Symptoms in the Late Reproductive Stage Through Postmenopause
Symptoms in the Late Reproductive Stage Through Postmenopause
Using MLCA and fit indices for MLCA, a three-class solution was the best fitting model based on the BIC that declined substantially from the one-class to three-class model and then began to stabilize (Fig. 1). The class solutions for one to six latent classes are presented in Table 2 . The entropy provided additional support for the three-class model. Although the posterior probabilities in the four-class model indicated an adequate model classification, it did not add anything clinically significant to the model. The fourth class represented a slight splitting of an existing class in the three-class model. We chose the three-class model because it most substantially and parsimoniously explained the data in a theoretically meaningful way.
(Enlarge Image)
Figure 1.
Mean symptom severity level according to class. The means were calculated from symptom severity ratings provided from all occasions during the late reproductive period, early and late menopausal transition, and early postmenopause. Each class contains data from all stages.
In the three-class model seen in Table 3 , the class with the largest proportion of observations represented low severity responses and accounted for 74.9% of the sample (Class 1). The other two classes were almost evenly split between responses. Class 2 included observations of low hot flash severity with higher severity ratings for all other symptom groups, and accounted for 13% of the observations. Class 3 included observations of high hot flash severity with lower severity for all other symptom groups and accounted for 12% of the observations.
After determining the best fitting model, latent class membership was regressed on stage in a multinomial logistic regression to determine whether stage was a significant predictor of class membership. In the regression model, the low symptom severity class (class 1) served as the reference group. Relative to being in class 1, being in the early and late MT stages increased the likelihood of being in class 2, whereas being in early postmenopause reduced the likelihood of being in class 2, but the effects were not statistically significant (P > 0.05).
Relative to being in class 1, being in either the early or the late MT stage or early postmenopause versus being in the late reproductive stage increased the likelihood of being in class 3 (high-severity hot flashes, lower severity for other symptoms; see Table 4 for multinomial regression results). All stage effects (relative to late reproductive stage) were positive, indicating an increased likelihood of being in class 3 relative to class 1 during each of these stages. The strongest effect relative to being in the late reproductive stage was being in early postmenopause, which increased the log odds of being in class 3 vs being in class 1 by 3.117. In other words, women with a higher propensity for hot flashes versus those who experienced very low severity symptoms were 3 times more likely to be in early postmenopause.
Results
Using MLCA and fit indices for MLCA, a three-class solution was the best fitting model based on the BIC that declined substantially from the one-class to three-class model and then began to stabilize (Fig. 1). The class solutions for one to six latent classes are presented in Table 2 . The entropy provided additional support for the three-class model. Although the posterior probabilities in the four-class model indicated an adequate model classification, it did not add anything clinically significant to the model. The fourth class represented a slight splitting of an existing class in the three-class model. We chose the three-class model because it most substantially and parsimoniously explained the data in a theoretically meaningful way.
(Enlarge Image)
Figure 1.
Mean symptom severity level according to class. The means were calculated from symptom severity ratings provided from all occasions during the late reproductive period, early and late menopausal transition, and early postmenopause. Each class contains data from all stages.
In the three-class model seen in Table 3 , the class with the largest proportion of observations represented low severity responses and accounted for 74.9% of the sample (Class 1). The other two classes were almost evenly split between responses. Class 2 included observations of low hot flash severity with higher severity ratings for all other symptom groups, and accounted for 13% of the observations. Class 3 included observations of high hot flash severity with lower severity for all other symptom groups and accounted for 12% of the observations.
After determining the best fitting model, latent class membership was regressed on stage in a multinomial logistic regression to determine whether stage was a significant predictor of class membership. In the regression model, the low symptom severity class (class 1) served as the reference group. Relative to being in class 1, being in the early and late MT stages increased the likelihood of being in class 2, whereas being in early postmenopause reduced the likelihood of being in class 2, but the effects were not statistically significant (P > 0.05).
Relative to being in class 1, being in either the early or the late MT stage or early postmenopause versus being in the late reproductive stage increased the likelihood of being in class 3 (high-severity hot flashes, lower severity for other symptoms; see Table 4 for multinomial regression results). All stage effects (relative to late reproductive stage) were positive, indicating an increased likelihood of being in class 3 relative to class 1 during each of these stages. The strongest effect relative to being in the late reproductive stage was being in early postmenopause, which increased the log odds of being in class 3 vs being in class 1 by 3.117. In other words, women with a higher propensity for hot flashes versus those who experienced very low severity symptoms were 3 times more likely to be in early postmenopause.