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Objectives To explore the status of reproductive health and related factors in female patients with systemic sclerosis (SSc). Methods A cross-sectional study was conducted among female patients from the Chinese Organization for Scleroderma through a questionnaire. Data on the status of reproductive health including fertility condition and menstrual status were obtained. The clinical and laboratory data of SSc were collected. For patients with pregnancies after disease onset, each pregnancy was matched with a healthy control. Associations between clinical characteristics and the status of reproductive health were analysed. Results A total of 342 female patients with SSc were included, and 31.8% (108/342, 95% CI 26.9%–36.7%) of them presented problems with reproductive health. Compared with the national data, the menopausal age of patients with disease onset before menopause was earlier (45.2 ± 6.1 vs 48.2 ± 4.4, P  < 0.001). Age of disease onset (P  = 0.018) and digital ulcer (P  = 0.020) had statistically significant effects on menopausal age. Although the infertility rate of patients was not increased, the rate of spontaneous abortions was higher compared with the national data (9/74, 12.2% vs 4.3%, P  < 0.001). Compared with the healthy control group, the rate of premature infants (12/55, 21.8% vs 7/110, 6.4%, P  = 0.003), low birth weight infants (15/55, 27.3% vs 6/110, 5.5%, P  < 0.001), and cesarean section (27/55, 49.1% vs 21/110, 19.1%, P  < 0.001) increased significantly. Conclusion The impairment of reproductive health is common and in many quarters in patients with SSc. Further action should be taken to improve reproductive health in patients with SSc, especially in maternal care. [ABSTRACT FROM AUTHOR]

Objectives: To determine the risk factors and the rate of endometrial carcinoma (EC) among Chinese postmenopausal women with atypical endometrial hyperplasia (AEH). Methods: We retrospectively reviewed medical records of Chinese postmenopausal women with AEH who underwent endometrial biopsy (using pipelle) or curettage between 1 January 2012 and 31 December 2023 at the Queen Elizabeth Hospital. Postmenopausal women with a final diagnosis of AEH or EC were compared to determine the risk factors for EC. Results: In total, 45 Chinese postmenopausal women with AEH underwent hysterectomy and bilateral salpingooophorectomy. Of these, 15 (33.3%) underwent additional pelvic lymph node dissection with or without para-aortic lymph node dissection or subdiaphragmatic scraping, based on preoperative imaging findings (n=10) or intraoperative findings (n=5). All these 15 patients had a histopathological diagnosis of EC. Of the 45 patients, 11 and 34 had a histopathological diagnosis of AEH and EC, respectively. The final diagnosis of EC was not associated with age, body mass index, parity, hypertension, diabetes, or hyperlipidaemia in postmenopausal women with AEH. Conclusion: Of 45 Chinese postmenopausal women with AEH, 75.6% had a final diagnosis of EC and 24.4% required lymph node dissection in addition to hysterectomy and bilateral salpingo-oophorectomy. In selected patients, preoperative imaging and referral to a gynaecological oncologist for tumour staging may be necessary for optimal treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Few articles have focused on the cytological misinterpretation of high-grade squamous intraepithelial lesion (HSIL). Due to estrogen deficiency, cervical epithelial cells in postmenopausal women tend to show atrophic change that looks like HSIL on Papanicolaou-stained cytology slides, resulting in a higher rate of cytological misinterpretation. P16INK4a immunocytochemical staining (P16 cytology) can effectively differentiate diseased cells from normal atrophic ones with less dependence on cell morphology. Objective: To evaluate the role of P16 cytology in differentiating cytology HSIL from benign atrophy in women aged 50 years and above. Methods: Included in this analysis were women in a cervical cancer screening project conducted in central China who tested positive for high-risk human papillomavirus (hrHPV) and returned back for triage with complete data of primary HPV testing, liquidbased cytology (LBC) analysis, P16 immuno-stained cytology interpretation, and pathology diagnosis. The included patients were grouped by age: ≥50 (1,127 cases) and <50 years (1,430 cases). The accuracy of LBC and P16 cytology in the detection of pathology ≥HSIL was compared between the two groups, and the role of P16 immunostain in differentiating benign cervical lesions from cytology ≥HSIL was further analyzed. Results: One hundred sixty-seven women (14.8%; 167/1,127) in the ≥50 group and 255 (17.8%, 255/1,430) in the <50 group were pathologically diagnosed as HSIL (Path-HSIL). LBC [≥Atypical Squamous Cell Of Undetermined Significance (ASCUS)] and P16 cytology (positive) respectively detected 63.9% (163/255) and 90.2% (230/255) of the Path-≥HSIL cases in the <50 group and 74.3% (124/167) and 93.4% (124/167) of the Path-≥HSIL cases in the ≥50 group. LBC matched with pathology in 105 (41.2%) of the 255 Path-≥HSIL cases in the <50 group and 93 (55.7%) of the 167 Path-≥HSIL cases in the ≥50 group. There were five in the <50 group and 14 in the ≥50 group that were Path-≤LSIL cases, which were interpreted by LBC as HSIL, but negative in P16 cytology. Conclusion: P16 cytology facilitates differentiation of Path-≤LSIL from LBC-≥HSIL for women 50 years of age and above. It can be used in the lower-resource areas, where qualified cytologists are insufficient, as the secondary screening test for women aged ≥50 to avoid unnecessary biopsies and misinterpretation of LBC primary or secondary screening [ABSTRACT FROM AUTHOR]

Background: With the natural cessation of estrogen, after menopause, women, especially those who are overweight, are at a high risk for cardiovascular disease. Diet control and adequate physical activity (PA) are recommended as the essence of promoting cardiovascular health for women after menopause. Objective: The aim of this study was to examine the effects of a theory-based educational program on health behaviors and cardiovascular health outcomes among overweight postmenopausal Chinese women compared with conventional didactic education. Methods: In this randomized controlled trial, 288 participants were randomly allocated to intervention (n = 144) or control (n = 144) groups. The control group received conventional didactic education. The intervention group received a 3-month theory-based educational program. Primary outcomes were PA and dietary behavior. Secondary outcomes included cardiovascular health knowledge, self-efficacy in PA and diet, and cardiovascular health outcomes. Data were collected at baseline (T0), 3 months (T1), 6 months (T2), and 12 months (T3). Results: The intervention group demonstrated significantly greater improvements in PA, dietary behavior, self-efficacy in PA and diet, and several cardiovascular health outcomes (body weight, body mass index, waist circumference, blood pressure, and Framingham risk score [body mass index]) at postintervention compared with the control group (all P s <.05). These significant effects maintained at T2, and the effects on self-efficacy in PA and diet also were maintained at T3. Conclusions: A theory-based educational program may be an effective strategy for improving PA, dietary behavior, self-efficacy in PA and diet, and several cardiovascular health outcomes for overweight postmenopausal Chinese women. However, further strategies are needed to enhance the sustainability of the positive changes. [ABSTRACT FROM AUTHOR]

Objective: To measure symptoms and health-related quality of life in a cross-sectional cohort of menopausal-aged women in China. Method: A cross-sectional survey was conducted in a general population cohort of 2,000 Chinese females over the age of 45 years. Patients completed the Chinese version of the EuroQol-5D five level (EQ5D5L) health-related quality of life instrument via Personal Digital Assistant. Raw scores were converted to utility tariffs using value sets for China. Statistical analysis included Pearson's chi-square test, z test for multiple comparisons with adjustment by the Bonferroni method, independent-sample t-test, ANOVA, and adjustment by the Tukey method for multiple comparison. Results were considered statistically significant when p < 0.05 and the study was reported according to the STROBE recommendations. Results: In a cohort of 2000 women, 732 (37%) were premenopausal, 798 (40%) were perimenopausal and 470 (23%) were postmenopausal. Perimenopausal women reported significantly more symptoms (91%) compared to premenopausal (77%) and postmenopausal (81%) women. Health-related quality of life was significantly lower in symptomatic perimenopausal women compared to premenopausal (0.919, p < 0.05) and postmenopausal (0.877, p < 0.05) women. Within each group there was a statistically significant difference between the health-related quality of life of women with symptoms compared to without symptoms. Conclusion: The perimenopausal phase of menopause is associated with significantly more symptoms and significantly lower HRQoL compared to premenopausal and postmenopausal phases. Plain English summary: Why is this study needed? • It is important to understand the impact of menopausal symptoms on women's quality of life so that decisions can be made about what healthcare services to provide and what treatments to fund. • Currently there are only a few older studies investigating menopausal symptoms in the perimenopausal phase, which is characterised by hormone fluctuations and symptoms likely to impact quality of life, and lasts up to four years. What is the key problem this manuscript addresses? • This research measures symptoms and the impact on quality of life of menopausal women in China. What are your main results and what do they mean? • Women in the perimenopausal phase are disproportionately affected by symptoms compared to premenopausal and postmenopausal women. • Perimenopausal women have significantly lower HRQoL compared to premenopausal and postmenopausal women. • This information is critical to informing pharmacoeconomic decisions about healthcare provision and publicly funded treatments in China. [ABSTRACT FROM AUTHOR]

