Endocrine and well-being profiles shape psychosexual health and menopausal symptoms after menopause

Menopause is a major neuroendocrine transition characterised by substantial changes in endocrine milieu, physiological, psychological, and psychosexual health. Although menopausal symptoms are common, their range and severity vary considerably between individuals, suggesting that menopause is a multifaceted process. Endocrine markers (luteinising, follicle-stimulating & anti-Mullerian hormone), together with perceived well-being, may contribute to this variability. Thus, the aim was to capture the complex impact of endocrine and well-being markers on psychosexual health and menopausal symptoms. Therefore, we first applied principal component analyses to identify individual endocrine and well-being profiles, to then assess their association with psychosexual health and menopausal symptoms in pre- and post-menopausal females. Post- compared to pre-menopausal females report reduced psychosexual health and greater urogenital and psychological menopausal symptom burden. Endocrine and well-being profiles interact with reproductive status: Post-menopausal females with lower subjective well-being and a stronger menopause-like endocrine milieu report decreased overall psychosexual health and more sexual related pain. Additionally, endocrine milieu interacted with reproductive status on urogenital symptoms: Post-menopausal females with a stronger menopause-like endocrine milieu report less urogenital symptoms. Together, these findings suggest that endocrine factors and subjective well-being jointly influence psychosexual health and menopausal symptoms after menopause. No association is seen before menopause. Therefore, females after menopause need to be considered separately in research and clinic. Multivariate analyses capture patterns that are not identified using individual biomarkers and conventional univariate approaches. Our findings highlight the value of integrative multivariate approaches for improving the assessment of menopausal health and characterising individual variability across the menopausal transition.