Middle-aged Chinese Women Research Articles

Mediatory role of abdominal obesity in the association of early menopause with diabetes among middle-aged and older Chinese women.

The aim of this study was to assess the association of early menopause with diabetes and the mediating effect of abdominal obesity. This cross-sectional study was conducted among 5,693 participants. The data from the second follow-up (2015) of the China Health and Retirement Longitudinal Study were used. Participants self-reported their age at menopause and were divided into three age groups (<45, 45-54, and >54 years) according to the 10th, 10th to 90th, and 90th percentiles, with a menopausal age of 45 to 54 years serving as reference. The total effect was decomposed into direct and indirect (mediating) effects using logistic regression based on the Karlson-Holm-Breen method. Compared to the menopausal age of 45 to 54 years, early menopause (<45 years) was associated with diabetes (odds ratio = 2.19, 95% CI: 1.29-3.69) among Chinese women. The mediating effect of early menopause (<45 years) on diabetes was 4.98% (P = 0.321) for abdominal obesity. Early menopause may be associated with diabetes among Chinese women. Moreover, the mediating effect of abdominal obesity makes up a small percentage and has no statistical significance. Further studies are needed to examine other mechanisms behind the association of early menopause with diabetes.

A Longitudinal Analysis of Patient-Level Factors Associated with Pap Test Uptake Among Chinese American Women.

The purpose of this study was to longitudinally examine patient-level factors associated with Pap test uptake among middle-aged Chinese American women. The study analyzed data from 498 Chinese American women (1326 person-time-waves) who participated in the Study of Women's Health Across the Nation (SWAN) Series. Generalized estimating equation (GEE) was used to longitudinally examine patient-level factors associated with Pap test uptake over the 7-year period. Of the 1326 person-time-waves, 61% had a Pap test and 39% did not. Higher amounts of time spent by female healthcare providers for female health needs (eb = 3.35, p< 0.01), having a female healthcare provider for female health needs (eb = 3.36, p< 0.01),, and a history of cancer (eb = 6.05, p< 0.01) or fibroids (eb = 1.66, p< 0.01) were positively associated with Pap test uptake among Chinese American women, whereas not having a primary care provider (eb = 0.27, p< 0.05) and not having time to go to the doctor (eb = 0.31, p< 0.05) were negatively associated with Pap test uptake. Health education and health promotion messaging that accentuates the benefits of access to primary care providers and allocation of time to attend to health needs may bolster Chinese American women's acceptability and uptake of routine Pap testing for cervical cancer prevention. If health education and health promotion efforts are not developed, suboptimal rates of Pap testing will widen the disparity gap and contribute to Chinese American women's increased risk of cervical cancer morbidity and mortality in the coming years.

The effect of square dance on family cohesion and subjective well-being of middle-aged and empty-nest women in China

Researchers in this study aimed to examine the effect of square dance on the subjective well-being of middle-aged and empty-nest women, as well as the potential moderating role of group belongingness in the relationship between family cohesion and subjective well-being. A total of 331 middle-aged and empty-nest Chinese women participated in a survey to measure their family adaptability and cohesion, group belongingness, general well-being, and square-dancing participation information. The results were found as follows: (a) Chinese middle-aged and empty-nest women’s family cohesion was positively associated with subjective well-being, and their group belongingness in square dance was positively associated with subjective well-being; (b) participation in square dance can be the moderator the relationship between family cohesion and subjective well-being; (c) group belongingness was found to be a moderator in the relationship between family cohesion and subjective well-being.