Background: After decades of rapid economic development, anemia remains a significant public health challenge globally. This study aimed to estimate the associations of sociodemographic, dietary, and body composition factors with anemia among the Zhuang in Guangxi Zhuang Autonomous Region, China. Methods: Our study population from the baseline survey of the Guangxi ethnic minority Cohort Study of Chronic Diseases consisted of 13,465 adults (6,779 women and 6,686 men) aged 24–82 years. A validated interviewer-administered laptop-based questionnaire system was used to collect information on participants' sociodemographic, lifestyle, and dietary factors. Each participant underwent a physical examination, and hematological indices were measured. Least absolute shrinkage and selection operator (LASSO) regression was used to select the variables, and logistic regression was applied to estimate the associations of independent risk factors with anemia. Results: The overall prevalences of anemia in men and women were 9.63% (95% CI: 8.94–10.36%) and 18.33% (95% CI: 17.42─19.28%), respectively. LASSO and logistic regression analyses showed that age was positively associated with anemia for both women and men. For diet in women, red meat consumption for 5–7 days/week (OR = 0.79, 95% CI: 0.65–0.98, p = 0.0290) and corn/sweet potato consumption for 5–7 days/week (OR = 0.73, 95% CI: 0.55–0.96, p = 0.0281) were negatively associated with anemia. For men, fruit consumption for 5–7 days/week (OR = 0.75, 95% CI: 0.60–0.94, p = 0.0130) and corn/sweet potato consumption for 5–7 days/week (OR = 0.66, 95% CI: 0.46–0.91, p = 0.0136) were negatively correlated with anemia. Compared with a normal body water percentage (55–65%), a body water percentage below normal (< 55%) was negatively related to anemia (OR = 0.68, 95% CI: 0.53–0.86, p = 0.0014). Conversely, a body water percentage above normal (> 65%) was positively correlated with anemia in men (OR = 1.73, 95% CI: 1.38–2.17, p < 0.0001). Conclusions: Anemia remains a moderate public health problem for premenopausal women and the elderly population in the Guangxi Zhuang minority region. The prevention of anemia at the population level requires multifaceted intervention measures according to sex and age, with a focus on dietary factors and the control of body composition. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of stress urinary incontinence (SUI) increases around menopause. The quality of life of perimenopausal and postmenopausal women with SUI is significantly affected. This study aimed to investigate the prevalence of SUI and the associated risk factors in a population of Chinese perimenopausal and postmenopausal women. Methods: A total of 273 perimenopausal and postmenopausal women were enrolled, and a cross‐sectional study was conducted. SUI was defined as an involuntary loss of urine with increases in abdominal pressure. Data including personal characteristics, menopause information, estrogen levels, and pelvic floor muscle strength levels were statistically analyzed. Results: The study enrolled 158 (57.9%) perimenopausal and 115 (42.1%) postmenopausal women. Sixty‐six (41.8%) perimenopausal women and 56 (48.7%) postmenopausal women complained of SUI. The mean age was 49.42 ± 5.58 years. Body mass index over 24 kg/m2 (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.07–3.81), vaginal delivery (OR 2.47, 95% CI 1.33–4.58), and diabetes (OR 4.65, 95% CI 1.23–17.62) were high‐risk factors for SUI. Climacteric symptoms (evaluated by Kupperman index scores) were statistically related to SUI, and among the 13 symptoms, insomnia, nervousness, weakness and fatigue, arthralgia and myalgia, headache, palpitation, and sexual complaints were all correlated with SUI in perimenopausal and postmenopausal women. Conclusions: Several factors are associated with SUI in Chinese perimenopausal and postmenopausal women. Obesity, vaginal delivery, climacteric symptoms, and diabetes were identified as the most notable risk factors. The management strategy could focus on the prevention and management of risk factors. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that metabolic diseases are risk factors for thyroid disease; most studies are cross-sectional design. We aimed to evaluate the causal relationship between thyroid and metabolic diseases in a cohort of Chinese nurses. Methods: We conducted an ambispective cohort study of the National Nurses' Health Study. Thyroid disease data based on ultrasonography from 2017 to 2021 were collected. We described thyroid disease incidence and the risk factors associated with a cluster of metabolic factors. We used the Mann‒Whitney U test, repeated-measures ANOVA and multivariable Cox proportional hazard regression to analyze the data. Results: A total of 1529 female nurses without thyroid disease were enrolled in 2017, of which, complete data were available for 1269 nurses. In 2018–2020, thyroid nodule incidence ranged from 32.8%-46.3%, thyroiditis incidence was 13.4%–14.3%, and goiter incidence was 4.1%–29.1%, thyroid adenoma and thyroid tumors incidence were 0.1%–0.5% and 1%–1.5%. We also found that NAFLAD was an independent risk factor for thyroid adenoma (p =.003). The age at diagnosis was an independent risk factor for goiter (p <. 001) and thyroid nodules (p <.001). Fasting blood glucose was an independent risk factor for thyroid tumors (p =.004). The age at diagnosis (p =.003), Body Mass Index (p =.006) and menopause (p =.031) were risk factors for thyroiditis. Conclusion: Thyroid disease incidence among nurses is increasing. Age at diagnosis, BMI, fasting blood glucose, and nonalcoholic fatty liver disease are independent risk factors for different types of thyroid disease. This study provides evidence for future studies to further explore the pathogenesis and prevention of thyroid diseases. [ABSTRACT FROM AUTHOR]

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Aim: The aim of the study was to investigate the incidence of sleep disturbance and its relationship with anxiety and depression symptoms, social support and hope in breast cancer patients in China during chemotherapy. Design: A single‐centre cross‐sectional study. Methods: A total of 329 breast cancer patients were selected via convenience sampling method before they began chemotherapy (n = 115), before the 5th week of chemotherapy (n = 117) or 1 month after chemotherapy ended (n = 97) and administered paper‐and‐pencil questionnaires to evaluate sleep quality, depression and anxiety symptoms, social support and hope. Risk factors significantly associated with sleep disturbance during bivariate were incorporated in the multivariate analysis. Bivariate analyses showed that age, menopausal status, depression and anxiety symptoms, emotional/informational support, tangible support, affectionate support, positive social interaction and total support were predictors of sleep disturbance. Results: Sleep disturbance was prevalent in breast cancer patients before (27.0%), during (32.5%) and after (39.2%) chemotherapy, with 37.4%, 41.9% and 52.6% of participants, respectively, reporting sleeping below the recommended 7 h. Only 8.6%–15.5% of patients reported taking sedative‐hypnotic drugs during the chemotherapy. Multivariate analyses found that participants reporting clinically significant anxiety (HADS > 8) were 3.5 times more likely to report sleep disturbance (PSQI > 8) than participants without clinically significant anxiety, and each increment in emotional/informational support was associated with a 9.04% reduced risk of sleep disturbance. Moreover, age was an independent predictor of sleep disturbance during multivariate modelling. [ABSTRACT FROM AUTHOR]

There is growing, but inconsistent evidence suggesting oestrogen may play a key role in lung cancer development, especially among never‐smoking women for whom lung cancer risk factors remain largely elusive. Using the China Kadoorie Biobank, a large‐scale prospective cohort with 302 510 women aged 30 to 79 years recruited from 10 regions in China during 2004 to 2008, we assessed the risk of lung cancer death among self‐reported never‐smoking women who were cancer‐free at baseline, in relation to age at menarche, age at menopause, time since menopause, prior use of oral contraceptives (OCP), number of livebirths, breastfeeding and age at first livebirth. Women were followed up to December 31, 2016 with linkage to mortality data. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression, adjusting for key confounders including several socio‐demographic, environmental and lifestyle factors. Among 287 408 never‐smoking women, 814 died from lung cancer with a median follow‐up of 10.3 years. Women who had used OCP within 15 years prior to baseline had a significantly higher hazard of lung cancer death compared with never‐users: HR = 1.85 (95% CI: 1.14‐3.00) and risk increased by 6% with each additional year of use: HR = 1.06 (1.01‐1.10). Among parous women, the hazard of lung cancer death increased by 13% with each single livebirth: HR = 1.13 (1.05‐1.23); and among post‐menopausal women, the risk increased by 2% with each year since menopause: HR = 1.02 (1.01‐1.04). These results suggest that reproductive factors which were proxies for lower endogenous oestrogen level, for example, longer duration of OCP use, could play a role in lung cancer development. [ABSTRACT FROM AUTHOR]

• Female sexual dysfunction is one of the most common symptoms in aging women. • The relationship between serum androgen levels and female sexual dysfunction is controversial. • Liquid chromatography mass spectrometry is the best way to assess serum androgens. • The intensity of climacteric symptoms significantly affects women's sexual function. • A low education level was found to be a risk factor for female sexual dysfunction in China. The aim of this study was to investigate the factors affecting the sex lives of postmenopausal Chinese women, especially the influence of body weight, climacteric symptoms and androgens. A total of 437 postmenopausal women were investigated in the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University and two allied medical institutions from April 2020 to March 2021. Sociodemographic data were collected. Female sexual dysfunction was evaluated using the Female Sexual Function Index (FSFI). The modified Kupperman index was used to assess climacteric symptoms. Methods based on liquid chromatography-tandem mass spectrometry were employed to measure the serum levels of total testosterone, bioavailable testosterone, free testosterone, androstenedione and dehydroepiandrosterone. Pearson's correlation coefficient and multiple linear regression analyses were performed to determine the correlation between characteristics and FSFI scores. The multivariate linear regression analysis revealed that the modified Kupperman index score and the factor unsatisfactory marital relations had the strongest negative correlations with all FSFI domains (P < 0.05); secondary education level was negatively associated with desire, arousal and orgasm (P < 0.05). Total testosterone positively affected the score for pain (P < 0.05). There was no correlation between bioavailable testosterone, free testosterone, androstenedione and dehydroepiandrosterone and all FSFI domains (P > 0.05). Climacteric symptoms and sociodemographic factors had a notable effect on sexual function. It is necessary to provide more attention to and intervention for their climacteric symptoms to improve the quality of life of postmenopausal women. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between physical activity and the severity of menopausal symptoms in middle-aged women in northwest China. Methods: This was a cross-sectional online survey study. Using a snowball sampling method, 468 women aged 45 to 60 were recruited from northwest China and their demographic information was collected. The modified Kupperman Menopausal Index scale and International Physical Activity Questionnaire short form were used in this study. Random forest was used to rank the importance of variables and select the optimal combination. The direction and relative risk (odds ratio value) of selected variables were further explained with an ordinal logistic regression model. Results: The prevalence of menopausal syndromes was 74.8% and more than one-half of the participants had moderate or severe symptoms (54.3%). The Mantel-Haenszel linear-by-linear chi-square test showed a strong and negative correlation between physical activity level and the severity of menopausal symptoms (P < 0.001). Random forest demonstrated that the physical activity level was the most significant variable associated with the severity of menopausal symptoms. Multiple random forest regressions showed that the out-of-bag error rate reaches the minimum when the top 4 variables (physical activity level, menopausal status, perceived health status, and parity) in the importance ranking form an optimal variable combination. Ordinal logistic regression analysis showed that a higher physical activity level and a satisfactory perceived health status might be protective factors for menopausal symptoms (odds ratio (OR) < 1, P < 0.001); whereas perimenopausal or postmenopausal status and 2 parities might be risk factors for menopausal symptoms (OR > 1, P < 0.001). Conclusions: There is a strong negative correlation between physical activity and the severity of menopausal symptoms. The results have a clinical implication that the menopausal symptoms may be improved by the moderate-to-high level physical activity in the lives of middle-aged women. [ABSTRACT FROM AUTHOR]

Background: Menopausal women are regarded as "abnormal people" in China and are often discriminated against and ostracized, especially in the privacy of their homes. However, research on the stigmatization of menopausal women in China is limited. The aim of this study is to explore and describe the stigmatization experiences of Chinese menopausal women in the family and their feelings about these experiences. Methods: A phenomenological qualitative research design involving in-depth semi-structured interviews was selected. Our data analysis adopted Colaizzi's methodology. Results: Fourteen menopausal women participated in this study. Four themes and 12 subthemes emerged: (1) violent treatment (verbal and physical violence); (2) lack of attention and companionship (lack of understanding of physical and psychological suffering, neglect of the value of labour and difficulty finding someone to talk to and accompany them); (3) coping struggles (keeping quiet, fighting back, changing inappropriate perceptions and developing a menopausal transition management plan); and (4) despair (deep-rooted perceptions, restrictions on travel and consumption, and unknown "healing" times). Conclusion: Our results suggest that Chinese menopausal women suffer physically and mentally within their families. The stigma of menopause is both a symptom of the broad societal lack of knowledge regarding menopause and a reflection of the patriarchal oppression of women in a specific cultural context. Accordingly, this study can help menopausal women and society in general better understand the former's stigmatization experiences and amplify their inner voices. Moreover, it can serve as a reference for the formulation of menopause-related health policies in China and for advocating and promoting humanistic care for menopausal women. [ABSTRACT FROM AUTHOR]

Objectives To identify genetic variants and polygenic risk score (PRS) relating to female gout and asymptomatic hyperuricaemia (AH) in a genome-wide association study (GWAS). Methods Gout, AH and normouricemia controls were included from Taiwan biobank and China Medical University Hospital. All participants were divided into discovery and replication cohorts for GWAS. PRS was estimated according to whether the variant exhibited a protective effect on the phenotypes or not. Each cohort was separated into two groups by the age of 50 years old. Results A total of 59 472 females were enrolled, and gout and AH occupied 1.60% and 19.59%, respectively. Six variants located in genes SLC2A9 , C5orf22 , CNTNAP2 and GLRX5 were significantly predictors of female gout in those aged ≥50. For those aged <50 years old, only the variant rs147750368 (SPANXN1) on chromosome X was found. Most variants located in genes SLC2A9 , ZNF518B , PKD2 and ABCG2 were found to be significantly related to AH in both age groups. The PRS could explain ∼0.59% to 0.89% of variance of gout in variants with protective effects, which showed 6.2 times of mean PRS in the risk variants, but only 1.2 times in the AH phenotype. Moreover, the PRS also revealed a dose-response trend between AH rates and quartile scores. Conclusion The variants in gene SLC2A9 are the major genetic factors for females associated with gout in those aged ≥50. PRS can provide a more robust prediction of the gout/AH under a homogeneous selection of variants that show effects on the traits. [ABSTRACT FROM AUTHOR]

Background: Peri-menopausal syndrome (PMPS) has a high incidence rate and seriously affects the physical and mental health of women. Honghua Xiaoyao Pill (HHXYP) is a Chinese patent medicine, which has been reported to be used to treat PMPS. However, there is still a lack of randomized clinical trial to evaluate the efficacy and safety of HHXYP on life quality, mood and vasomotor symptoms for PMPS women. This study aims to investigate whether HHXYP is effective and safe in treating PMPS and the possible mechanism. Methods: A multicenter, randomized, controlled clinical trial will be conducted in China to evaluate the efficacy and safety of HHXYP. Sixty women with perimenopausal syndrome will be recruited at three centers and randomly in a 1: 1 ratio to a treatment group using HHXYP (HHXYP group) and a control group using oryzanol (OC group). Participants will be treated with HHXYP or oryzanol for 12 weeks and followed up for 4 weeks. The primary outcome is the modified Kupperman Index (KI), which will be measured at baseline and 4, 8, 12, 16 weeks after randomization. The secondary outcomes include Hot flash scale (HFs), Menopause-Specific Quality of Life Scale (MENQOL) and Hamilton Depression/ Anxiety Scale (HAMD/HAMA). The HFs are measured at the same point as the KI, other secondary outcomes are measured at baseline and 12, 16 weeks after randomization. The other outcomes are the levels of serum sex hormone, monoamine neurotransmitter, vascular vasomotor factor and the expression of phosphatidylinositol 3-active enzyme (PI3K)/protein activator enzyme B (Akt), which will be measured at baseline and 12 weeks after randomization. Adverse events will also be reported. Discussion: HHXYP is a potential alternative Chinese patent medicine for PMPS. This trial will provide evidence for HHXYP on improving the quality of life, mood and vasomotor symptoms, and sex hormone levels of PMPS patients. [ABSTRACT FROM AUTHOR]

Aim: This study aims at understanding mammographic density profile in China by comparing the density between women in China and Australia. Methods: Data of 3250 women aged 45–69 were obtained from the Cancer Screening Program in Urban China and data of 1384 Australian counterparts at same age range were gathered from the Lifepool project. Demographic and reproductive details and mammograms for each cohort were collected. Mammographic density was assessed using AutoDensity, and two metrics, percentage density (PD) and dense area (DA), were applied. T‐tests were used to compare the means of mammographic density between two populations of all, premenopausal, and postmenopausal women. Two‐way ANOVA was conducted to examine interactions of population (Chinese/Australian) and each variable of interest upon mammographic density. Results: Chinese women had 9.61%, 8.20%, and 9.28% higher PD than their Australian counterparts in all, premenopausal, and postmenopausal women, respectively (all p < 0.001). The mean differences in DA between two population were 1.81 cm2 (p < 0.001), 0.55 cm2 (p = 0.472), and 1.76 cm2 (p = 0.003) for all, premenopausal, and postmenopausal women, respectively. There were significant interactions between population and age (F[4, 4624] = 4.12, p = 0.003), BMI (F[2, 4628] = 3.92, p = 0.020), age at first birth (F[1, 4250] = 11.69, p < 0.001), breastfeeding history (F[1, 4479] = 17.79, p < 0.001), and breastfeeding duration (F[1, 3526] = 66.90, p < 0.001) upon PD. Interaction was only found for breastfeeding history (F[1, 4479] = 4.79, p = 0.029) and breastfeeding duration (F[1, 3526] = 17.72, p < 0.001) for DA. Conclusions: Both PD and DA were found to be higher in Chinese women compared to Australian women. The density difference by menopause status was shown and breastfeeding history affected breast density differently in both populations. [ABSTRACT FROM AUTHOR]

Background: Yin Huo Tang (YHT), a traditional Chinese herbal formula, is effectively used for the clinical treatment of menopause-like symptoms in China. This study aimed to investigate its efficacy on menopause-like symptoms in mice using behavioral tests and histopathological assessment, and to determine its possible mechanism of action based on network pharmacology. Methods: Liquid chromatography-mass spectrometry (LC-MS) technology was used to identify the potential active ingredients of YHT. In mice, menopause-like symptoms were induced by combination of bilateral ovariectomy and empty bottle stimulation. The mice were then treated with the YHT aqueous extract for three weeks. Behavior, sleep state, body weight, organ index, and histomorphology were analyzed separately. Additionally, network pharmacology and molecular docking were used to predict the mechanisms underlying the action of YHT. Finally, serum estradiol was quantified to preliminarily verify the results of network pharmacology. Results: YHT not only improved the behavior of mice (attack and explore behavior reduced; modify behavior increased) but also ameliorated the sleep state (sleep time increased and incubation time reduced). YHT reduced body weight, increased uterine weight, and improved the histomorphology of some organs. Network pharmacology and molecular docking analyses revealed that the estrogen signaling pathway might play a key role in attenuating menopause-like symptoms. Furthermore, YHT treatment reversed the reduction in serum estradiol levels. Conclusions: YHT alleviates menopause-like symptoms in a mouse model, providing a rationale for using it as a potential therapeutic strategy. [ABSTRACT FROM AUTHOR]

