Hemoglobin Levels as a Predictor of Menopausal Symptom Severity Based on the Menopause Rating Scale (MRS)

Sumarni Sumarni(1*), Dyah Puji Astuti(2)


(1) Universitas Muhammadiyah Gombong, Kebumen, Indonesia
(2) Universitas Muhammadiyah Gombong, Kebumen, Indonesia
(*) Corresponding Author

Abstract


Menopause is a physiological phase characterized by a decline inestrogenlevels and the emergence of various symptoms that affect women’s quality of life. In addition to hormonal factors,hemoglobin(Hb) levels are suspected to influence the severity of menopausal symptoms.Purpose of the studytoanalyzehemoglobinlevels as a predictor of menopausal symptom severity based on the Menopause Rating Scale (MRS). This study used an observational analytic design with a cross-sectional approach involving 67 menopausal women aged 45–60 years in Pasir Lor Village,Banyumas. Data were collected through Hb measurement and MRS questionnaires. Data analysis included correlation tests and linear regression. The results showed a mean Hb level of 13.18 ± 1.17 g/dL and an MRS score of 17.03 ± 8.59. There was a significant negative correlation between Hb and MRS scores (rs= -0.355; p = 0.003). However, linear regression analysis indicated that Hb was not a significant predictor of menopausal symptom severity (p = 0.141; R² = 0.033). In conclusion,hemoglobinlevels are associated with menopausal symptom severity but are not a strong predictor. Other factors may play a more dominant role in determining the severity of menopausal symptoms.


Keywords


Hemoglobin Levels; Menopause; Menopause Rating Scale (MRS)

Full Text:

PDF

References


Ahanchi, N. S., Khatami, F., Llanaj, E., Quezada-Pinedo, H. G., Dizdari, H., Bano, A., Glisic, M., Eisenga, M. F., Vidal, P.-M., & Muka, T. (2024). The complementary roles of iron and estrogen in menopausal differences in cardiometabolic outcomes. Clinical Nutrition, 43(5), 1136–1150. https://doi.org/10.1016/j.clnu.2024.03.026

Avis, N. E., Crawford, S. L., Greendale, G., Bromberger, J. T., Everson-Rose, S. A., Gold, E. B., Hess, R., Joffe, H., Kravitz, H. M., Tepper, P. G., & Thurston, R. C. (2015). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Internal Medicine, 175(4), 531–539. https://doi.org/10.1001/jamainternmed.2014.8063

Crandall, C. J., Mehta, J. M., & Manson, J. E. (2023). Management of menopausal symptoms: A review. JAMA, 329(5), 405–420. https://doi.org/10.1001/jama.2022.24140

Freeman, A. M., & Zubair, M. (2025). Anemia screening. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499905/

Karismaz, A., Pasin, O., Kara, O., Eren, R., Smith, L., Doventas, A., & Soysal, P. (2024). Associations between anemia and dependence on basic and instrumental activities of daily living in older women. BMC Geriatrics, 24, 741. https://doi.org/10.1186/s12877-024-05342-1

Mediboina, A., Pratyusha, P., & Kumar, G. S. (2024). Determining the prevalence and severity of menopausal symptoms in post-menopausal women of Eluru, Andhra Pradesh, India, using the Menopause Rating Scale (MRS). International Journal of Medical Students, 12, 152–160. https://doi.org/10.5195/ijms.2024.2116

Neumann, S. N., Li, J. J., Yuan, X. D., Chen, S. H., Ma, C. R., Murray-Kolb, L. E., Shen, Y., Wu, S. L., & Gao, X. (2021). Anemia and insomnia: A cross-sectional study and meta-analysis. Chinese Medical Journal, 134(6), 675–681. https://doi.org/10.1097/CM9.0000000000001306

Pertynska-Marczewska, M., & Pertynski, T. (2024). Non-hormonal pharmacological interventions for managing vasomotor symptoms—how can we help: 2024 landscape. European Journal of Obstetrics & Gynecology and Reproductive Biology, 302, 141–148. https://doi.org/10.1016/j.ejogrb.2024.09.013

Sahoo, D. P., Gupta, A., War, G. A., & Deb, S. (2025). Unmasking anemia in the elderly: A systematic review of prevalence, causes, and consequences. Journal of Family Medicine and Primary Care, 14(11), 4466–4475. https://doi.org/10.4103/jfmpc.jfmpc_829_25

Salis, F., Locci, G., Mura, B., & Mandas, A. (2023). Anemia in elderly patients—The impact of hemoglobin cut-off levels on geriatric domains. Diagnostics, 13(2), 191. https://doi.org/10.3390/diagnostics13020191

Santo, J. E., De Loureiro, N. E. M., Loureiro, B. V., Aibar-Almazán, A., & Contreras, F. H. (2023). Psychometric properties and validity of the Menopause Rating Scale in postmenopausal Portuguese women. Menopause, 30(2), 179–185. https://doi.org/10.1097/GME.0000000000002104

World Health Organization. (2021). Menopause. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/menopause

Wouters, H. J. C. M., van der Klauw, M. M., de Witte, T., Stauder, R., Swinkels, D. W., Wolffenbuttel, B. H. R., & Huls, G. (2019). Association of anemia with health-related quality of life and survival: A large population-based cohort study. Haematologica, 104(3), 468–476. https://doi.org/10.3324/haematol.2018.195552

