Menopausal symptoms – Comparing East and West

Abstract

Well known are the typical “menopausal symptoms”, i.e. symptoms during the transit from pre- to peri- to early postmenopause, like vasomotor symptoms (hot flush and sweating), sleep disorders and mood changes, urogenital atrophy and dyspareunia with sexual disfuntion. Very typical also are menstrual disorders, which are the basis of the definition of menopausal stages according to the “2011 Stages of Reproductive Aging Workshop (STRAW + 10) report”. By comparison of different countries or continents, resp., it should be considered that in the studies the symptoms have been assessed by different menopausal transit definitions and also by different scales, and there are also large differences dependent on study design, sampling and screening. However, there are some striking observations: Our own large recent study (n = 1225) shows that the main climacteric symptoms in Chinese women are muscle and joint pain, depression and irritability (about 60%) whereas vasomotor symptoms only in about 40% have been observed, all symptoms according Kupperman Index are higher in post-compared to perimenopause. This also is confirmed in large intercontinental reviews. An alarming increase of depression is observed also in other parts of Asia, in Eastern Europe and South Amercia, e.g. also seen in the SWAN study comparing different ethnic groups within USA. Although metaanalyses and systematic reviews concluded in general no clear pattern of menopausal symptoms, in general there is an increase of all symptoms within the recent years, thus great need for treatment in every country.