Our aim is to evaluate the efficacy of bazedoxifene (BZA) plus conjugated estrogens (CE) on menopausal symptoms in postmenopausal women. A series of databases including PubMed, EMBASE, Medline, Web of science, China national knowledge internet and Wanfang database up to 31 October 2021 were searched, and randomized controlled trials (RCTs) of BZA/CE for menopausal symptoms were included. Seven RCTs involving 5431 patients were included in this study. Compared with placebo group, there were significantly reduce in daily number of hot flushes, daily number of moderate or severe hot flushes, the percentages of parabasal cells and the time to fall sleep when patients treated with BZA/CE. Besides, there were significant improvement in sleep disturbance and total MENQOL. However, no significant improvements in sleep adequacy were observed in the three groups. Furthermore, BZA 20 mg/CE 0.625 mg was more effective than BZA 20 mg/CE 0.45 mg in improving the menopausal symptoms. Therefore, both bazedoxifene 20 mg plus conjugated estrogens 0.45 mg and bazedoxifene 20 mg plus conjugated estrogens 0.625 mg could significantly improve the menopause-related symptoms and MENQOL in postmenopausal women, and the curative effects of BZA 20 mg/CE 0.625 mg were better than that of BZA 20 mg/CE 0.45 mg. These findings need to be further confirmed by more high-quality RCTs. [ABSTRACT FROM AUTHOR]

The study examined the relationship between menopausal symptoms and sleep disturbances and the related influencing factors. Methods. We recruited women aged 40-65 years who attended the menopause clinic at Shanghai Jiao Tong University's Sixth People's Hospital from February 2011 to November 2019. The Menopause Rating Scale (MRS) was used to collect women's menopausal symptoms, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the subjects' sleep condition. We used logistic regression models to identify the relationship between menopausal symptoms and sleep quality. Results. A total of 1341 participants were recruited in this study. The most frequent three symptoms assessed by MRS were fatigue (72.9%), sleep disturbance (67%), and hot flashes with night sweats (65%). Participants' age was significantly associated with the severity of menopausal syndrome (P < 0.01). According to the PSQI sleep evaluation, 66.9 percent of participants had sleep disturbances (PSQI > 5). Logistic regression analysis revealed that women with mild, moderate, or severe menopausal syndrome had a 3-, 7-, and 17-fold increased chance of having sleep disturbances compared to women without menopausal syndrome. Conclusion. Women aged 40–65 years were found to have a significantly higher risk of menopausal syndrome and sleep disturbances. [ABSTRACT FROM AUTHOR]

Introduction: Little information on rural older women in northern China has been reported, apart from three studies in southern and eastern China in the past decade. This study aims to evaluate the relationships between reproductive factors and the risk of cognitive impairment, including mild cognitive impairment (MCI) and dementia, in Chinese women with natural menopause. Methods: The cross-sectional study was conducted in 112 community primary healthcare centers in rural northern China between April 2019 and January 2020. A total of 4,275 women aged =65 years who had natural menopause were included. Reproductive factors as well as the reproductive period (= age at menopause - age at menarche) were recorded. The relationships between reproductive factors and cognitive impairment were evaluated by correlation and logistic regression analysis. Results: Overall, 28.6% and 11.4% of women were diagnosed with MCI or dementia, respectively. In natural menopause women, the age at menopause (adjusted r = 0.070, p < 0.001), reproductive period (adjusted r = 0.053, p = 0.001), and number of pregnancies (adjusted r = -0.042, p = 0.007) and parities (adjusted r = -0.068, p < 0.001) were correlated with Mini-Mental State Examination (Chinese version) scores, and with similar findings concerning MCI and dementia with Lewy bodies (DLB). Greater age at menopause and a long reproductive period significantly decreased the risk of MCI and Alzheimer's disease (AD), and more parities significantly increased the risks of MCI (odds ratio (OR) = 1.111, 95% confidence interval (CI): 1.039-1.187, p = 0.002), dementia (OR = 1.162, 95% CI: 1.061-1.271, p = 0.001), particular AD (OR = 1.131, 95% CI: 1.010-1.266, p = 0.032), DLB (OR = 1.238, 95% CI: 1.003-1.528, p = 0.047), and vascular dementia (VaD) (OR = 1.288, 95% CI: 1.080-1.536, p = 0.005). Conclusions: The prevalence rates of MCI and dementia were 28.6% and 11.4% in older women. Greater age at menarche, young age at menopause, shorter reproductive period, and larger numbers of pregnancies/parities were correlated with poor cognition and significantly increased the risks of MCI and dementia, particularly AD, DLB, and VaD. [ABSTRACT FROM AUTHOR]

Background: Menopause significantly impacts the immune system. Postmenopausal women are more susceptible to infection. Nonetheless, the pattern of change in peripheral white blood cell counts around the menopause remains poorly understood., Methods: We conducted a prospective longitudinal cohort study with repeated measurements using Kailuan cohort study of 3632 Chinese women who participated in the first checkup (2006-2007) and reached their final menstrual period (FMP) by the end of the seventh checkup (2018-2020). Peripheral WBC count indicators included total white blood cells (TWBC), neutrophils (NEUT), lymphocytes (LYM), and monocytes (MON). Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of WBC count indicators as a function of time before or after the final menstrual period (FMP). Interaction and subgroup analysis were used to explore the effects of age and body mass index (BMI) on changes in WBC indicators around FMP., Results: WBC count indicators decreased before the FMP, and the reduction in TWBC, NEUT, and MON continued for 2 years following the FMP. LYM and NEUT declined during < -1 years and - 4 ∼ + 2 years relative to FMP, respectively. A reduction in MON was observed pre-FMP, extending continuously through the two-year period post-FMP. TWBC declined from - 3 to + 2 years relative to FMP, but both MON and TWBC increased during > + 2 years. The baseline age had an interaction effect on changes in WBC indicators during specific menopausal stages, except for TWBC. Individuals in different age subgroups showed distinct trajectories for NEUT, LYM and MON around the FMP. High baseline BMI had a synergistic effect on changes in specific menopause segments for TWBC, LYM, and MON. The impact of menopause on TWBC and LYM was postponed or counterbalanced in high BMI individuals. Individuals in three BMI subgroups experienced similar MON changes around FMP, and there were slight variations during < -4 years., Conclusions: Menopause was associated with count changes of peripheral WBC. The trajectories of various WBC types differ around menopause. Age and BMI affected WBC trajectory around menopause. The menopause period may represent a window of opportunity to promote immune health in middle-aged women., (© 2024. The Author(s).)

Objective: This study aimed to examine the association between severity of menopausal symptoms and cardiovascular disease (CVD) risk among middle-aged Chinese women., Methods: A cross-sectional study recruited 9679 women aged 40-70 years from three socioeconomic regions of China in 2018. Menopausal symptoms were assessed by the modified Kupperman Menopausal Index (KMI). The severity of individual symptoms was classified as none (0 points), mild (1 points) and moderate-to-severe symptoms (2-3 points), and overall menopausal symptoms were classified as none (<15 points), mild (15-24 points) or moderate-to-severe (≥25 points) according to the sum score of the KMI. Logistic regression models were used to examine associations of the severity of menopausal symptoms with CVD risk., Results: A total of 5.6% of participants reported being diagnosed with CVD. Overall menopausal symptoms were more common in women aged 60-70 years than in women aged 40-59 years. After multiple adjustment, mild (odds ratio [OR] = 2.07, 95% confidence interval [CI]: 1.64-2.61) and moderate-to-severe (OR = 2.64, 95% CI: 1.92-3.63) overall menopausal symptoms were associated with increased risk of CVD compared with no symptoms. Significant positive associations between the severity of individual menopausal symptoms and CVD risk were observed for all 13 items., Conclusion: The severity of menopausal symptoms was positively associated with CVD risk in middle-aged Chinese women.

