Six findings from one of the world’s biggest women’s health studies

This research has been going for 25 years and is teaching us a lot about our health from middle to older age.

The Study of Women’s Health Across the Nation (SWAN) started in America in the mid-1990s to develop a better understanding of menopause.

Its leaders initially recruited over 3000 Black, White, Hispanic, Chinese and Japanese women aged 42 to 52 years from seven locations across the country.

At the 25-year mark, members of the study team released a summary of their findings. Here are six of them.

1. Sleep. Sleep quality is known to deteriorate in middle-age, but that’s not just about flushes and sweats or even hormonal changes. Many women find this stage of life stressful, and mental and emotional issues often underlie their disturbed sleep.

2. Incontinence. About 68% of the SWAN women said they experienced urinary incontinence at least monthly. Ageing, being overweight, and having diabetes can increase the risk of incontinence, far more so than menopause.

3. Bone health. It’s commonly thought that our risk of bone loss is especially high in the years just after menopause. But a loss of bone is triggered by a drop in estrogen, which happens most intensely a couple of years before our last period and stabilises a couple of years after it. So the years when we’re most vulnerable to bone loss occur earlier than we’ve been told.

The SWAN research has also shown that fracture risk is about more than bone density. For example, fracture rates among Black and     Asian women are about half those of White women, yet Asian women typically have lower bone density than White women.

4. Cardiovascular disease. Menopause can contribute to the likelihood of heart disease and stroke in women. It increases our risk of high cholesterol and encourages belly fat, making us more ‘apple-shaped’. Women who have frequent hot flushes and poor sleep seem to be at greater risk for cardiovascular disease.

5. Brain function. While around 60% of women say they have memory problems through menopause, the SWAN research found no evidence of an actual decline in brain function in midlife.

6. Mental health. Depression and anxiety in middle-age are often blamed on menopause, but these have far more to do with stressful life events, financial problems, a lack of social support and insufficient physical activity.

In summary, menopause can have an adverse effect on bone health, cardiovascular health, and often, sleep. The SWAN researchers argue that it plays a lesser role in mental health, brain function and incontinence.

Fortunately, a healthy lifestyle helps to counter the negative consequences of menopause.

Interestingly though — and disturbingly — just 1.7%of the SWAN women reported healthy behaviours over time.

Today most are in their 70s. As the study continues, one of its ongoing values will be to keep tracing the links between menopause, lifestyle and older age.

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