title: Women's mid-life health experiences in urban UK: an international comparison.
abstract: OBJECTIVE
  First, to investigate cross-cultural variations in symptom prevalence for mid-life women using data from studies undertaken in the UK, Japan, China, Canada and the USA, and, second, to examine the relationship between symptoms, ethnicity, age and menopausal status for London's multi-ethnic urban women aged 45-55 years.
  
  
  METHODS
  Cross-sectional, self-administered, postal questionnaire of women aged 45-55 years in London, UK (n = 1115), recruited from general practitioner lists. Participants recalled 15 general symptoms and the prevalence rates were compared with those of cohorts from methodologically similar studies.
  
  
  RESULTS
  London women experienced high levels of general symptom reporting. Tiredness was the most prevalent symptom (65%) followed by aches or stiffness in the joints (54%). The prevalence of seven symptoms varied by menopausal group. Only the symptom of hot flushes varied by age. Tiredness, insomnia and irritability varied by ethnic group. The pattern of symptom reporting for the London cohort was more similar to the pattern of women in Beijing than to the pattern of cohorts in Manitoba, Massachusetts and Japan.
  
  
  CONCLUSIONS
  Our data do not support the existence of a single menopausal syndrome. There appears to be dialectic between culture and biology. It can be argued that symptoms experienced during the menopausal transition arise through a complexity of factors, not simply declining levels of estrogen or ethnicity; geographic location, local culture and temporality are factors that also need to be taken into account.
authors.affiliation: School of Integrated Health, University of Westminster, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Ward
authors.forename: V
authors.initials: V
authors.lastname: Scheid
authors.forename: V
authors.initials: V
authors.lastname: Tuffrey
mesh_terms: D000367:Age Factors; D018771:Arthralgia / Q000453:epidemiology; D002170:Canada; D002681:China; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology; D006801:Humans; D007508:Irritable Mood; D007564:Japan; D016015:Logistic Models; D008131:London; D008593:Menopause; D008875:Middle Aged; D044469:Racial Groups; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population