Women with late effects of polio experience menopause differently than their non-disabled peers

Women with late effects of polio experience menopause differently than their non-disabled peers – physiologically, physically and psychologically – according to a new study funded by Post-Polio Health International.

A team of researchers from the University of Michigan Health System conducted a nationwide study to explore the experience of menopause for the 500,000 women in the U.S. with a history of polio. To highlight the unique contribution of menopause, men with a history of polio also participated and served as a control group.

In their final report "Women with Polio: Menopause, Late Effects, Life Satisfaction and Emotional Distress," the researchers present significant findings:

• Severity of post-polio symptoms was significantly related to severity of menopause symptoms, especially in four areas: sensory (numbness, tingling, constipation, dry eyes), psychological (tension, moodiness, depression, irritability), sleep (sleeplessness, cold hands and feet), and vasomotor (hot flashes, sweating).
• Greater menopause symptom severity was significantly related to lower emotional well-being.
• Women who were further along in menopause had more severe post-polio symptoms and more difficulty with activities of daily living than did post-polio men of the same age.
• Women approaching menopause were more satisfied with their lives and less unhappy than post-polio men their age, but women who were at least five years into menopause were more stressed than post-polio men the same age.
• More post-polio women (39 percent) use hormone replacement therapy (HRT) than their non-disabled sisters (23 percent). However, study participants using HRT did not report an improvement in post-polio symptoms, and, in fact, women using HRT who were more than five years into menopause reported more severe late effects of polio than post-polio men of the same age; this same difference was not found between women not using HRT and men their same age.
• Hysterectomy rates among women in this study - nearly 35 percent – were significantly higher than the average rate for U.S. women (21 percent).
• Rates of education achievement among these polio survivors were significantly higher than the national average. They were married at similar rates, but were employed at lower rates than similarly aged non-disabled peers, except for women over age 65 who were employed at similar rates as non- disabled peers.
• In general, women in this study had an overall positive (45 percent) or neutral (35 percent) experience of menopause; comparatively, far fewer had a negative experience (18 percent) of menopause.

"This study provides the first solid evidence that post-polio women experience menopause differently," said Joan L. Headley, Post-Polio Health International executive director. "Post-polio women should educate themselves and their health care providers about the differences in their experiences. While there is much more to be learned about menopause in the context of disability, this study is an important first step toward future generations of menopause studies that no longer ignore women with disabilities."

Researchers Claire Z. Kalpakjian, Ph.D., principal investigator and project director, and Denise G. Tate, Ph.D., co-principal investigator, both from the University's Department of Physical Medicine and Rehabilitation, and Elisabeth H. Quint, M.D., co-investigator, from the Department of Obstetrics and Gynecology, studied almost 1,000 post-polio women, aged 34 to 99 from 49 states during 2003.

"Of the 30 million women with physical disabilities in the United States, more than 16 million are over the age of 50, constituting a large and growing population of women who have been relatively understudied with regards to the psychological and physical experience of menopause," said Kalpakjian. "Women with disabilities in general have long been neglected in rehabilitation research. As such, little is known about the unique biological milestones women experience as they age and the interaction of physical disability and these biological changes."