Follicle stimulating hormone and estradiol trajectories from menopausal transition to late postmenopause in indigenous Chinese women

Objective The aim of this study was to examine follicle stimulating hormone (FSH) and estradiol (E2) trajectories in indigenous Chinese women through the ovarian aging process from 10 years before the final menstrual period (FMP) to 20 years after. Methods A prospective community-based longitudinal cohort study of 362 Chinese middle-aged women with a clearly determined FMP was performed. Results FSH and E2 trajectories were identified according to years from FMP and the Stages of Reproductive Aging Workshop + 10 (STRAW + 10), and further classified by body mass index. E2 decreases relatively steadily from Stage −2 to +1c, while FSH stabilizes quickly from Stage −2 to +1a. Obese women have higher E2 levels and lower FSH levels during menopausal transition, which last for decades after the FMP. There was no obvious decline in FSH levels for at least 20 years after the FMP. Conclusions The FSH and E2 trajectories in this indigenous Chinese cohort appear similar to those discussed in the Study of Women’s Health Across the Nation, with ethnic differences. STRAW + 10 criteria may be used to ascertain the ovarian aging process in Chinese women. Obese women may experience different levels of hormonal fluctuations during the menopause transition, while FSH levels in all women appear to remain high even at late postmenopause.

Insomnia symptoms in relation to menopause among middle-aged Chinese women: Findings from a longitudinal cohort study

ObjectiveOur 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 DesignThis is a longitudinal cohort study conducted in an urban Chinese community with a total of 458 participants. Main Outcome MeasuresPresence 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. ResultsMultivariable 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. ConclusionThis 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.

Serum uric acid and risk of incident diabetes in middle-aged and elderly Chinese adults: prospective cohort study.

The association between serum uric acid and the risk of incident diabetes in Chinese adults remains unknown. This study aimed to investigate this association in a community-dwelling population aged ≥ 40 years in Shanghai, China. Oral glucose tole3rance test was conducted during baseline and follow-up visits. Relative risk regression was utilized to examine the associations between baseline gender-specific serum uric acid levels and incident diabetes risk. A total of 613 (10.3%) incident diabetes cases were identified during the follow-up visit after 4.5 years. Fasting plasma glucose, postload glucose, and glycated hemoglobin A1c during the follow-up visit progressively increased across the sex-specific quartiles of serum uric acid (all Ps < 0.05). The incidence rate of diabetes increased across the quartiles of serum uric acid (7.43%, 8.77%, 11.47%, and 13.43%). Multivariate adjusted regression analysis revealed that individuals in the highest quartile had 1.36-fold increased risk of diabetes compared with those in the lowest quartile of serum uric acid (odds ratio (95% confidence interval) = 1.36 (1.06-1.73)). Stratified analysis indicated that the association was only observed in women. Accordingly, serum uric acid was associated with the increased risk of incident diabetes among middle-aged and elderly Chinese women.

Changes in ultrasound uterine morphology and endometrial thickness during ovarian aging and possible associated factors: findings from a prospective study

The aim of the study was to provide reference values for sonographic measurements of uterine morphology, quantify changes in uterine morphology across the menopausal transition, and identify possible factors associated with sonographic findings in uterine morphology. This is a longitudinal cohort study conducted in middle-aged Chinese women. Using transvaginal ultrasound, we measured morphologic parameters of the uterus (volume and endometrial thickness) under standardized conditions every year for over a decade. Uterine volume begins to decrease before the final menstrual period and declines rapidly thereafter. Compared with a baseline measurement taken in the year of the final menstrual period, uterine volume decreased by 20% and 35% at the first year and second year of postmenopause, respectively. The rate of decrease was slower in the third year. Compared with endometrial thickness in the year of the final menstrual period, the figures for 2 and 3 years before the final menstrual period were 5% and 10% higher, while they decreased by 9% and 18% at the first and second year after the final menstrual period. Similarly, the endometrial thickness became relatively stable 3 years after the final menstrual cycle. These observations were fairly consistent across all women without uterine fibroids. Endometrial thickness was significantly positively associated with body mass index (P = 0.049) after adjusting for time and menopausal stage. The figures for uterine volume and endometrial thickness decrease around menopause using ultrasound measurments with large reductions in the first and second year after the final menstrual period. A higher body mass index is associated with increased endometrial thickness.

Menopause and risk of hip fracture in middle-aged Chinese women: a 10-year follow-up of China Kadoorie Biobank.