Objective: More than 2 billion women are experiencing menopause transition in China and some of them suffered from depression; while the risk factors of depression during menopause transition were still unclearin China. We aimed to investigate the risk factors in mid-life women in Southeast China.Method: This study included 1748 Chinese women aged 40-65 years-old who visited gynecology outpatient department of Women's hospital School of Medicine, Zhejiang University during 2010-2018. Demographic information was collected, and the modified Kupperman Menopausal Index (mKMI) and Hamilton Rating Scale for Depression were assessed. Circulating levels of sex hormones were tested. Ordinal logistic regression analysis was performed to identify risk factors for depression.Results: The prevalence of depression symptoms was 47.43%. The majority of women had mild (38.56%) or moderate depressive symptoms (8.00%); only 0.86% had severe depressive symptoms. Compared with perimenopausal women, postmenopausal women had increased risks of more severe depression. The associations between menopausal syndromes and the intensity of depression were strongly positive (OR 6.69, 95% CI 5.39-8.29). Elder age, higher follicle stimulating hormone levels, lower estradiol levels, and fewer parity were positively related with the intensity of depression. Among postmenopausal women, underweight, mKMI > 14, earlier age at menopause, shorter reproductive period, and longer duration after menopause were risk factors for incresed intensity of depression.Conclusions: The results demonstrated a high proportion of depression in women complaining of menopause. Menopausal symptoms were strongly related to the intensity of depression. In postmenopausal women, estrogen related events are associated with the intensity of depression. Gynecological endocrinologists in China should consider screening for depression in high-risk women. [ABSTRACT FROM AUTHOR]

Background: Existing studies on the association of age at menarche and age at natural menopause with diabetes are conflicting. Objective: To explore the associations of age at menarche and age at natural menopause with diabetes, and to estimate whether body mass index, abdominal obesity, hypertension, and dyslipidemia would influence the relationships. Methods: In this cross‐sectional study, 5090 postmenopausal women were included from the China Multi‐Ethnic Cohort Study (CMEC) baseline in Chongqing province. Questionnaires, physical examinations, and biological samples testing were conducted. Logistic regression was used to generate odds ratios (ORs) and 95% confidence intervals (CIs). And restricted cubic splines were performed to evaluate the pattern of association between ages at menarche and menopause with diabetes. Results: The adjusted ORs for diabetes grouped by age at menarche (<12, 12–17, >17 years) were 0.76 (95%CI: 0.42–1.40), 1.00 (reference), and 0.73 (95%CI: 0.57–0.94). Similarly, the adjusted ORs for diabetes grouped by age at menopause (<44, 44–52, >52 years) were 1.38 (95%CI: 1.04–1.82), 1.00 (reference), and 1.11 (95%CI: 0.89–1.39). No significant interaction of age at menarche and menopause with body mass index, abdominal obesity, hypertension, and dyslipidemia in odds of diabetes was observed. Conclusion: Late menarche is associated with a lower prevalence of diabetes, while early natural menopause is associated with a higher prevalence of diabetes. No significant effect modification was observed by body mass index, abdominal obesity, hypertension, or dyslipidemia. [ABSTRACT FROM AUTHOR]

Study Question: Are there genetic variants that interact with smoking to reduce reproductive lifespan in East-Asian women?Summary Answer: Our study corroborates several recently identified genetic loci associated with reproductive lifespan and highlights specific genetic predispositions that may interact with smoking status to adversely affect reproductive lifespan in East-Asian women.What Is Known Already: Epidemiological data as well as evaluations on genetic predisposition to smoke indicate on the importance of smoking in adverse effects on reproductive lifespan in women. However, there are no previous smoking and gene interaction studies for reproductive traits in East-Asian women.Study Design, Size, Duration: This population-based prospective cohort study comprised 11 643 East-Asian Chinese women with overlapping genome-wide genotyping and reproductive data.Participants/materials, Setting, Methods: We performed a genome-wide association study for reproductive lifespan in women (n = 11 643) from the Singapore Chinese Health Study (SCHS) and carried out a genome-wide interaction study to identify loci that interacted with smoking status to affect age of natural menopause and reproductive-time.Main Results and the Role Of Chance: Two known loci associated with menopause, rs113430717 (near HMCES, chromosome 3, Pmeta = 5.72 × 10-15) and rs3020136 (near RAD21, chromosome 8, Pmeta = 1.38 × 10-8) were observed beyond genome-wide levels of association with age at menopause in this study. For reproductive lifespan, the genome-wide association observed at rs79784106 (chromosome 3, Pmeta = 5.05 × 10-12) was in linkage disequilibrium with the menopause lead single-nucleotide polymorphism (SNP) (rs113430717). Four additional loci, first reported to be associated with menopause, were also associated with reproductive lifespan in our study (PAdj between 7.42 × 10-5 to 4.51 × 10-3). A significant interaction was observed between smoking and an East-Asian specific SNP, rs140146885, for reduced reproductive lifespan, per copy of the minor C allele (beta = -1.417 years, Pinteraction = 2.31 × 10-10). This interaction was successfully replicated in additional independent samples (beta = -1.389 years, Pinteraction = 6.78 × 10-3). Another known variant associated with menopause, rs11031006 (near FSHB), was also observed to interact with smoking status to reduce age at menopause in our dataset (beta = -0.450 years, Padj = 0.042).Limitations, Reasons For Caution: The modest sample size of the replication datasets used likely affected the statistical power to firmly replicate all identified novel loci observed in our smoking interaction analyses.Wider Implications Of the Findings: Age of natural menopause and reproductive lifespan have clear genetic predispositions with distinct ethnic differences, and they may be adversely truncated by lifestyle factors such as smoking, which can pose a significant impact on the reproductive lifespan and future health outcomes in women.Study Funding/competing Interest(s): The Singapore Chinese Health Study is funded by the National Medical Research Council, Singapore (NMRC/CIRG/1456/2016), National Institutes of Health (R01 CA144034 and UM1 CA182876) and National Research Foundation, Singapore (Project Number 370062002). W.-P.K. is supported by the National Medical Research Council, Singapore (MOH-CSASI19nov-0001). The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The authors do not report conflicts of interest.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Background: Strong evidence has linked overweight and obesity to increased risks of cardiovascular disease and all-cause mortality in Chinese populations. Menopause is considered associated with increased obesity and central body fat distribution. However, the correlation between obesity and menopausal symptoms has not been well studied. Objective: To examine the associations between obesity or abdominal obesity and menopausal symptoms as women progressed from premenopausal to postmenopausal status. Design: This study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. Physical examinations and questionnaires should be completed annually. The questionnaires include the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors. Results: Among women who were not obese (n=345) or not abdominal obese (n=372) at baseline, 5.8% and 31.7% became obese or abdominal obese at the recent follow-up visit, respectively. Women at the recent follow-up visit had an increased body mass index (BMI) by 0.14%, and the waist-to-hip ratio (WHR) increased by 5.2% compared with the data at baseline. In multivariate analysis, more frequent hot flashes, moderate/severe bothered vasomotor symptoms (VMS), mild bothered sexual functioning, and less anxiety symptoms were significantly associated with obesity. Increasing age, moderate/severe bothered VMS, and less anxiety symptoms were independently associated with abdominal obesity. Multivariable analysis also showed that less education level is independently associated with both obesity and abdominal obesity. Conclusion: Our findings suggest that the proportion of obesity and abdominal obesity increased gradually during menopause. The increase of abdominal obesity is more rapidly than obesity in middle-aged women. Both obesity and abdominal obesity are related with severe or frequent VMS and anxiety symptoms in Chinese women. Although the proportion of obese women in China is lower than in western countries, the problem of abdominal obesity and related complications cannot be ignored. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) persistence is the most critical cause of cervical cancer. This study focuses on exploring the prevalence and risk factors related to persistent HPV infection among rural Chinese women. Participants were recruited through a multi-stage stratified cluster sample. A total of 847 women were initially selected in 2015, and 159 were detected HPV-DNA positive at baseline. A two-year follow-up was conducted for those who were HPV-DNA positive at baseline. HPV infection was evaluated at both baseline and follow-up. Depending on the results of two HPV tests, women were divided into two categories: (1) persistence; (2) clearance. Student's t, chi-square and logistic regression were employed to find the risk factors for HPV persistence and the relationship between HPV persistence and cervical intraepithelial neoplasia (CIN). Among 129 participants with HPV16/18 infection at baseline, 60 (46.51 percent) were reported to have persistent HPV16/18 infection. Oral contraceptive use and menopause were the significant factors related to persistent HPV16/18 infection. The persistence of HPV infection was significantly related to CIN. Our results indicate that better HPV prevention strategies for rural Chinese women should be developed. [ABSTRACT FROM AUTHOR]

Background: Menopause characteristics have been implicated in future health consequences, yet little is known about its relevance to diabetes. We examined the associations of menopausal status and age at natural menopause with diabetes risk in Chinese women. Methods: We used prospective data of the China Kadoorie Biobank study that recruited 302,522 women aged 30–79 years in 2004–2008 from 10 areas across China. During average 10.8 years of follow-up, 11,459 incident diabetes cases were recorded among 281,319 women without prior diabetes diagnosis at baseline. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for incident diabetes associated with menopausal status and age at natural menopause. Results: Overall, the mean (SD) age at natural menopause was 48.2 (4.4) years among 141,789 post-menopausal women. Naturally peri-, or post-menopausal women were at higher risk of diabetes, with HRs of 1.17 (95% CI 1.06–1.29) and 1.15 (1.06–1.25) compared with pre-menopausal women, adjusting for several potential confounders. Among women who had natural menopause, the HR of diabetes was 1.14 (1.01–1.30), 1.01 (0.93–1.09), 1.10 (1.04–1.16), and 1.10 (1.01–1.20) for menopause at ages less than 40, 40–44, 50–53, and 54 years or older, respectively, relative to 45–49 years. Conclusions: In this study, we found that women with naturally peri-, or post-menopausal status had higher risk of developing diabetes. Besides, among the post-menopausal women, both earlier and later age at natural menopause were associated with increased risk of diabetes. [ABSTRACT FROM AUTHOR]

