Race, ethnicity impact gastrointestinal symptoms during menopausal transition

December 16, 2021

2 min read


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Race and ethnicity as well as menopausal status are significant factors that affect the number and severity of the gastrointestinal symptoms that midlife women experience, according to a study published in Menopause.

Eun-Ok Im, PhD, MPH, RN, CNS, FAAN, senior associate dean of research and innovation and the Edith Folsom Honeycutt Endowed Chair at the Nell Hodgson Woodruff School of Nursing at Emory University in Atlanta, and colleagues conducted the secondary analysis on data from a pair of internet-based studies on health issues pertaining to midlife women.


Race, ethnicity impact gastrointestinal symptoms during menopausal transition

Im EO, et al. Menopause. 2021;doi:10.1097/GME.0000000000001898.

The 1,051-woman cohort included 315 non-Hispanic white women (30%), 249 non-Hispanic Black women (24%), 255 Hispanic women (about 24%) and 232 Asian women (22%) between age 40 and 60 years (mean age, 48.96 years; standard deviation [SD], 5.68 years).

Also, more than 28% were premenopausal, 32% were perimenopausal and about 40% were postmenopausal. About 95% said they did not have any diagnosed gastrointestinal diseases, and more than 73% said their general health was good.

The researchers assessed the women to see if they experienced any of the nine gastrointestinal symptoms listed in the Midlife Women’s Symptoms Index and how severe those symptoms may have been. The mean total number of gastrointestinal symptoms per participant was 1.98 out of nine (SD, 1.79).

The most frequently reported symptoms included weight gain (44.3%), bloating (32.1%) and weight loss (26.9%). However, the total number of symptoms were significantly different among the four racial and ethnic groups (F = 13.05; P < .001). Asians had significantly lower mean total numbers of symptoms (1.37 ± 1.44 out of nine).

The researchers also found significant differences in the frequencies of nausea/vomiting, diarrhea, constipation, weight loss, weight gain, bloating and heartburn between the racial and ethnic groups. However, they found no racial or ethnic differences in the frequencies of stomach pain or loss of appetite.

While the mean total severity score for symptoms among all participants was 5.67 out of 36 (SD, 6.01), there were significant differences in the mean total severity scores by racial and ethnic group (F = 13.44; P < .001).

Asian women had significantly lower total severity scores (3.68 ± 4.48 out of 45) and white women had higher total severity scores (6.63 ± 6.72 out of 45) compared with the other groups (all pairs, P < .001). There also were significant differences between the groups in their severity scores for nausea and vomiting, diarrhea, constipation, loss of appetite, weight loss, weight gain and bloating.

White women had higher severity scores for nausea and vomiting (0.78 ± 1.47), diarrhea (0.84 ± 1.5), constipation (0.63 ± 1.35) and loss of appetite (0.38 ± 0.1) compared with the other groups. Hispanic women were more likely to have higher severity scores for constipation (0.65 ± 1.44), weight gain (1.57 ± 1.66) and bloating (1.28 ± 1.67). Black women were more likely to report higher severity scores for weight loss (0.71 ± 1.08).

The total number and severity scores of symptoms were significantly different across the premenopausal, perimenopausal and postmenopausal stages for all symptoms except for weight loss (all, P < .001). Also, the total number and severity scores increased through the menopausal transition in Hispanic, white and Black women, though these scores peaked in the perimenopausal period and decreased in the postmenopausal period for Asian women.

Premenopausal status was the strongest factor influencing the total number of symptoms and total severity scores of symptoms in all participants when all covariates were controlled.

The researchers concluded that race and ethnicity and menopausal status were significant factors influencing the total number and severity scores of gastrointestinal symptoms among midlife women, though they added that more in-depth studies are needed on specific types of symptoms, racial and ethnic differences and cultural influences with more diverse groups of participants.

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