Longitudinal analysis of alcohol consumption pattern and menopause-specific quality of life in middle-aged women undergoing the menopausal transition.

Abstract

Quality of life (QoL) often declines during the menopausal transition, and alcohol use may worsen menopause-related symptoms. This study examined the longitudinal association between alcohol consumption and menopause-specific quality of life (MENQOL) questionnaire scores. Cohort study. Hospital-based health screening center, with repeated measures from 2014 to 2023 (mean follow-up 7.43 years, average of 4.74 visits). 3622 women aged 42-52 years (mean baseline age 44.33, standard deviation = 2.48) in premenopausal or early menopausal transition stages who underwent annual or biennial health examinations between 2014 and 2018. MENQOL scores ranged from 1 to 8, with higher scores indicating poorer QoL. Alcohol use was categorized as non-drinker, former, light (0.1 to <10 g/day), moderate (10 to <20 g/day) or heavy (≥20 g/day), and problematic drinking was assessed by the Alcohol Use Disorders Identification Test (AUDIT). Baseline ovarian reserve was measured using anti-Müllerian hormone (AMH). Adjusted mean differences in MENQOL scores versus non-drinkers were 0.12 (P = 0.026) for light, 0.14 (P = 0.033) for moderate and 0.20 (P = 0.008) for heavy drinkers. Domain-specific analysis showed that alcohol consumption, particularly heavy drinking, was statistically significantly associated with poorer vasomotor, psychosocial and physical domains; however, the sexual domain was non-significantly associated. Among women with below-median AMH, each 1-point AUDIT increase was associated with higher MENQOL overall (0.05, P = 0.001) and in vasomotor (0.05, P = 0.008), psychosocial (0.05, P = 0.011) and physical (0.06, P = 0.001) domains; associations were weaker or non-significant above the median. No interactions were found between alcohol use and time or menopausal stage. In lagged analysis, AUDIT ≥ 20 was associated with higher MENQOL at the next visit (1.25, P = 0.004). Light, moderate and heavy drinking appear to be associated with poorer scores on the menopause-specific quality of life questionnaire, with greater vulnerability in women with lower anti-Müllerian hormone levels.