Background: Nursing staff are on the front line of providing healthcare that addresses patients' needs. Sleep quality is highly related to work performance and quality of life among nurses. Aims: This study aimed to examine the influence of sociodemographic variables, menopause syndrome, and health‐promoting behaviors on sleep quality in a sample of middle‐aged nurses in China. Methods: A cross‐sectional design was employed. A consecutive sample of 424 nurses was recruited from a university‐affiliated hospital in Bengbu, China. Self‐reported, structured questionnaires, including sociodemographic surveys, the Kupperman Menopausal Index, the Health Promoting Lifestyle Profile II, and the Pittsburgh Sleep Quality Index, were administered between October 2018 and July 2019. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Results: Study participants had a mean sleep quality level of 5.30 points (SD = 3.16), indicating potential sleep problems. The results of regression models showed that menopause syndrome and spiritual growth were important predictors of sleep quality for premenopause, perimenopause, and postmenopause groups. Conclusion: Middle‐aged nurses with more severe menopause syndrome and less spiritual growth might experience worse sleep quality. Relevance to clinical practice: This study highlights important factors influencing the level of sleep quality in Chinese middle‐aged nurses. Identifying the factors that are associated with sleep quality may help with the development of proper interventions. [ABSTRACT FROM AUTHOR]

Introduction: Premature ovarian insufficiency (POI) seriously affects the quality of life, endocrine function, and fertility of women of childbearing age. Currently, hormone replacement therapy for POI has some limitations, either with low efficacies or high side effects. Bushen Huoxue (BSHX) plays an important role in alleviating clinical symptoms and improving health status of POI patients. This placebo-controlled, randomized, double-blind, and multicenter clinical trial protocol aims to evaluate the effectiveness and safety of BSHX in women with POI.Methods and Design: We plan to recruit 150 women with POI from four participating hospitals in China. Participants will be randomized in a 1:1 to receive oral BSHX or BSHX placebo. All participants will be treated for 3 months and will be followed up for another 3 month. The primary outcome is questionnaire scores based on the changes in the total symptoms, which is the Chinese version of the Menopause-Specific Quality of Life (CMS) (Nie G, Yang H, Liu J, Zhao C, Wang X, Menopause 24(5):546-554, 2017). CMS will be measured before the intervention, at 3 months and 6 months after randomization for all participants. The other measurements include serum sex hormone levels, anti-Müllerian hormone (AMH) levels, ovarian peak systolic velocity (PSV; cm/s), and antral follicle count (AFC). In this study, the regulatory effects of traditional Chinese medicine on hormones were evaluated by the changes of serum sex hormone levels, which include serum estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH). These indicators will be measured before intervention and at 3 months after randomization.Ethics and Dissemination: This study was approved by the Research Ethics Committee of Jiangsu Province Hospital on Integration of Chinese and Western Medicine (2019LWKY014). All participants will provide written informed consent prior to randomization. The results of this research will be presented to academic conferences and peer-reviewed journals.Trial Registration: ChiCTR1900028451. Registered on 22 December 2019, https://www.chictr.org.cn/index.aspx . [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate age- and menopause-related differences in bone mineral density (BMD), bone structure and estimated bone strength at surgical neck of humerus in Chinese female sample., Methods: We conducted a cross-sectional cohort study of 171 Chinese women. Bone mass, indices of geometric properties and estimated mechanical strength of the surgical neck were evaluated by quantitative computed tomography (QCT). Comparisons were performed across menstrual status categories. Age-related changes in QCT-derived bone parameters were calculated., Results: The age-related difference of BMD and cortical thickness was 40.25 % and 32.86 % between the age of 20 and 86 years. Progressive periosteal and endosteal expansion was associated linearly with age. Estimated mechanical strength indexes showed significant quadratic associations with age, with their peak occurred at the age of 46-55 years. The quartile of women with the greatest medullary diameter also had the lowest valve of BMD and cortical thickness and the greatest in skeletal width. Compared to premenopausal individuals, perimenopausal women were distinguished by lower cortical thickness (18.63 %) and BMD (20.05 %). The continued decrease in cortical thickness and BMD was noted after menopause. The medullary and periosteal diameter increased by 17.98 % and 9.34 % respectively in perimenopausal period, but not after menopause. The accelerated loss of the maximum and polar section modulus was observed in late postmenopausal women., Conclusions: The increase in bone size only occurred during the menopause transition. Obvious loss of resistance to bending was in late postmenopausal period., Competing Interests: Declaration of competing interest Yeming Wang, Jian Li, Yutao Men and Wanfu Wei declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Vulvovaginal atrophy (VVA) includes a wide range of conditions affecting the reproductive and urinary systems, often requiring careful evaluation and management for optimal health., Aims: This study aims to evaluate the symptom management effects of a real time temperature-monitored non-ablative RF device for the treatment of postmenopausal Chinese women with VVA symptoms., Methods: This pilot study involved 24 postmenopausal Chinese women with one or more VVA symptoms, who wished to remain sexually active. VHIS, VAS, and FSFI were used to track and evaluate various aspects of the patient's condition. Analyses were conducted at the end of the study to verify the statistical significance of the treatment's results., Results: All patients reported substantial, statistically significant, improvements on every VVA symptom tracked. Approximately 80% of the patients reported total symptom reversal at 12-week post-treatment follow-up., Conclusion: This pilot study demonstrated that non-ablative, monopolar RF technology equipped with real time temperature monitoring is feasible and safe in the treatment of postmenopausal women with VVA symptoms, and efficacious at up to 12 weeks post-treatment., (© 2024 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Background: This study aimed to delineate the association between menopausal-related symptoms and brain cortical hemodynamics in peri-postmenopause women., Methods: Cross-sectional data from a total of 358 Han-Chinese women who visited the Menopause Clinic in the Shanghai Sixth People's Hospital from August 2019 to August 2022. Menopausal-related symptoms were analyzed through Kupperman index (KMI) scale and PSQI scale, while cerebral blood flow was measured using a functional near-infrared spectroscopy (fNIRS). Multiple linear regression model was used to assess the risk factors for subregions of brain hemodynamic response., Results: After adjusting for confounding factors, we identified that menopausal symptom (B = -1.575, 95 % CI (-2.661, -0.488), p = 0.005) and duration of menopause (B = -14.583, 95 % CI (-26.753, -4.192), p = 0.007) were independently associated with the lower brain hemodynamic response in the prefrontal lobe, while in the temporal lobe, overweight (BMI ≥ 24 kg/m 2 ) was negatively associated with the lower brain cortical activity (B = -36.882, 95 % CI (-72.708, -1.056), p = 0.044) after adjusting for other confounding variables., Conclusions: Our findings proposed that menopausal symptom and overweight should be attached great importance to the postmenopausal women, which provides clinical evidence for the feasible early detection and effective prevention such as menopausal hormone therapy (MHT) of brain health in postmenopausal women., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest regarding the publication of this article., (Copyright © 2023. Published by Elsevier B.V.)

Purpose: This study aimed to assess the potential association between blood pressure and osteoporosis in a rural population with limited resources. Existing evidence on this association is limited, particularly in such settings., Methods: Data from 7,689 participants in the Henan Rural Cohort study were analyzed. Four blood pressure indicators [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP)] were measured. The logistic regression model and restricted cubic spline plots were used to assess the relationship between blood pressure indicators and osteoporosis prevalence., Results: Positive trends were noted between blood pressure indicators and osteoporosis prevalence in the entire group and women ( P trend < 0.05 for SBP, MAP, and PP). Women with higher SBP and PP exhibited elevated odds of osteoporosis compared with those with the lowest SBP and PP ( OR s ranging from 1.15 to 1.5 for SBP and 1.06 to 1.83 for PP). No such associations were found in men. These relationships were only evident in postmenopausal women. Dose-response analysis confirmed these findings. Excluding participants taking hypertension medication did not alter the results., Conclusion: In resource-limited settings, higher SBP and PP are associated with the increased prevalence of osteoporosis in women, potentially influenced by menopause-related factors. This indicates that potential gender-based differences and social inequalities may affect bone health., Clinical Trial Registration: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Jin, Zhao, Jin, Yi, Liu, Wang, Zhang and Pan.)

Objective: We aimed to assess long-term safety and tolerability of fezolinetant, a nonhormonal neurokinin 3 receptor antagonist, among Chinese women with vasomotor symptoms associated with menopause participating in the MOONLIGHT 3 trial., Methods: In this phase 3 open-label study, women in menopause aged 40-65 years received fezolinetant 30 mg once daily for 52 weeks. The primary endpoint was frequency and severity of treatment-emergent adverse events (TEAEs), assessed at every visit through week 52 and one follow-up visit at week 55., Results: Overall, 150 women were enrolled (mean age, 54 years) and 105 completed treatment. The frequency of TEAEs was 88.7%. Most TEAEs were mild (63.3%) or moderate (22.7%). The most common TEAE was upper respiratory tract infection (16.0%), followed by dizziness, headache, and protein urine present (10.7% each). There was no clinically relevant change (mean ± standard deviation) in endometrial thickness (baseline, 2.95 ± 1.11 mm; week 52, 2.94 ± 1.18 mm). Alanine aminotransferase and/or aspartate aminotransferase levels >3 times the upper limit of normal were reported in 1.4% of women; no Hy's Law cases occurred., Conclusions: Fezolinetant 30 mg once daily was generally safe and well tolerated over a 52-week period among women in China with vasomotor symptoms associated with menopause. ClinicalTrials.gov Identifier: NCT04451226., Competing Interests: Declaration of conflicting interestsWeizhong He was an employee of Astellas Pharma Global Development, Inc., at the time of the study. Kentaro Miyazaki is an employee of Astellas Pharma, Inc., Xuegong Wang is an employee of Astellas Pharma Global Development, Inc., and Xiao Ma is an employee of Astellas (China) Investment Co, Ltd. The remaining authors have no conflicts of interest to disclose.