Bone loss is accelerated after menopause in women, as is the risk of hip fracture, but little is known about the importance of age at menopause, time since menopause, and total reproductive years for risk of hip fracture. Between 2004 and 2008, the China Kadoorie Biobank recruited 125,336 postmenopausal women who had a natural menopause and recorded 1,327 incident cases of hip fracture during the first 10 years of follow-up. Multivariable Cox regression was used to estimate hazard ratios and 95% CIs for incident hip fracture for age at menopause, time since menopause, and total reproductive years. The mean (SD) age at menopause was 48.8 (4.0) years. Compared with women who reached menopause before age 53 years, women with a later age at menopause had a 22% (95% CI, 11%-35%) lower risk of hip fracture. Compared with women who were <5 years since menopause, those who were 5 to 9, 10 to 14, 15 to 19, and ≥20 years since menopause had hazard ratios of hip fracture of 1.43 (95% CI, 1.01-2.04), 2.10 (95% CI, 1.71-2.57), 2.50 (95% CI, 2.21-2.83), and 2.33 (95% CI, 1.97-2.75), respectively. Women with a longer (≥36 y) versus shorter (<30 y) duration of total reproductive years had a 19% (95% CI, 9-28) lower risk of hip fracture. Women with younger age at menopause, longer interval since menopause, or shorter duration of total reproductive years had the highest risks of hip fracture.

Comparison of energy expenditure and substrate metabolism during overground and motorized treadmill running in Chinese middle-aged women

The purpose of this study was to compare differences of energy expenditure and substrate metabolism between motorized-treadmill and overground running in three different velocities in Chinese middle-aged women. In total, 74 healthy middle-aged women (age, 48 ± 4 years; height, 159.4 ± 4.9 cm; weight, 58.6 ± 6.7 kg; and body-mass index (BMI), 23.1 ± 2.7 kg/m2) volunteered to participate in this study. Bioelectrical-impedance analysis was used to measure body composition. Energy expenditure, carbohydrates (CHO), and fat oxidation were calculated with indirect calorimetry during motorized-treadmill and overground running. Running speed from slow to fast was 7.0, 8.0, and 9.0 km/h. The duration of each velocity was 6 min, separated by 5–15 min rest. There was no significant difference in energy expenditure between overground and treadmill running at the speed of 7 km/h (8.10 ± 1.25 vs. 7.75 ± 1.13 kcal/min, p > 0.05). Energy expenditure of overground running at 8 and 9 km/h was higher than that of treadmill running (9.36 ± 1.40 vs. 8.54 ± 1.21 kcal/min; 10.33 ± 1.55 vs. 9.54 ± 1.36 kcal/min; both p < 0.01). Fat contribution to energy consumption was significantly higher during treadmill running than during overground running (both p < 0.01) at speeds of 8 and 9 km/h. Overground running at high intensity incurred greater energy consumption than treadmill running did. However, results showed greater fat utilization during treadmill running than during overground running at high intensity. It is critical that these differences are taken into account when we prescribe training modes and intensities for middle-aged women.

Predictors of never having a mammogram among Chinese, Vietnamese, and Korean immigrant women in the U.S.

BackgroundBreast cancer is the most common cancer among Asian women in the U.S. The first objective was to investigate predictors (including ethnicity) of never having a mammogram in middle-aged and older Chinese, Vietnamese, and Korean immigrant women (main effects). The second objective was to explore whether relationships between predictors and never having a mammogram varied across the three groups (moderation effects of ethnicity).MethodsMerged (2005-2007-2009-2011) California Health Interview Survey data were utilized. Unweighted sample was 3,710 Asian women ages 40 years and older (Chinese = 1,389; Vietnamese = 1,094; Korean = 1,227). Replicate weighted total sample size was 1,710,233 (Chinese = 940,000; Vietnamese = 410,000; Korean = 360,000). Replicate-weighted multivariate logistic regression was applied. Interaction effects (moderator role of ethnicity) were also examined, using multivariate logistic regression, for the second objective.ResultsFor the first objective, odds of never having a mammogram were higher for women who were Korean (Ref = Vietnamese), unmarried, or a non-U.S. citizen. Odds were lower in women ages 50–59 or 60–69 (Ref = 70–85). Regarding the second objective, only for Chinese women, odds of never having a mammogram were lower as the number of physician visits got higher.ConclusionCulturally-sensitive outreach and services should be developed to target higher-risk groups. Patient-centered healthcare strategies tailored for the three groups could be effective. For Chinese women, in particular, regular information sessions or education programs could be provided for enhancing their physician visits.

