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

To assess the prevalence and factors influencing menopausal symptom severity among perimenopausal women in the Chinese community.

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.

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%).

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.