title: Factors associated with the age of natural menopause and menopausal symptoms in Chinese women.
abstract: OBJECTIVE
  To investigate the factors associated with the age of natural menopause and menopausal symptoms in a large population of Chinese middle-aged women.
  
  
  METHODS
  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).
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: The State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: Jie
authors.initials: J
authors.lastname: Wu
authors.forename: Danhua
authors.initials: D
authors.lastname: Pu
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.forename: Chunhua
authors.initials: C
authors.lastname: Wan
authors.forename: Lihua
authors.initials: L
authors.lastname: Sun
authors.forename: Cai-e
authors.initials: CE
authors.lastname: Shen
authors.forename: Weihua
authors.initials: W
authors.lastname: Sun
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Yuan
authors.forename: Qin
authors.initials: Q
authors.lastname: Shen
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: He
authors.forename: Jian
authors.initials: J
authors.lastname: Jiang
authors.forename: Naimei
authors.initials: N
authors.lastname: Luo
authors.forename: Ya
authors.initials: Y
authors.lastname: He
authors.forename: Qiuju
authors.initials: Q
authors.lastname: Qian
authors.forename: Peiqin
authors.initials: P
authors.lastname: Cai
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires