Factors associated with the age of natural menopause and menopausal symptoms in Chinese women.

OBJECTIVE To investigate the factors associated with the age of natural menopause and menopausal symptoms in a large population of Chinese middle-aged women. STUDY DESIGN In this cross-sectional study, a total of 20,275 women (40-65 years) attending health screening in Jiangsu Province of China were enrolled. A structured questionnaire was used to collect data of demographics, menopausal status, chronic diseases, reproductive history, etc. Also we evaluated the severity of menopausal symptoms by Kupperman menopause index (KMI). MAIN OUTCOME MEASURE Menopausal age and scorings of Kupperman menopause index. RESULTS The overall median age at natural menopause was 50 years. Lower educational level, poor economic status, lower body mass index (BMI), age at menarche less than 14 years, nulliparity and smoking were associated with earlier onset of natural menopause (P<0.05). The most frequently symptoms in postmenopausal women were sexual problems (57.05%), muscle/joint pain (53.29%) and insomnia (51.02%), while fatigue, insomnia and muscle/joint pain were predominant symptoms in pre- and peri-menopausal women. After adjusting for confounding factors, logistic regression analysis revealed that women with poor educational background, low income, divorce, higher BMI, higher parity, smoking and chronic diseases presented higher KMI scores (P<0.05). CONCLUSION The study provided an estimate of median age at natural menopause in Chinese women. The main factors contributing to earlier onset of menopause and severity of menopausal symptoms were lower educational level, poor economic status, and smoking. Thus, this study provides important insights for physicians to prevent and treat menopause related symptoms.

[1]  You-ji Feng,et al.  [Survey on menopausal age and menstruation span in women in Pudong district of Shanghai]. , 2010, Zhonghua fu chan ke za zhi.

[2]  D. Roth,et al.  Racial and regional differences in age at menopause in the United States: findings from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. , 2011, American journal of obstetrics and gynecology.

[3]  H. S. Kim,et al.  Sexuality and related factors of postmenopausal Korean women. , 2003, Taehan Kanho Hakhoe chi.

[4]  M. Soules,et al.  Stages of Reproductive Aging Workshop (STRAW). , 2001, Journal of women's health & gender-based medicine.

[5]  R. Glass,et al.  Clinical gynecologic endocrinology , 2012 .

[6]  M. Burchardt,et al.  The epidemiology and definition of female sexual disorders , 2002, World Journal of Urology.

[7]  D. Jarvis,et al.  Is age at menopause increasing across Europe? Results on age at menopause and determinants from two population-based studies , 2009, Menopause.

[8]  S. Farrell,et al.  The detection and management of vaginal atrophy , 2005, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[9]  P. Chedraui,et al.  Severe menopausal symptoms in middle-aged women are associated to female and male factors , 2010, Archives of Gynecology and Obstetrics.

[10]  R. Segraves,et al.  Sexual Arousal and Lubrication Problems in Women With Clinically Diagnosed Hypoactive Sexual Desire Disorder: Preliminary Findings from the Hypoactive Sexual Desire Disorder Registry for Women , 2012, Journal of sex & marital therapy.

[11]  S. Farrell,et al.  The detection and management of vaginal atrophy. , 2004 .

[12]  P. Chedraui,et al.  Assessing menopausal symptoms among healthy middle aged women with the Menopause Rating Scale. , 2007, Maturitas.

[13]  M. Kaczmarek.  The timing of natural menopause in Poland and associated factors. , 2007, Maturitas.

[14]  F. Yanik,et al.  Quality of life and postmenopausal symptoms among women in a rural district of the capital city of Turkey , 2007, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology.

[15]  K. Matthews,et al.  Prospective study of the determinants of age at menopause. , 1997, American journal of epidemiology.

[16]  J. Blümel,et al.  Age at menopause in Latin America , 2006, Menopause.

[17]  S. Saw,et al.  The prevalence of menopausal symptoms in a community in Singapore. , 2002, Maturitas.

[18]  G. Lindmark,et al.  Menopausal symptoms and quality of life during the menopausal transition in Sri Lankan women , 2009, Menopause.

[19]  S. Crawford,et al.  Psychosocial, behavioral, and health factors related to menopause symptomatology. , 1997, Women's health.

[20]  M. Hammar,et al.  Climacteric symptoms in a postmenopausal Czech population. , 1996, Maturitas.

