Rural Women Experience Worse Menopausal Symptoms and Limited Resources, Study Finds

Women living in rural areas experience higher rates of menopausal symptoms — such as mood changes, sleep issues sand musculoskeletal pain — compared to women in urban and suburban communities.

A new, first-of-its-kind study published in Menopause found that these symptoms occur particularly during the late menopause transition and post-menopause.

Women living in rural communities tend to face more health issues than those in urban communities, such as higher rates of anxiety, depression, obesity and heart disease.

However, there is limited research on how women in rural, suburban and urban communities experience menopause differently, according to study authors.

Menopause — a natural but sometimes burdonsome stage in a woman’s life — can greatly affect her health and well-being. Many women (80%) experience symptoms such as hot flashes and night sweats, which can lead to poor sleep, memory issues and depression.

Rural women may have a more difficult time during menopause as they are more likely to deal with challenges including higher stress, financial problems, smoking and lower levels of education.

Common menopause symptoms such as trouble sleeping, mood swings, memory issues and discomfort in the urinary area are well-known, but little is known about how often or how severely rural women experience them.

Researchers of the study compared how menopause affects rural women differently from those in suburban and urban communities, focusing on symptoms, treatments and attitudes toward menopause care, using data from a 2019 online survey by HealthyWomen and WebMD.

From September to October 2019, the survey gathered responses from 3,197 U.S. women aged 18 and older. Researchers focused on women aged 45 and older in the late menopause transition or postmenopause.

Data was divided by rural, suburban and urban residence, and age-weighted proportions of symptoms and treatments were analyzed using chi-square tests to identify differences between groups.

Out of 1,531 women, 45% were in the late menopause transition (average age 50) and 55% in postmenopause (average age 65). Rural women in late menopause transition reported higher rates of muscle aches (65%) and panic attacks (30%) compared with urban and suburban women.

In postmenopause, rural women experienced more mood swings (23%), urinary incontinence (23%) and vaginal dryness (37%) than those in urban and suburban communitues.

Hot flashes were common with 71% in late menopause transition and 20% in postmenopause, but only 11% of women used menopause hormone therapy, regardless of where they lived.

Access to menopause resources did vary by location.

Additionally, researchers found that rural, urban and suburban women use different ways to find health information.

To raise awareness about the risks and benefits of therapies such as menopause hormone therapy (MHT), it’s suggested that organizations should modify communication methods to fit the target audience.

Researchers found that rural women in the late menopause transition relied more on healthcare providers for information, while urban women used social media more often. Postmenopausal rural women were also less likely to engage with blogs or message boards compared to urban women.

Previous studies show that self-confidence, support and knowledge are key factors in helping rural women make informed decisions about MHT.

This study holds many strengths based on the range of findings. One includes using data from a large, diverse U.S. population and comparing rural, suburban and urban women.

However, there are limitations. The study relied on self-reported survey data, it did not track symptom duration and used categories for residence that were defined by the participants themselves.

Recruitment through WebMD provided diversity, but it also created a sample that might not fully represent all women's menopause experiences.

With the low use of menopause hormone therapy, researchers suggest that more education is needed about this treatment. This education should be designed to fit the needs and lifestyles of women in different communities.