The purpose of the study was to investigate whether premenopausal body mass index (BMI) and waist circumference (WC) influence age at menopause. A total of 2116 women aged 35–64 years from two communities of the CMCS Beijing cohort were recruited in 1992 and followed up to 2018. Of 1439 premenopausal women at baseline, 6 women data were missing. Finally, 1433 women were included for analysis. Overweight was defined as BMI 24–27.99 kg/m2. Central obesity was defined as WC ≥80 cm. Age at menopause was categorized as <45 years, 45–49 years, 50–51 years (reference), and >51 years. Multinomial logistic regression models were used to estimate relative odds ratios (RORs) and 95% confidence intervals (CIs). Compared to women with normal weight and normal WC, overweight women with normal WC had higher risk of menopause at >51 years (ROR 1.64, 95% CI 1.10–2.45; P =.01); and overweight women with central obesity had higher risk of menopause at not only >51 years (ROR 1.82, 95% CI 1.13–2.93; P =.01) but also <45 years (ROR 3.13, 95% CI 1.20–8.43; P =.02) and 45–49 years (ROR 2.76, 95% CI 1.71–4.46; P <.001). When overweight women combine with central obesity, the risk of early menopause will increase in some of them. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate genitourinary syndrome of menopause (GSM) in a large cohort, analyzing the dependency on age and menopausal status and possible differences between non-hysterectomized and hysterectomized women.Methods: Data were assessed by validated questionnaires, collected over 2 years for all eligible women attending our 'Menopause Clinic' from 31 Chinese provinces. Simple and unconditional logistic regression analysis was used with adjustments by all analyzed factors.Results: A total of 4063 women (mean age 50.53 ± 6.57 years), 2107 perimenopausal and 1956 postmenopausal, were included. Almost all GSM symptoms were more frequent and severe in postmenopausal women. GSM was more frequent in hysterectomized women compared to non-hysterectomized women. Independent of menopausal status, low sexual interest (92.78%), urinary incontinence (91.65%) and vaginal dryness (91.60%) were the top three GSM symptoms. Most severe were low sexual interest (21.01%), vaginal pain (20.10%) and decreased sexual pleasure (17.13%). Prevalence and severity of GSM were not related to age, but were related to menopausal status and increased with time since menopause.Conclusions: Within 2 years, more than 4000 women with GSM traveled from all over China to our specialized clinic, indicating the great importance of GSM. Hysterectomy can increase the risk of GSM, and GSM symptoms increase from perimenopause to postmenopause and with an increase of time since menopause, pointing to the dependency on the loss of ovarian function. [ABSTRACT FROM AUTHOR]

Background: Sex and gender are crucial variables in coronavirus disease 2019 (COVID-19). We sought to provide information on differences in clinical characteristics and outcomes between male and female patients and to explore the effect of estrogen in disease outcomes in patients with COVID-19. Method: In this retrospective, multi-center study, we included all confirmed cases of COVID-19 admitted to four hospitals in Hubei province, China from Dec 31, 2019 to Mar 31, 2020. Cases were confirmed by real-time RT-PCR and were analyzed for demographic, clinical, laboratory and radiographic parameters. Random-effect logistic regression analysis was used to assess the association between sex and disease outcomes. Results: A total of 2501 hospitalized patients with COVID-19 were included in the present study. The clinical manifestations of male and female patients with COVID-19 were similar, while male patients have more comorbidities than female patients. In terms of laboratory findings, compared with female patients, male patients were more likely to have lymphopenia, thrombocytopenia, inflammatory response, hypoproteinemia, and extrapulmonary organ damage. Random-effect logistic regression analysis indicated that male patients were more likely to progress into severe type, and prone to ARDS, secondary bacterial infection, and death than females. However, there was no significant difference in disease outcomes between postmenopausal and premenopausal females after propensity score matching (PSM) by age. Conclusions: Male patients, especially those age-matched with postmenopausal females, are more likely to have poor outcomes. Sex-specific differences in clinical characteristics and outcomes do exist in patients with COVID-19, but estrogen may not be the primary cause. Further studies are needed to explore the causes of the differences in disease outcomes between the sexes. [ABSTRACT FROM AUTHOR]

To assess the relationship between childbearing age and elements of metabolic syndrome (MS) among menopausal women in China. One thousand one hundred and forty-one subjects were divided into four interim average childbearing age (ACA) groups: ≥16 < 24 years old, ≥24 < 29 years old, ≥29 < 34 years old, and ≥34 years old. The group with the lowest prevalence of MS was used as a control. Body mass index, waist circumference (WC) and waist-to-hip ratio were assessed. Plasma glucose, lipids, glycated hemoglobin (HbA1c) and fasting insulin (FINS) were measured. Insulin resistance (IR) was assessed using the homeostasis model assessment (HOMA) method. The prevalence of MS in the 16–24 and 29–34 age groups was higher than that in the control group (p <.05). Compared with the control group, the odds ratios of MS were 1.431 for the 16-24 group (p <.05) and 1.553 for the 29-34 group (P < 0.01). ACA was correlated with FINS, HOMA-IR, WC, fasting plasma glucose, and triglycerides independent of age (p <.05). Average childbearing age was correlated with parameters of IR and components of MS independent of age in Chinese menopausal women. [ABSTRACT FROM AUTHOR]

Objectives: To examine Chinese middle-aged women's health and wellbeing and the associated biosocial correlates.Study Design: This study used a cross-sectional design, including selected retrospectively collected information on the final menstrual period, drawn from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS). Women aged 45 to 59 were selected.Main Outcome Measures: Factor analysis of 16 menopausal symptom ratings yielded four different and independent measures of pre-/peri-menopausal and early postmenopausal women's health. These were: negative mood (feel frustrated, sad, lonely, worried, bored, angry, tired and stressed), positive emotions (feel enthusiastic, content and happy), musculoskeletal pain (shoulder/neck pain, knee and other joint pain, and back pain), and sleep and memory problems (trouble sleeping and poor memory).Results: Menopausal status was positively associated with sleep and memory problems, whilst the number of years since the final menstrual period was positively associated with musculoskeletal pain. In contrast, lifestyle activities and social participation were linked to positive emotions. The association between selected biosocial factors and negative mood was not significant after controlling for other demographic and social background factors.Conclusions: Musculoskeletal health as well as sleep and memory problems are positively associated with menopausal biological factors amongst Chinese mid-life women. Maintaining active social engagement contributes to positive wellbeing among middle-aged women. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the epidemiology of atrial fibrillation (AF) in postmenopausal women and to evaluate the association between age of menopause and AF.Study Design: A total of 9117 postmenopausal women were selected from a cross-sectional study conducted among the general population of north-east China from September 2017 and March 2019.Main Outcome Measures: AF was diagnosed according to self-reported medical history of AF and/or current ECG findings. The epidemiology of AF including prevalence, awareness, use of anticoagulants and cardiovascular risk factors in postmenopausal women were carefully assessed. The association between age of menopause and AF was evaluated by stepwise logistic regression.Results: The prevalence of AF was up to 1.1 % (95 % CI, 0.9 %-1.3 %) in postmenopausal women, but the awareness of it was 61.2 %. The proportion of AF patients requiring treatment with an oral anticoagulant (OAC) was as high as 87.8 % according to CHA2DS2-VASc score, while only 5.8 % of them received it. The prevalence of cardiovascular risks factors was high among postmenopausal women with AF, but awareness, treatment and control of these comorbidities were unacceptably low. Compared with the women with premature menopause (< 45 years), participants reporting onset of menopause at 50-54 years had a significantly lower risk of AF (OR 0.49, 95 % CI 0.27-0.91).Conclusions: The widespread use of OAC and the control of cardiovascular risk factors in postmenopausal women with AF was of great significance in preventing AF-related stroke. The history of premature menopause provided a reliable opportunity for primary prevention of AF. [ABSTRACT FROM AUTHOR]

This study evaluated the relationships between parity and the age at menopause and menopausal syndrome among Chinese women in Gansu. A total of 7236 women aged 40 to 55 years met study eligibility criteria. The modified Kupperman Menopausal Index scale was used to assess the severity of menopausal syndrome. Cox regression was applied to estimate hazard ratio and 95% confidence interval, and logistic regression was performed to calculate odds ratio and confidence interval. The mean age at menopause was 47.91 ± 3.31 years. There is no relationship between parity and age at menopause. Women with nulliparity or multiparity seemed to have higher risks of moderate and severe menopausal syndrome. The potential beneficial effects of one or two births on menopausal syndrome were also observed by applying the multivariable logistic regression analysis, particularly in urogenital symptoms. Women with nulliparity and multiparity appeared to be at the higher risks of menopause syndrome. [ABSTRACT FROM AUTHOR]

Background and Aim: Little is known about whether early menopause in Chinese ethnicity is associated with acute myocardial infarction (AMI). We aimed to determine whether self-reported early menopause (either surgical or natural menopause at an age <50 year) was associated with first AMI in Chinese women. Methods: The study population was from the INTERHEART China Study, part of the INTERHEART global study. INTERHEART global study was a standardized case-control study that was designed to evaluate the risk factors for first AMI among 52 countries. Data for demographic factors, education, income, and cardiovascular risk factors were obtained by structured questionnaires. A standard set of questions that inquired about menstrual history was included in the interview. Results: Of the 1,771 Chinese women, 1,563 (88.3%) reported either natural or surgical menopause. In univariate logistic regression model, women with early menopause had higher risk of AMI (odds ratio [OR]: 1.51; 95% confidence interval [CI]: 1.23-1.87). After controlling for age, birth control measures, type of menopause, and other traditional risk factors (including waist/hip ratio, lifestyle factors, history of hypertension and diabetes, psychosocial factors, and apolipoprotein B [ApoB]/A1 [ApoA1]), the risk for AMI remained (OR: 1.36; 95% CI: 1.03-1.79). The population attributable risk for AMI in women with early menopause at <50 years was 10.1% (95% CI: 4.0-20.0) compared with women who had menopause at ≥50 years. Conclusion: Early menopause is associated with increased risk of AMI in Chinese women, independent of other traditional coronary heart disease risk factors.