Number of parity is associated with low-grade albuminuria in middle-aged and elderly Chinese women

BackgroundWomen with a higher number of pregnancies have a higher risk of developing cardiovascular diseases. Subtle fluctuations in albumin excretion could be related to pathophysiologic changes in the vascular system. We aimed to investigate the possible association of parity with low-grade albuminuria.MethodsWe conducted a community-based study in 6495 women aged 40 years or older. Low-grade albuminuria was defined according to the highest quartile of urine albumin-to-creatinine ratio in participants free of micro- or macro-albuminuria.ResultsParous women with a higher number of pregnancies had increased age, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), fasting plasma glucose (FPG), and fasting insulin, as well as decreased high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate (eGFR) levels, and proportion of menopause. The prevalence of low-grade albuminuria in parous women gradually increased with parity number. Compared with women with one childbirth, those with more than two childbirths were independently associated with a higher prevalent low-grade albuminuria (odds ratios [ORs] 1.41, 95% confidence interval [CI], 1.09–1.81) after multiple adjustments. In subgroup analysis after multiple adjustments, significant relation between parity number and prevalent low-grade albuminuria was detected in subjects age 55 years or older.ConclusionNumber of parity is associated with prevalent low-grade albuminuria in middle-aged and elderly Chinese women without micro- or macro-albuminuria.

Primary hepatic leiomyoma in a Chinese female patient without underlying disease: a case report

BackgroundPrimary hepatic leiomyoma (PHL) is a rare manifestation of tumors in the liver; it is mainly characterized by its origin in the mesenchymal tissue. To date, the mechanisms underlying the pathogenesis of this disease remain unclear, however most reported PHL patients suffer from acquired immunity deficiency syndrome (AIDS) or take immunosuppressive medications after organ transplantation.Case presentationIn this case report we describe a rare case of PHL in a middle-aged Chinese woman who was asymptomatic with no history of hepatitis or other liver disease. She had no history of immune suppression medication therapy. In view of the benign features of the hepatic lesion, along with our implementation of the respecting the patience choices, a laparoscopic partial hepatectomy of the right lower liver was performed, which appeared to be highly effective and give a good prognosis.ConclusionsClinical characteristics of the patient should be compared to previously reported aspects of this disease to reach a clear diagnosis. Moreover, although PHL is extremely rare, it should still be considered a possibility. Surgical intervention is effective in treating this disease.

Abstract 631: High BMI in relation to low risk of lung cancer among never smokers

