A survey of menopausal symptoms in Chinese community women based on the STRAW+10 staging system

OBJECTIVE: To assess the prevalence and factors influencing menopausal symptom severity among perimenopausal women in the Chinese community. METHODS: Participants aged 35-60 from 26 districts in 12 Chinese provinces were recruited through the Epidemiological Investigation of Menopause Status among Chinese Women (EIM-CW). Exclusion criteria included congenital absence of the uterus and premenopausal hysterectomy. Data collected included demographics, lifestyle, Kupperman index, physical examination, and menstrual history. RESULTS: Of 55,056 women screened, 51,118 met the inclusion criteria. A total of 27,953 participants were classified in stage -3, 1,983 in stage -2, 2,319 in stage -1, 880 in stage +1a, 3,027 in stage +1b, 6,580 in stage +1c, and 8,376 in stage +2. The prevalence of symptoms after menopause (18,863 individuals including stage +1a and subsequent stages) included insomnia (50.60%), sexual complaints (45.70%), fatigue (44.70%), nervousness (42.40%), arthralgia/myalgia (41.40%), and hot flushes (27.30%). Higher education, better family satisfaction, and lower physical labor were associated with more mild symptoms (P<0.05). Symptoms prevalence varied by STRAW+10 stages: nervousness peaked at stage -3 (51.82%), fatigue at stage -2 (50.13%), and insomnia during stages -1 to +2 (50.23%-55.15%). In stage -2, the most severe symptoms include headaches (1.11%), paresthesia (0.50%), palpitations (0.35%), and formication (0.25%). Hot flushes are most severe in stage -1, with a prevalence of 1.08%. The greatest severity of symptoms is observed in stage +1a, particularly for insomnia (1.59%), nervousness (1.14%), fatigue (1.14%), vertigo (0.68%), and melancholia (0.45%). Stage +2 shows the highest severity for sexual complaints (8.15%), urinary symptoms (0.88%), and musculoskeletal pain (0.69%). CONCLUSIONS: Insomnia is the most common symptom among perimenopausal women (during STRAW+10 stages -1 to +2) in Chinese communities. Insomnia, nervousness, fatigue, vertigo, and melancholia symptoms are most severe in stage +1a; headaches, paresthesia, palpitations, and formication are most severe in stage -2; sexual discomfort, urinary tract infection, and musculoskeletal pain are most severe in stage +2; hot flashes are most severe in stage -1. Menopausal symptom severity is associated with multiple factors such as education, family satisfaction, and physical labor.