Based on longitudinal mixed methods ethnographic research conducted in China from the mid-1990s to 2018, this article argues that Chinese lay language use divides what Americans and Canadians refer to as "menopause" into two distinct though overlapping concepts of the narrow juejing or end of menstruation and the broader non-gender-specific gengnianqi or "transition between middle and old age." While comparison with research done by Lock in Japan shows that Japanese language uses a similar set of two overlapping yet distinct terms called heikei and könenki, there are important differences between Chinese and Japanese views and experiences of female midlife amidst the similarities. While views and experiences of juejing in China are very similar to notions of heikei in Japan, gengnianqi is quite different from könenki. Like in Japan, the end of menstruation tends to be welcomed by women in China. Also like in Japan, midlife women in China had a lower prevalence of hot flashes than that found in the US and Canada. Also similar to Japan, Chinese women rarely associate hot flashes with embarrassment. However, unlike in the Japanese sample, the Chinese women reported a higher rate of irritability than even the American and Canadian samples. Contrasting with könenki, which is primarly associated with bodily aches and self-restraint in Japan, gengnianqi is commonly viewed as a time of vulnerability to irritable outbursts which must be allowed, though managed carefully. Overall, I show how menopause and midlife aging as concepts and as lived experiences are subject to variation related to differences in language, cultural ideas and practices, local biologies, and culturally-mediated generational experiences of historical change. [ABSTRACT FROM AUTHOR]

Objective: Our study aims to investigate the differences in insomnia between Chinese and Western women during menopause to fill the gaps in the research on menopause in Chinese women, and to examine the premenopausal factors predictive of moderate to severe insomnia during menopause.Study Design: This is a longitudinal cohort study conducted in an urban Chinese community with a total of 458 participants.Main Outcome Measures: Presence of insomnia symptoms (trouble falling asleep, waking up early); vasomotor symptoms; anxiety and depression assessed by the Hospital Anxiety and Depression Scale; and menopausal stages.Results: Multivariable analysis showed that compared with that in premenopause, the prevalence of trouble falling asleep was significantly higher in menopausal transition (P = 0.029) and postmenopause (P < 0.001), and the prevalence of early-morning awakenings also significantly increased in menopausal transition (P = 0.003) and postmenopause (P = 0.011). In multivariable analysis anxiety (P = 0.022) and depression (P = 0.005) were independently and significantly positively associated with trouble falling asleep. Anxiety (P < 0.001), depression (P = 0.018), and levels of follicle stimulating hormone (P-0.031) were independently and significantly positively associated with trouble falling asleep. Women who experienced insomnia in premenopause had a significantly higher risk of moderate to severe insomnia in menopausal transition (P = 0.003) and postmenopause (P = 0.047) than those who did not.Conclusion: This study showed that the prevalence of sleep disturbance significantly increased during and after menopause. Women with anxiety and depression had a higher risk of insomnia. Difficulty in sleep initiation in the premenopausal period was a strong predictor of moderate to severe insomnia at menopausal transition and postmenopause. [ABSTRACT FROM AUTHOR]

Context: During the menopausal transition, there is a greater likelihood of the prevalence of various bothersome symptoms, including vasomotor symptoms (VMS) and mood symptoms.Objective: To investigate the association among bothersome VMS and symptoms of anxiety and depression in Chinese women during perimenopause and early in menopause.Design, Patients, Setting, and Interventions: This study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. A structured questionnaire was provided annually, comprising the VMS Bother Score (range 1-8) from the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors.Results: Among the 430 women evaluated, 78.8% had experienced VMS during long-term follow-up. The overall level of VMS bother score was relatively low (1.92 ± 1.32). Both anxiety and depressive symptoms were significantly associated with VMS bother. After adjusting for potential covariates, the association between anxiety or depression symptoms and VMS bother remained highly significant. Menopausal stage, body mass index, general health, follicle-stimulating hormone, and estradiol were independent contributors to VMS. In time-lagged (1-year) models, VMS bother scores significantly predicted the risk of symptoms of both anxiety and depression the following year. In contrast, anxiety symptoms, rather than depressive symptoms, could predict VMS bother the following year.Conclusion: The prevalence of VMS in our cohort was higher than has been previously reported; however, the overall level of bother was relatively low. This study demonstrated a strong relationship between VMS bother and mood symptoms in Chinese women progressing from perimenopause through natural menopause. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has shown a definite association with gender, a predilection for males in terms of morbidity and mortality. The indirect evidence of the protective effect of estrogen has been shown by Channappanavar, in the animal model and Ding T. in a multihospital study from China, suggesting menopause as independent risk factor and estrogen is negatively correlated with severity. Objective: Study the clinical profile and outcomes in premenopausal and menopausal. Covid-19-infected women and analyzed the effect of menstrual status on the outcome. Materials and Methods: A retrospective cohort study conducted on 147 mild and moderate category COVID-19 females admitted between May and August 2020 using hospital records and telephonic follow-up. Two groups formed based on menstrual status: group-1 (premenopausal/estrogenic) and Group-2 (menopausal/hypoestrogenic). Hospital stay duration was considered as primary, while the category of disease on admission, clinical course, the requirement of oxygen, and mortality and residual symptoms were taken as a secondary outcome to compare the groups. Results: Overall Group-1 had significantly more of mild disease, while Group-2 had moderate cases (39 [76.5%] vs. 14 [14.6%] P < 0.01). Menopausal group has significantly more requirement of oxygen (32 [62.7%] vs. 20 [20.8%]), ventilation (14 [27.5%] vs. 1 [1%]) progression-to-severe disease (23.5% vs. 7.3%) and prolonged hospital stay ([14.1 ± 8.9 vs. 8.6 ± 3.9 days] P < 0.01). However, multivariate logistic regression failed to show a significant association between hospital stay and progression with menopause. Ferritin and residual symptoms found significantly higher in menopausal. Conclusions: No definite association was found between menopause and COVID-19 outcome with hospital stay duration or disease progression in our study. [ABSTRACT FROM AUTHOR]

Background: One of most important concerns of postmenopausal women is obesity. The relationships between menstruation status and obesity phenotypes are unclear. This study aimed to assess the associations between menstrual status and different obesity phenotypes in women. Methods: In total, 5373 women aged ≥40 years were recruited from the Jidong and Kailuan communities. Basic information was collected via clinical examination, laboratory testing and standardized questionnaires. The women were stratified into the following three groups: menstrual period, menopausal transition period and postmenopausal period. General obesity was defined as a body mass index (BMI) of ≥28 kg/m2. Central obesity was defined as a waist-to-hip ratio (WHR) of > 0.85. Visceral obesity was defined as the presence of nonalcoholic fatty liver disease (NAFLD) and increased pericardial fat volume (PFV). Results: The numbers of women in the menstrual, menopausal transition, and postmenopausal periods were 2807 (52.2%), 675 (12.6%) and 1891 (35.2%), respectively. The adjusted odds ratio (OR) and 95% confidence interval (CI) for central obesity among women in the menopausal transition and postmenopausal periods compared with women in the menstrual period were 0.99 (0.82–1.19) and 1.52 (1.26–1.84), respectively. The OR for NAFLD among postmenopausal women was 1.78 (1.44–2.20). The adjusted β-coefficient (standard error, SE) for PFV among postmenopausal women was 41.25 (7.49). The adjusted OR for general obesity among postmenopausal women was 1.01 (0.77–1.34). Conclusions: This study demonstrated that menopause is an independent risk factor for central and visceral obesity but not general obesity. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the bone mineral density (BMD) of older women living in rural and urban areas, and evaluate the potential factors affecting the risk of osteoporosis.Methods: We recruited 574 women aged 65 years or older from rural areas and 496 from urban areas in Shanghai, China. The BMD values of the lumbar vertebrae and total left hip were measured by a dual energy X-ray absorptiometry densitometer. We also recorded information about education level, family income, medications, reproductive and menstrual history, diet, smoking, and alcohol consumption.Results: Women in urban areas had significantly higher BMD in their lumbar spine, and there was a dramatic increase in the proportion of women with osteoporosis in rural areas. The age at menarche was significantly higher among women living in rural areas, and there were more years from menarche to menopause among urban women. Rural women had significantly higher numbers of both pregnancies and parity, and a significantly lower age at first parity. In multiple linear regression analyses, years from menarche to menopause was independently related to high lumbar spine BMD, while age at menarche and parity was independently related to low lumbar spine BMD.Conclusion: More older women in rural areas had osteoporosis. Later menarche, less years from menarche to menopause and higher parity might partially contribute to decreased BMD among women in rural areas. More attention should be paid to women in rural areas to prevent bone loss and further bone and health impairment. [ABSTRACT FROM AUTHOR]