title: Age of menopause and impact of climacteric symptoms by geographical region.
abstract: OBJECTIVE
  To describe differences in the age of onset of menopause and in the prevalence of climacteric symptoms in different geographical areas.
  
  
  METHODS
  Systematic review of published data on onset of menopause and symptoms in Europe, North America, Latin America and Asia.
  
  
  METHODS
  We identified publications by searching electronic databases, including MEDLINE (1966-October 2009) and EMBASE (1975-October 2009). Primary search criteria were age of menopause and climacteric symptoms. A sensitive analysis that excluded papers without full data was performed.
  
  
  RESULTS
  The median age at menopause in Europe ranges from 50.1 to 52.8 years, in North America from 50.5 to 51.4 years, in Latin America from 43.8 to 53 years, and in Asia from 42.1 to 49.5 years. The frequency of vasomotor symptoms varies widely depending on the geographical region, selection of criteria, and method of symptom identification. The prevalence of such symptoms ranges from 74% of women in Europe, 36-50% in North America, 45-69% in Latin America and 22-63% in Asia, as reported in different, large, epidemiological studies.
  
  
  CONCLUSIONS
  There are wide geographical differences in the prevalence of menopausal symptomatology and some differences in the age of onset of menopause. Both in Asia and Latin America, women of poorer socioeconomic status have significantly earlier onset of menopause. Within a geographical region, there are ethnic differences in menopause symptoms. Given differences in study methodologies, firm conclusions are not possible. However, regional differences in age at menopause and in climacteric symptoms are important to acknowledge and lay the foundation for an informed approach to the management of menopause and an understanding of its impact on women's health in the different regions of the world.
authors.affiliation: Palacios Institute of Women's Health, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Palacios
authors.forename: V W
authors.initials: VW
authors.lastname: Henderson
authors.forename: N
authors.initials: N
authors.lastname: Siseles
authors.forename: D
authors.initials: D
authors.lastname: Tan
authors.forename: P
authors.initials: P
authors.lastname: Villaseca
mesh_terms: D000328:Adult; D001208:Asia / Q000453:epidemiology; D001294:Attitude to Health; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D019584:Hot Flashes / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008593:Menopause; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D016387:Women's Health