The dynamics of stress and fatigue across menopause

Attractors, coupling, and resilience

Lisa Taylor-Swanson, Alexander E. Wong, David Pincus, Jonathan E. Butner, Jennifer Hahn-Holbrook, Mary S Koithan, Kathryn Wann, Nancy F. Woods

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience. Methods: Participants were drawn from the longitudinal Seattle Midlife Women's Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. STRAW+10 criteria were used to stage women in either in late reproductive, early or late transition, or EPM stage. Change values were generated for fatigue and stress and analyzed with a multilevel structural equation model; slopes indicate how quickly a person returns to homeostasis after a perturbation. Coupling of stress and fatigue was modeled to evaluate resilience, the notion of maintaining stability during change. Results: Eligible women were on average 35 years old (SD = 4.71), well educated, employed, married or partnered, and white. Fit indices suggested the model depicts the relationships of stress and fatigue (χ2 (9 df) = 7.638, P = 0.57, correction factor = 4.9244; root mean square error of approximation (RMSEA) 90% CI = 0.000 ≤ 0.000 ≤ 0.032; comparative fit index (CFI) = 1.00). A loss in model fit across stages suggests that the four stages differed in their dynamics (χ2 Δ(12 df) = 21.181, P = .048). All stages showed fixed-point attractor dynamics: fatigue became less stable over time; stress generally became more stable over time. Coupling relationships of stress on fatigue show evidence for shifts in regulatory relationships with one another across the MT. Conclusions: Results are suggestive of general dysregulation via disruptions to coupling relationships of stress and fatigue across the MT. Findings support a holistic approach to understanding symptoms and supporting women during the MT.

Original languageEnglish (US)
Pages (from-to)380-390
Number of pages11
JournalMenopause
Volume25
Issue number4
DOIs
StatePublished - Apr 1 2018

Fingerprint

Menopause
Fatigue
Postmenopause
Annual Reports
Structural Models
Women's Health
Medical Records
Homeostasis
Health

Keywords

  • Attractors
  • Dynamics
  • Fatigue
  • Menopausal transition
  • Stress

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Taylor-Swanson, L., Wong, A. E., Pincus, D., Butner, J. E., Hahn-Holbrook, J., Koithan, M. S., ... Woods, N. F. (2018). The dynamics of stress and fatigue across menopause: Attractors, coupling, and resilience. Menopause, 25(4), 380-390. https://doi.org/10.1097/GME.0000000000001025

The dynamics of stress and fatigue across menopause : Attractors, coupling, and resilience. / Taylor-Swanson, Lisa; Wong, Alexander E.; Pincus, David; Butner, Jonathan E.; Hahn-Holbrook, Jennifer; Koithan, Mary S; Wann, Kathryn; Woods, Nancy F.

In: Menopause, Vol. 25, No. 4, 01.04.2018, p. 380-390.

Research output: Contribution to journalArticle

Taylor-Swanson, L, Wong, AE, Pincus, D, Butner, JE, Hahn-Holbrook, J, Koithan, MS, Wann, K & Woods, NF 2018, 'The dynamics of stress and fatigue across menopause: Attractors, coupling, and resilience', Menopause, vol. 25, no. 4, pp. 380-390. https://doi.org/10.1097/GME.0000000000001025
Taylor-Swanson, Lisa ; Wong, Alexander E. ; Pincus, David ; Butner, Jonathan E. ; Hahn-Holbrook, Jennifer ; Koithan, Mary S ; Wann, Kathryn ; Woods, Nancy F. / The dynamics of stress and fatigue across menopause : Attractors, coupling, and resilience. In: Menopause. 2018 ; Vol. 25, No. 4. pp. 380-390.
@article{6ad0652d5d7d454bb5afb2edd9183b2d,
title = "The dynamics of stress and fatigue across menopause: Attractors, coupling, and resilience",
abstract = "Objective: The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience. Methods: Participants were drawn from the longitudinal Seattle Midlife Women's Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. STRAW+10 criteria were used to stage women in either in late reproductive, early or late transition, or EPM stage. Change values were generated for fatigue and stress and analyzed with a multilevel structural equation model; slopes indicate how quickly a person returns to homeostasis after a perturbation. Coupling of stress and fatigue was modeled to evaluate resilience, the notion of maintaining stability during change. Results: Eligible women were on average 35 years old (SD = 4.71), well educated, employed, married or partnered, and white. Fit indices suggested the model depicts the relationships of stress and fatigue (χ2 (9 df) = 7.638, P = 0.57, correction factor = 4.9244; root mean square error of approximation (RMSEA) 90{\%} CI = 0.000 ≤ 0.000 ≤ 0.032; comparative fit index (CFI) = 1.00). A loss in model fit across stages suggests that the four stages differed in their dynamics (χ2 Δ(12 df) = 21.181, P = .048). All stages showed fixed-point attractor dynamics: fatigue became less stable over time; stress generally became more stable over time. Coupling relationships of stress on fatigue show evidence for shifts in regulatory relationships with one another across the MT. Conclusions: Results are suggestive of general dysregulation via disruptions to coupling relationships of stress and fatigue across the MT. Findings support a holistic approach to understanding symptoms and supporting women during the MT.",
keywords = "Attractors, Dynamics, Fatigue, Menopausal transition, Stress",
author = "Lisa Taylor-Swanson and Wong, {Alexander E.} and David Pincus and Butner, {Jonathan E.} and Jennifer Hahn-Holbrook and Koithan, {Mary S} and Kathryn Wann and Woods, {Nancy F.}",
year = "2018",
month = "4",
day = "1",
doi = "10.1097/GME.0000000000001025",
language = "English (US)",
volume = "25",
pages = "380--390",
journal = "Menopause",
issn = "1072-3714",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - The dynamics of stress and fatigue across menopause

