Infertility may increase odds of severe menopausal symptoms

Key takeaways:

• Women with infertility history were more likely to have more severe menopause symptoms vs. women without.
• They also were more likely to report depressive mood or irritability.

Midlife women aged 45 years or older with a history of infertility were more likely to experience menopausal symptoms than women without infertility, according to secondary analysis results published in Menopause.

“Although the literature on the relation of infertility with the onset of menopause or the severity of menopausal symptoms is scarce, there is some indication that women with a history of infertility may experience earlier menopause and greater severity of some menopausal symptoms,” Victoria W. Fitz, MD, MSCR, reproductive endocrinology and infertility fellow at Massachusetts General Hospital, and colleagues wrote. “Moreover, infertility has been found to be an equivalent life stressor to a cancer diagnosis and experiencing stressful life events is associated with report of more menopausal symptoms.”

Fitz and colleagues conducted a secondary analysis of Project Viva, a prospective cohort of 695 midlife women aged 45 years or older who reported 12 months or more of amenorrhea who were enrolled from 1999 to 2002 during pregnancy and followed for 18 years. Researchers defined infertility history as time to pregnancy of 12 months or more, use of medical treatments to conceive or infertility consultation or treatment in the 6 months before study enrollment.

The primary outcome was a score below or above the median on the Menopause Rating Scale, which asks users to assess severity of 11 menopause symptoms, with higher scores indicating more severe symptoms. Secondary outcomes included individual symptom Menopause Rating Scale score and self-reported age at menopause.

Overall, 36.6% of women had a history of infertility and, of these women, 77% were white. Women with a history of infertility were older (53.4 vs. 51.2 years) and more had reached menopause (61.8% vs. 39.9%) compared with women without infertility history. In addition, compared with women without infertility, women with infertility history had a higher likelihood of scoring above the median on the Menopause Rating Scale (adjusted OR = 1.45; 95% CI, 1.04-2.01) and had higher odds of reporting depressive moods (aOR = 1.56; 95% CI, 1.12-2.16) or irritability (aOR = 1.57; 95% CI, 1.13-2.19).

Researchers also observed a trend toward greater sleep problem severity among women with a history of infertility (OR = 1.91; 95% CI, 1.09-3.36). There was no association between infertility history and reporting of other menopausal symptoms or age at menopause.

“These findings suggest that history of infertility in a woman’s lifetime may be considered as a flag for increased screening for depressive symptoms in midlife,” the researchers wrote.