Abstract Background. Lean smokers have increased oxidative DNA damage relative to their non-lean counterparts, indicating their heightened susceptibility to tobacco carcinogens-induced DNA damage. Epidemiological association between body mass index (BMI) and lung cancer is inconclusive. We have reported that BMI is a protective factor for smoking-related lung cancer and so did a recent meta-analysis. Knowledge about the association between BMI and non-smoking related lung cancer is limited as this is rare in Western population. We therefore sought to investigate the association between BMI and the risk of never-smoking related lung cancer in an on-going prospective cohort study, the Singapore Chinese Health Study. Methods. The current analysis used data from the Singapore Chinese Health Study, a cohort of 63,257 middle-aged and older Chinese men and women enrolled between 1993 and 1998. As of December 31, 2015, 2,001 study participants who were free of lung cancer at baseline developed lung cancer of whom 621 were never smokers. Cox proportional hazard regression method was used to calculate hazard ratio (HR) and the corresponding 95% confidence interval (CI) for lung cancer associated with BMI in never-smokers. Results. Our results shown that increasing BMI was a protective factor for never-smoking related lung cancer and there is no interaction by gender. The respective HRs and 95% CIs were 0.66 (0.45-0.95) for overall and 0.60 (0.39-0.93) in female for those with BMI&amp;gt;27.5 compared to those with BMI&amp;lt;18.5. Even after eliminating those with exposure to any second-hand smoke in childhood or adulthood, the inverse association between BMI and the risk of never-smoking related lung cancer was stronger and significant (HR=0.31, 95% CI: 0.13-0.75; Ptrend=0.01). There was no difference by histologic subtypes (i.e., adenocarcinomas vs. squamous cell). Conclusion. There was an inverse association between BMI and the risk of never-smoking related lung cancer and there is no interaction by gender for this association. This association was also not different by histologic subtypes. Citation Format: Hung N. Luu, Renwei Wang, Jennifer Adams-Haduch, Aizhen Jin, Woon-Puay Koh, Jian-Min Yuan. High BMI in relation to low risk of lung cancer among never smokers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 631.

Association between prediagnostic leukocyte telomere length and breast cancer risk: the Singapore Chinese Health Study

BackgroundTelomeres and telomerase play key roles in the chromosomal maintenance and stability. Recent epidemiological studies have shown that longer telomeres are associated with increased risk of several cancer types. However, epidemiological data for telomere length and risk of breast cancer are sparse.MethodsWe prospectively studied the association between telomere length and risk of breast cancer in 14,305 middle-aged or older Chinese women of the Singapore Chinese Health Study including 442 incident breast cancer cases after 12.3 years of follow-up. Relative telomere length in peripheral blood leukocytes was quantified using a validated monochrome multiple quantitative polymerase chain reaction method. The Cox proportional hazard regression method was used to estimate hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) for breast cancer associated with longer telomeres after adjustment for potential confounders.ResultsLonger telomeres were significantly associated with higher risk of breast cancer in a dose-dependent manner (Ptrend = 0.006); the highest quartile of telomere length was associated with a statistically significant 47% higher risk of breast cancer compared with the lowest quartile of telomere length after the adjustment for age and other known risk factors for breast cancer (HRQ4 vs Q1 = 1.47, 95% CI = 1.11, 1.94).ConclusionsThe findings of the present study support the hypothesis that longer telomeres may be a risk factor for breast cancer. Telomere length in peripheral blood leukocytes may be developed as a biomarker for breast cancer risk prediction.

Human papillomavirus type 18/16 infection and prevalence among middle-aged and older Chinese rural women: a cross-sectional survey in Wufeng, Hubei Province

ABSTRACTThis study aimed to measure the prevalence and potential factors related to HPV 16/18 infection among middle-aged and older Chinese rural women. The study was conducted among women aged 35–65 years in rural villages within Wufeng in Hubei Province. Data were collected using a pretested questionnaire between July and August 2015. Cervical specimens were collected for HPV DNA detection and typing by using careHPV. Pearson’s Chi-square and logistic regression analyses were used to examine associations with HPV positivity. Among 1001 participants, the prevalence of HPV 18/16 positive genotyping was 15.88% (n = 159). Husbands’ extramarital sex (adjusted odds ratio [OR] = 15.85, 95% confidence interval [CI] 5.76–43.59), cervicitis (adjusted OR = 9.27, 95% CI 5.06–16.99), condom usage (adjusted OR = 0.16, 95% CI 0.05–0.53), higher average number of live births (adjusted OR = 1.98, 95% CI 1.32–2.96 for two live births; adjusted OR = 3.29, 95% CI 1.39–7.81 for three or more live births) were associated with HPV infection. The prevalence of HPV infection among participating women from rural areas was higher than that in several other areas in China. Our findings can aid efforts to prevent HPV infection to lower the risk of cervical cancer.