T2 - Attractors, coupling, and resilience

AU - Taylor-Swanson, Lisa

AU - Wong, Alexander E.

AU - Pincus, David

AU - Butner, Jonathan E.

AU - Hahn-Holbrook, Jennifer

AU - Koithan, Mary S

AU - Wann, Kathryn

AU - Woods, Nancy F.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Objective: The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience. Methods: Participants were drawn from the longitudinal Seattle Midlife Women's Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. STRAW+10 criteria were used to stage women in either in late reproductive, early or late transition, or EPM stage. Change values were generated for fatigue and stress and analyzed with a multilevel structural equation model; slopes indicate how quickly a person returns to homeostasis after a perturbation. Coupling of stress and fatigue was modeled to evaluate resilience, the notion of maintaining stability during change. Results: Eligible women were on average 35 years old (SD = 4.71), well educated, employed, married or partnered, and white. Fit indices suggested the model depicts the relationships of stress and fatigue (χ2 (9 df) = 7.638, P = 0.57, correction factor = 4.9244; root mean square error of approximation (RMSEA) 90% CI = 0.000 ≤ 0.000 ≤ 0.032; comparative fit index (CFI) = 1.00). A loss in model fit across stages suggests that the four stages differed in their dynamics (χ2 Δ(12 df) = 21.181, P = .048). All stages showed fixed-point attractor dynamics: fatigue became less stable over time; stress generally became more stable over time. Coupling relationships of stress on fatigue show evidence for shifts in regulatory relationships with one another across the MT. Conclusions: Results are suggestive of general dysregulation via disruptions to coupling relationships of stress and fatigue across the MT. Findings support a holistic approach to understanding symptoms and supporting women during the MT.

AB - Objective: The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience. Methods: Participants were drawn from the longitudinal Seattle Midlife Women's Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. STRAW+10 criteria were used to stage women in either in late reproductive, early or late transition, or EPM stage. Change values were generated for fatigue and stress and analyzed with a multilevel structural equation model; slopes indicate how quickly a person returns to homeostasis after a perturbation. Coupling of stress and fatigue was modeled to evaluate resilience, the notion of maintaining stability during change. Results: Eligible women were on average 35 years old (SD = 4.71), well educated, employed, married or partnered, and white. Fit indices suggested the model depicts the relationships of stress and fatigue (χ2 (9 df) = 7.638, P = 0.57, correction factor = 4.9244; root mean square error of approximation (RMSEA) 90% CI = 0.000 ≤ 0.000 ≤ 0.032; comparative fit index (CFI) = 1.00). A loss in model fit across stages suggests that the four stages differed in their dynamics (χ2 Δ(12 df) = 21.181, P = .048). All stages showed fixed-point attractor dynamics: fatigue became less stable over time; stress generally became more stable over time. Coupling relationships of stress on fatigue show evidence for shifts in regulatory relationships with one another across the MT. Conclusions: Results are suggestive of general dysregulation via disruptions to coupling relationships of stress and fatigue across the MT. Findings support a holistic approach to understanding symptoms and supporting women during the MT.

KW - Attractors

KW - Dynamics

KW - Fatigue

KW - Menopausal transition

KW - Stress

UR - http://www.scopus.com/inward/record.url?scp=85045193952&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045193952&partnerID=8YFLogxK

U2 - 10.1097/GME.0000000000001025

DO - 10.1097/GME.0000000000001025

M3 - Article

VL - 25

SP - 380

EP - 390

JO - Menopause

JF - Menopause

SN - 1072-3714

IS - 4

ER -