Hypertensive Disorders of Pregnancy May Increase Future Risk for Bothersome Menopausal Symptoms

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Perimenopausal women with a history of hypertensive disorders may be candidates for anticipatory guidance for menopause symptom management.

Women with a history of hypertensive disorders of pregnancy may have more bothersome menopausal symptoms, including somatic, psychological, and urogenital domains, according to the results of a study published in Menopause.

This cross-sectional study included a total of 2684 women aged 40 to 65 who received a specialty consultation in the women’s health clinics at the Mayo Clinic in Rochester, Minnesota, and Scottsdale, Arizona, between 2015 and 2019. Participants completed the 11-question validated Menopause Rating Scale (MRS) at their clinical evaluation.

The MRS questionnaire assessed self-reported menopause symptoms and asked participants about the impact these symptoms had on health-related quality of life. Symptom domains included somatic (questions about sweating/flushing, cardiac complaints, sleep disturbances, and joint and muscle pain), psychological (questions about depression, irritability, anxiety, and exhaustion), and urogenital (questions about sexual problems, urinary complaints, and vaginal dryness) domains. Additional questionnaires were used to examine the prevalence of depression and anxiety among participants.

Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, were determined by self-reported questionnaires. Women were categorized into 3 groups: no pregnancy (n=402), pregnancy with no hypertensive disorders of pregnancy (n=2102), and pregnancy complicated by hypertensive disorders of pregnancy (n=180).

Univariate analyses found a significant association between pregnancy groups and MRS total scores in both somatic and psychological domains. When evaluating women who received hormone therapy, investigators found between-pregnancy group differences in MRS scores. Among these women, those with a history of hypertensive disorders of pregnancy scored a mean of 2.28 points higher on the MRS compared with women with pregnancy and no history of hypertensive disorders of pregnancy (95% CI, 0.12-4.44; P =.039).

For the somatic symptom domain on the MRS, women with pregnancy had significantly higher scores compared with women with no pregnancy (pregnancy with no high blood pressure vs no pregnancy: adjusted difference, 0.36; 95% CI, 0.06-0.67; P =.020 compared with pregnancy with high blood pressure vs no pregnancy: adjusted difference, 0.70; 95% CI, 0.18-1.22; P =.008).

The primary limitation of this study was the inclusion of mostly white, employed, educated, and partnered women, which brings into question the generalizability of the findings.

Based on these findings, investigators suggest that perimenopausal women with a history of hypertensive disorders of pregnancy “may be candidates for anticipatory guidance on management of menopause-related symptoms.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Faubion SS, King A, Kattah AG, et al. Hypertensive disorders of pregnancy and menopausal symptoms: a cross-sectional study from the data registry on experiences of aging, menopause, and sexuality. Published online August 17, 2020. Menopause. doi: 10.1097/GME.0000000000001638