Maturitas 38 (2001) 129–136 Women at mid-life: symptoms, attitudes, and choices, an internet based survey L. Conboy a, *, A. Domar b , E. O’Connell b a Department of Health and Social Behaior, Harard School of Public Health, 677 Huntington Aenue, Boston, MA, USA b Mind -Body Clinic at Beth, Israel Deaconess Hospital, Boston, MA, USA Received 31 January 2000; accepted 1 December 2000 Abstract Objecties: This Internet-based survey questioned middle-aged women (age 35 – 69) regarding their current attitudes, beliefs, symptoms, and treatment choices surrounding the climacteric. Methods: 448 respondents completed the 189 item, WEB-based survey that included measures of quality of life, lifestyle habits, anxiety symptoms, and questions regarding attitude toward and sources of information about menopause. Results: Three relationships were hypothesized and supported: frequency of self-reported menopause symptoms would be: (1) negatively associated with healthy behaviors; (2) positively associated with anxiety; (3) positively associated with stress. All measures were self-report. Fatigue, muscle and joint aches, and impatience were the most commonly reported symptoms. No particular symptom was strongly correlated (r 0.4) to lifestyle behaviors. Questions regarding information exchange reveal that many women are not consulting with their healthcare providers about HRT or frequently discussing alternatives. Many receive health information from lay sources. Conclusions: There is a need for improved information exchange on this subject. Our results are similar to those found using large randomized telephone survey methods, which supports the use of the Internet as a reliable and convenient venue for gathering data regarding health issues. It is important to consider healthy lifestyle behaviors toward the regulation of the climacteric syndrome. © 2001 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Menopause; Climacteric syndrome; Internet; Attitudes; Information; Hormone replacement therapy www.elsevier.com/locate/maturitas * Corresponding author. Tel.: +1-978-6359907. E-mail address: lconboy@hsph.harvard.edu (L. Conboy). 1 Since this study was done, the International Menopause Society, working with its international policy group, the Council of Affiliated Menopause Societies (CAMS) has developed standard definitions to be used in the field of menopause research. Menopause, or natural menopause, refers to the biological event of the cessation of menstruation for a year due to loss of ovarian follicular activity. Climacteric refers to the phase of life in which a woman moves from a reproductive to a non-reproductive state. This phase is more individually variable, extending before the perimenopause, through perimenopause, menopause, and past postmenopause. Climacteric syndrome refers to the symptoms that sometimes occur with the climacteric. [15]. In the present paper, we are looking at self-reported experience and symptoms that subjects attribute to menopause. The most appropriate term for a focus on this time of life and symptoms, and the one used in this paper, is climacteric syndrome. Yet menopause was used in our interactions with subjects, as it is the recognized term often used by the public to refer to this time of life. To accurately report our measures and results, and allow for comparisons to other work, in this paper we will remain true to the language that our subjects saw. Thus, this paper will use the terms menopause and perimenopause, presented in italics: (1) if these are the words that our subjects saw and interacted with; and (2) in reference to wording in measures that use these terms. Additionally, the terms will appear in plain text if used per the International Menopause Society definition. 0378-5122/01/$ - see front matter © 2001 Elsevier Science Ireland Ltd. All rights reserved. PII: S0378-5122(00)00211-5