Premenopausal and perimenopausal predictors of postmenopausal health and well-being: Testing a disposition-belief-motivation framework.

The present study tested a Disposition-Belief-Motivation model of peri- and post-menopausal health and well-being using a 20-year prospective design from the Midlife in the United States (MIDUS) study. Screening algorithms based on World Health Organization guidelines produced a sample of women that was premenopausal at Time 1, perimenopausal at Time 2, and postmenopausal at Time 3 (N = 247). Prospective path modeling tested the direct and indirect effects of premenopausal factors on peri- and post-menopausal health and well-being. The results showed positive premenopausal attitudes toward aging were directly associated with greater postmenopausal well-being. Older baseline age was indirectly associated with greater postmenopausal well-being through perimenopausal well-being. Greater premenopausal functional ability was indirectly associated with greater self-rated postmenopausal health via greater perimenopausal self-rated health. Although premenopausal factors predicted perimenopausal optimism, coping, and symptoms, none was directly associated with postmenopausal health or well-being. Controlling for perimenopausal health and well-being, the results highlight the roles of greater premenopausal age, greater functional ability, and less concern about fertility, attractiveness, and illness in predicting perceptions of health and well-being across the menopause transition. The finding for aging attitudes, in particular, suggests the importance of reinforcing positive messaging and norms for women's aging and health, rather than medicalizing menopause and its symptoms.