Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

Question:

Do women who have never had children experience tougher or more difficult menopausal symptoms?

Answer

The severity of symptoms experienced by women undergoing the transition into menopause varies widely. However, there is no evidence that women who have not had children have more severe symptoms. Symptoms of early menopause are hot flashes, sleep disruption, and mood swings. Later, vaginal dryness and urinary incontinence are more common.

Characteristics that have been linked with more severe hot flashes are smoking, obesity, African-American race, and a less physically active lifestyle. Women who have never had children do tend to enter menopause at a younger age than those who have had pregnancies. The age when entering menopause may also be related to genetic factors and the presence of other medical conditions such as diabetes.

Menopause symptoms can be controlled in many women with lifestyle choices, such as getting regular exercise, maintaining good hydration, and avoiding excess intake of alcohol. Medical options include a short course of hormone therapy. Alternative and nutritional approaches such as eating soy products and using supplements such as black cohosh have less consistent benefit but are helpful in some women.