title: The age of menopause and the menopause transition in a multiracial population: a nation-wide Singapore study.
abstract: OBJECTIVE
  To describe the prevalence of menopausal symptoms, define the mean age of menopause, and determine contributory factors, which influence the experience of symptoms among Singaporean women of different racial groups.
  
  
  METHODS
  Cross-sectional nation-wide study of a random sample of 1000 women drawn from the entire population of Singaporean female (Chinese, Malay, and Indian) citizens between 45 and 60 years of age. Face-to-face interviews using structured questionnaires were conducted.
  
  
  RESULTS
  The response rate was 69.9%. The mean age of natural menopause was 49.0 years. This was not significantly different between the three ethnic groups. Increasing parity delayed the age of menopause (P=0.007). Muscle and joint ache was the most commonly reported symptom (52.6%). Although the prevalence of significant hot flushes in the general study population was low (3.9%), it was the most commonly reported complaint by peri-menopausal women (14.6%). Prevalence of significant hot flushes decreased with time from menopause (P=0.007) and completely disappeared beyond the fifth year of menopause. Recent unhappy events were associated with an increased risk of symptoms (P<0.001). Women of Chinese origin experienced a lower risk of menopausal symptoms when compared with other ethnic groups (P<0.05).
  
  
  CONCLUSIONS
  The mean age of menopause was 49.0 years among Singaporean women. Ethnicity and recent unhappy events were two major factors, which influenced the risk of experiencing menopausal symptoms. Among the three ethnic groups studied, Chinese women were the least likely to experience disturbing menopausal symptoms. The overall prevalence of menopausal symptoms was low when compared to studies on women in western societies.
authors.affiliation: Department of Obstetrics and Gynaecology, National University of Singapore, Singapore. fh_loh@pacific.net.sg
authors.forename: Foo-Hoe
authors.initials: FH
authors.lastname: Loh
authors.forename: Lay-Wai
authors.initials: LW
authors.lastname: Khin
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: Jeannette J M
authors.initials: JJ
authors.lastname: Lee
authors.forename: Ken
authors.initials: K
authors.lastname: Gu
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D044466:Asian People; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D004412:Dysmenorrhea / Q000453:epidemiology; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D008593:Menopause / Q000208:ethnology* / Q000502:physiology*; D008875:Middle Aged; D015995:Prevalence; D017584:Reproductive History; D012846:Singapore / Q000453:epidemiology; D012907:Smoking; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors