Investigating the Interconnections Between Dimensions of Menopause Symptoms, Body Image and Interoceptive Sensibility: A Network Analysis

Background: Midlife is a period of heightened vulnerability to menopausal symptoms and body image concerns. However, little is known about how the experience of menopausal symptoms relates to the awareness of and attention toward internal body signals. Taking a dimensional approach, this study employed network analysis to examine how menopausal symptom domains relate to dimensions of interoceptive sensibility and body image in middle-aged women and identified the most influential and bridging features within this interconnected system. Methods: Two hundred and thirteen cisgender women aged 40–60 years residing in Ireland completed online measures of body appreciation (BAS-2), state body satisfaction (BISS), interoceptive sensibility (MAIA-2), and menopausal symptoms (Menopause Rating Scale). Results: Attention Regulation, Trusting, Body Appreciation, and Body Listening showed the highest expected influence. Body Appreciation emerged as the strongest bridge node, connecting interoceptive sensibility, body image, and menopausal symptoms. Trusting was negatively associated with psychological symptoms, whereas Noticing was positively associated with somatic symptoms. Regression analyses showed that lower body appreciation predicted greater somatic, urogenital, and psychological symptom severity, and lower Trusting predicted higher psychological symptom severity. Older age was associated with higher somatic and urogenital symptoms, while younger age was associated with higher psychological symptoms. Conclusions: Findings suggest that body appreciation and interoceptive trust are central, bridging processes in women’s experience of menopausal symptoms. Interventions that enhance body appreciation and interoceptive trust may help reduce psychological and physical symptom burden during the menopausal transition.