Research Article| Volume 73, ISSUE 4, P354-360, December 2012

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

Published:September 26, 2012DOI:



      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.


      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).


      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.


      BMI (body mass index), CHD (coronary heart disease), CI (confidence interval), HR (hazard ratio), HRT (hormone replacement therapy), KMI (Kupperman menopause index), LMP (last menstrual period), OC (oral contraceptive), OR (odds ratio), SD (standard deviation), STRAW (Stages of Reproductive Aging Workshop), SWAN (Study of Women's Health Across the Nation)


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