[21]  M. Tashiro,et al.  Medial frontal cortex perfusion abnormalities as evaluated by positron emission tomography in women with climacteric symptoms , 2006, Menopause.

[22]  S. R. Zainudin,et al.  Assessment of menopausal symptoms using modified Menopause Rating Scale (MRS) among middle age women in Kuching, Sarawak, Malaysia , 2010, Asia Pacific family medicine.

[23]  Tippawan Liabsuetrakul,et al.  Sexual functioning in postmenopausal women not taking hormone therapy in the Gynecological and Menopause Clinic, Songklanagarind Hospital measured by Female Sexual Function Index questionnaire. , 2008, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[24]  M. Pike,et al.  Predictors of the timing of natural menopause in the Multiethnic Cohort Study. , 2008, American journal of epidemiology.

[25]  Ying Li,et al.  Prevalence of depression and anxiety symptoms and their influence factors during menopausal transition and postmenopause in Beijing city. , 2008, Maturitas.

[26]  Ingvild Dalen,et al.  Symptom prevalence during menopause and factors associated with symptoms and menopausal age. Results from the Norwegian Hordaland Women's Cohort study. , 2011, Maturitas.

[27]  P. Giraldo,et al.  The impact of physical activity on menopausal symptoms in middle‐aged women , 2012, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[28]  S. Ziaei,et al.  Female sexual dysfunction in Iranian postmenopausal women: prevalence and correlation with hormonal profile. , 2011, The journal of sexual medicine.

[29]  Epidemiology and neurobiology of female sexual dysfunction. , 2008, The journal of sexual medicine.

[30]  E. Baracat,et al.  Construction and validation of an instrument that breaks the silence: the impact of domestic and/or sexual violence on women’s health, as shown during climacterium , 2012, Menopause.

[31]  Shiao-Chi Wu,et al.  Effect of intestinal production of equol on menopausal symptoms in women treated with soy isoflavones , 2008, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[32]  S. Palacios,et al.  Assessing osteoporosis risk factors in Spanish menopausal women , 2011, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology.

[33]  W. Lu,et al.  Soy germ isoflavones improve menopausal symptoms but have no effect on blood lipids in early postmenopausal Chinese women: a randomized placebo-controlled trial , 2012, Menopause.

[34]  Thierry de Meeus,et al.  International Variability of Ages at Menarche and Menopause: Patterns and Main Determinants , 2001, Human biology.

[35]  Who Consultation on Obesity.  Obesity: preventing and managing the global epidemic. Report of a WHO consultation. , 2000, World Health Organization technical report series.

[36]  Wu Beishen,et al.  The Menopause Rating Scale:a comparision study with modified Kupperman Index and Greene Scale , 2010 .

[37]  S. Crawford,et al.  Factors associated with age at natural menopause in a multiethnic sample of midlife women. , 2001, American journal of epidemiology.

[38]  Wendy Levinson,et al.  A study of sexuality and health among older adults in the United States. , 2007, The New England journal of medicine.

[39]  E. Liske,et al.  Efficacy and tolerability of a medicinal product containing an isopropanolic black cohosh extract in Chinese women with menopausal symptoms: a randomized, double blind, parallel-controlled study versus tibolone. , 2007, Maturitas.

[40]  P. Chedraui,et al.  Menopausal symptoms and associated risk factors among postmenopausal women screened for the metabolic syndrome , 2007, Archives of Gynecology and Obstetrics.

[41]  J. Blümel,et al.  Impaired quality of life among middle aged women: a multicentre Latin American study. , 2008, Maturitas.

[42]  P. Chedraui,et al.  Obesity is Related to Increased Menopausal Symptoms among Spanish Women , 2010, Menopause international.

[43]  C. Sreeramareddy,et al.  Frequency of symptoms, determinants of severe symptoms, validity of and cut-off score for Menopause Rating Scale (MRS) as a screening tool: A cross-sectional survey among midlife Nepalese women , 2011, BMC women's health.

[44]  Ivar Heuch,et al.  Age at natural menopause and all-cause mortality: a 37-year follow-up of 19,731 Norwegian women. , 2003, American journal of epidemiology.

[45]  E. T. te Velde,et al.  Age at natural menopause in a population-based screening cohort: the role of menarche, fecundity, and lifestyle factors. , 1997, Fertility and sterility.

[46]  K. Hartmann,et al.  Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women , 2008, Menopause.