positive effects. More sexual symptoms and problems due to hot flashes/sweating were significantly associated with lower satisfaction (table 10). World Journal of Advanced Research and Reviews, 2025, 26(03), 526-537 534 Table 11 Multivariate linear regression of menopausal women with the dependent variable being the pain dimension and independent variables including their socio-demographic characteristics, sweating/ hot flashes, and menopausal symptoms Dependency coefficient Standard error of the coefficient t P-value Psychosocial symptoms -0.021 0.008 0.009 Sexual symptoms -0.016 0.006 0.010 More psychosocial and sexual symptoms led to increased pain during sexual intercourse (table 11). Table 12 Multivariate linear regression of menopausal women with the dependent variable being the overall sexual function and independent variables including their socio-demographic characteristics, sweating/ hot flashes, and menopausal symptoms Dependency coefficient Standard error of the coefficient t P-value Problems from hot flashes/ sweating -0.046 0.011 <0.001 Sexual symptoms -0.068 0.008 <0.001 Vasomotor symptoms -0.042 0.019 0.027 Psychosocial symptoms -0.021 0.011 0.048 The combination of psychosocial, sexual, and vasomotor symptoms, along with hot flashes/ sweats, contributed to worse overall sexual functionality. Next, a multivariate logistic regression was conducted on menopausal women, with the sleep quality scale as the dependent variable and their sociodemographic characteristics, hot flashes/ sweating, and menopausal symptoms as independent variables. Using the stepwise method, the results presented in the Τable S9 were obtained (table 12). 3.6. Multivariate Analysis of Sleep Quality Determinants Table 13 Multivariate logistic regression of menopausal women with the dependent variable being the sleep quality scale and independent variables including their socio-demographic characteristics, sweating/ hot flashes, and menopausal symptoms Odds Ratio (95% Confidence Interval) P-value Physical symptoms 2.17(1.32-3.56) 0.002 Sexual symptoms 1.37(1.03-1.83) 0.033 Frequency of hot flashes/sweating 1.04(1-1.07) 0.026 As demonstrated, women with more severe physical symptoms had 2.17 times higher odds of experiencing poorer sleep quality (p = 0.002). Also, increased sexual symptoms were associated with 1.37 times higher odds of poor sleep quality (p = 0.033). Higher frequency of hot flashes/ sweating slightly increased the likelihood of poor sleep quality (OR = 1.04, p = 0.026). Following, multivariate linear regressions were performed with the dimensions of quality of life as dependent variables and sleep quality, sexual function, anxiety/ stress/ depression symptoms, hot flashes/ sweating, menopausal symptoms, and the sociodemographic characteristics of menopausal women as independent variables. The results presented in Tables 13 and 14 were obtained.