Yang, J. L., Hodara, E., Sriprasert, I., Shoupe, D., & Stanczyk, F. Z. (2024). Estrogen deficiency in the menopause and the role of hormone therapy: Integrating the findings of basic science research with clinical trials. Menopause, 31(9), 926–939. https://doi.org/10.1097/GME.0000000000002407

Katsumi, A., Abe, A., Tamura, S., & Matsushita, T. (2021). Anemia in older adults as a geriatric syndrome: A review. Geriatrics & Gerontology International, 21(7), 549–554. https://doi.org/10.1111/ggi.14183

Susanti, H. D., Chang, P. C., & Chung, M. H. (2019). Construct validity of the Menopause Rating Scale in Indonesia. Climacteric, 22(5), 454–459. https://doi.org/10.1080/13697137.2019.1574737

Heinemann, K., Ruebig, A., Potthoff, P., Schneider, H. P. G., Strelow, F., Heinemann, L. A. J., & Thai, D. M. (2004). The Menopause Rating Scale (MRS) scale: A methodological review. Health and Quality of Life Outcomes, 2, 45. https://doi.org/10.1186/1477-7525-2-45

Morga, A., Ajmera, M., Gao, E., Patterson-Lomba, O., Zhao, A., Mancuso, S., Siddiqui, E., & Kagan, R. (2024). Systematic review and network meta-analysis comparing the efficacy of fezolinetant with hormone and nonhormone therapies for treatment of vasomotor symptoms due to menopause. Menopause, 31(1), 68–76. https://doi.org/10.1097/GME.0000000000002281

The 2022 Hormone Therapy Position Statement Advisory Panel. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028

The 2023 Nonhormone Therapy Position Statement Advisory Panel. (2023). The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause, 30(6), 573–590. https://doi.org/10.1097/GME.0000000000002200

Iyer, T. K., Fiffick, A. N., & Batur, P. (2024). Nonhormone therapies for vasomotor symptom management. Cleveland Clinic Journal of Medicine, 91(4), 237–244. https://doi.org/10.3949/ccjm.91a.23067

Chavez, M. P., Pasqualotto, E., Ferreira, R. O. M., Hohl, A., de Moraes, F. C. A., Schmidt, P. H. S., Rodrigues, A. L. S. O., & de Sá, J. R. (2024). Fezolinetant for the treatment of vasomotor symptoms associated with menopause: A meta-analysis. Climacteric, 27(3), 245–254. https://doi.org/10.1080/13697137.2024.2334083

National Institute for Health and Care Excellence. (2024). Menopause: Identification and management (NICE Guideline NG23). NICE.

Ahmadi, K., Dashti, S., & Bahri, N. (2026). Relationship between the severity of menopausal symptoms and quality of life during the menopause transition: A systematic review. Archives of Women's Mental Health, 29(3), 76. https://doi.org/10.1007/s00737-026-01716-z

Abay, H., Altun, E., & Kaplan, S. (2024). Development of the Menopause Perception Scale. Menopause, 31(9), 818–827. https://doi.org/10.1097/GME.0000000000002398

Ye, M., Shou, M., Zhang, J., Hu, B., Liu, C., Bi, C., Lv, T., Luo, F., Zhang, Z., Liang, S., Feng, H., Qian, C., Cao, S., & Liu, Z. (2022). Efficacy of cognitive therapy and behavior therapy for menopausal symptoms: A systematic review and meta-analysis. Psychological Medicine, 52(3), 433–445. https://doi.org/10.1017/S0033291721005407

Oyedeji, C. I., Artz, A. S., & Cohen, H. J. (2024). How I treat anemia in older adults. Blood, 143(3), 205–213. https://doi.org/10.1182/blood.2022017626

Ramya, N. R., & Gadgi, R. (2020). Menopause rating scale: A simple tool for assessment of climacteric symptoms. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9. https://doi.org/10.18203/2320-1770.ijrcog20204322

Wacka, E., Nicikowski, J., Jarmuzek, P., & Zembron-Lacny, A. (2024). Anemia and its connections to inflammation in older adults: A review. Journal of Clinical Medicine, 13(7), 2049. https://doi.org/10.3390/jcm13072049

Ogawa, M., Iioka, Y., Ideno, Y., Yamaguchi, A., Muramatsu, N., Takahashi, T., & Takamatsu, K. (2026). Validation of the Japanese Version of the Menopause Rating Scale. Journal of Women's Health. Advance online publication. https://doi.org/10.1177/15409996261456635

Manckoundia, P., Putot, A., Larosa, F., & Renoncourt, T. (2026). Microcytic anemia in older adults: A comprehensive review. Current Opinion in Clinical Nutrition and Metabolic Care, 29(1), 28–34. https://doi.org/10.1097/MCO.000000000000117


Article Metrics

Abstract view : 129 times
PDF - 2 times

DOI: https://doi.org/10.26714/jk.15.2.2026.97-103

Refbacks

  • There are currently no refbacks.


Copyright (c) 2026 Jurnal Kebidanan

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.



JURNAL KEBIDANAN

Program Studi Kebidanan
Fakultas Ilmu Keperawatan dan Kesehatan
Universitas Muhammadiyah Semarang, Indonesia
NRC Building, 2nd FLoor
Jl. Kedungmundu Raya No. 18, Semarang
Tlp. +6224-76740288, Fax. +6224-76740287