Adiposity and domain-specific menopausal symptom severity in midlife women: a cross-sectional clinical study in...

To investigate the association between body mass index (BMI) and the prevalence and severity of menopausal symptoms in a clinically characterized cohort of peri- and postmenopausal women in Eastern China.

In this cross-sectional study, 1,371 women aged 40-60 years were recruited from the Perimenopausal Health Care Center of Hangzhou Women's Hospital, Zhejiang University School of Medicine, between June 2022 and June 2025. Anthropometric measurements were obtained using standardized protocols, and BMI categories were defined according to Chinese guidelines. Menopausal symptoms were evaluated using the modified Kupperman Menopausal Index. Differences across BMI groups were assessed using analysis of variance or chi-square tests, and correlations between BMI and symptom severity were examined using Pearson correlation analysis.

Vasomotor symptoms were the most prevalent menopausal complaints in this cohort, reported by 76.6% of participants. High frequencies were also observed for sexual dysfunction (72.4%), fatigue (72.0%), insomnia (71.8%), and mood swings (66.3%). Although the overall prevalence of menopausal symptoms did not differ significantly across BMI categories, symptom severity was greater in several domains. Specifically, there were significant positive correlations between BMI and vasomotor symptoms, mood swings, sexual dysfunction, and urinary symptoms. These associations remained statistically significant but modest in multivariable analyses adjusting for waist-to-hip ratio. Consistently, women with obesity had significantly higher scores for vasomotor, sexual, and urinary symptoms compared with women of normal weight.

While BMI was not associated with overall symptom prevalence, it was associated with modest increases in the severity of selected symptom domains. These findings should be interpreted cautiously given the small effect sizes and cross-sectional design. Clinical trial number: not applicable.