Aim: Although menopause is a normal biological event, it does not cease to mark an important transition in women's lives that can have a catalytic effect on their quality of life. The purpose of this observational study was to evaluate the quality of life in perimenopausal and postmenopausal women and its correlation with climacteric symptoms and self-esteem. Additionally, the aim was to identify those determinants that may be associated with quality of life (sociodemographic, clinical). Finally, to investigate the level of information that women receive about the symptoms of menopause and ways of management.

Material and Method: This is a cross-sectional observational study. The final sample consisted of 278 cases (33,1% perimenopausal and 66,9% postmenopausal), aged 45-65 years and data collection took place from December 2023 to January 2024. The data collection was carried out at the gynecological clinic of the Athens Naval Hospital and at private gynecological offices in Athens and rural areas. A demographic questionnaire and the UTIAN quality of life, GREEN climacteric symptoms and Rosenberg self-esteem scales were used as collection instruments. The SPSS 26.0 program was used for the statistical analysis. Spearman's correlation coefficient was used to test the relationship between two quantitative variables. A linear regression analysis was performed to find independent factors related to quality of life scales (UTIAN) and menopausal symptoms (Green) and a logarithmic regression analysis was performed to find independent factors related to the usage of hormone replacement therapy.

Results: Menopausal symptoms and self-esteem, both when evaluated as univariates and in multivariate analysis, were found to have a statistically significant effect on all dimensions and on the overall quality of life scale (p<0,001). Regarding the effect of the various determinants in the final multivariate statistical analysis, it was found that only better self-assessment of health, as well as support from the family and social environment were related to a better quality of life on the overall scale. On the contrary, overweight/obese women had worse overall QoL. However, other factors played an important prognostic role, such as smoking, being married, exercise and healthy diet, regular visits to the gynecologist for check-up, satisfaction with the financial and living standards, information from the scientific community about menopause. Regarding the ways menopause was managed, the percentages of women who modified their lifestyle (exercise, diet) or sought help from specialists or received hormone replacement therapy were small, which highlights the gap that exists in the field of management, both by health professionals as well as by the women themselves.

Conclusions: In conclusion, there is a need for health promotion programs to empower, sensitize and thoroughly inform menopausal women about the consequences of menopause, the range of treatment options, but also about the need to adopt a healthier lifestyle and self-care practices. In addition, it is very important that women receive appropriate support from society, the state and work. Finally, it is also decisive to educate and inform all health professionals involved in the management of menopause, in order to have a multidisciplinary approach.