Serum lipid and lipoprotein levels of middle-aged and elderly Chinese men and women in Shandong Province

BackgroundCardiovascular and cerebrovascular diseases have become leading causes of death in China as the economy develop and lifestyles change. This study aimed to estimate the relationship of the age, gender, and glucose metabolism with the serum lipid and lipoprotein levels of middle-aged and elderly Chinese men and women in Shandong Province.MethodsWe conducted a cross-sectional study in Shandong Province that included 10,028 adults aged ≥40 years. Fasting serum total, low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol and triglycerides were measured by standard methods.ResultsThe estimates of total, LDL, and HDL cholesterol and triglycerides were as follows: 5.35, 3.18, 1.51, and 1.34 mmol/L in the middle-aged and elderly Chinese adult population; 5.14, 3.08, 1.42, and 1.33 mmol/L in male subjects; 5.46, 3.24, 1.56, and 1.34 mmol/L in females; 5.27, 3.11, 1.54, and 1.24 mmol/L in the normal glucose tolerance population, 5.49, 3.27, 1.50, and 1.41 mmol/L in the population with pre-diabetes, and 5.39, 3.23, 1.43, and 1.58 mmol/L in the population with diabetes, respectively. Moreover, 36.92 and 19.10% of the adults had borderline-high and high total cholesterol. The population estimates for borderline-high, high LDL and low HDL cholesterol levels were 25.24, 13.39, and 5.64%, respectively. Meanwhile, borderline high and high triglyceride levels accounted for 16.7 and 17.47% of the population, respectively.ConclusionsSerum total and LDL cholesterol levels were high in the ≥40 years old population of Shandong Province. Age, gender, glucose metabolism status, body mass index (BMI) and glycosylated hemoglobin (HbA1c) can affect serum lipid and lipoprotein levels.

Associations of the ages at menarche and menopause with blood pressure and hypertension among middle-aged and older Chinese women: a cross-sectional analysis of the baseline data of the China Health and Retirement Longitudinal Study.

We evaluated the associations of the ages at menarche and menopause with blood pressure (BP) and hypertension using the baseline data of 7893 women from the China Health and Retirement Longitudinal Study, a nationally representative survey among Chinese adults aged ≥45 years. Multivariate linear and logistic regression analyses were performed to evaluate the associations of the ages at menarche and men`opause with BP and hypertension, respectively. Nonlinear associations were evaluated using spline analyses. After controlling for age, education, marital status, living areas, smoking, drinking, and medication use if necessary, an early onset of menarche by 1 year was associated with a 6% (95% confidence interval [CI]: 3-9%) higher odds of hypertension and 0.82 mm Hg (P < 0.001) and 0.41 mm Hg (P < 0.001) higher systolic and diastolic BP, respectively. When further controlling for the body mass index (BMI), blood glucose, and lipids, the associations were still significant. Spline analyses did not support U-shaped relationships between menarche age and hypertension risk (P = 0.35), systolic BP (P = 0.60), or diastolic BP (P = 0.70). When stratified by location of residence, menarche age was only associated with BP and hypertension among women living in rural areas. The age of menopause was positively associated with hypertension (odds ratio [OR] = 1.02 per year delay of menopause, 95% CI: 1.01-1.03). However, when further controlling for BMI, such an association no longer existed (OR = 1.01, P = 0.32). These findings indicated that the associations of menarche age with BP and hypertension may be modified by factors related to the area of residence in China, and the association between menopause age and hypertension was driven by BMI.

Demands for perimenopausal health care in women aged 40 to 60 years-a hospital-based cross-sectional study in Shanghai, China.

The aim of the study was to describe the major complaints of menopausal symptoms among middle-aged women who initiated healthcare seeking for menopausal symptoms and to understand the factors influencing women's decisions to seek perimenopausal health care in Shanghai, China. A cross-sectional study was performed in five hospitals in Shanghai. Women aged 40 to 60 years at their first visit to the perimenopausal outpatient departments/clinics were investigated in person over a 3-month period. Information on sociodemographics, menopausal symptoms, and experiences in seeking perimenopausal health care was collected using a structured questionnaire. Menopausal symptoms were assessed with the modified Kupperman Menopausal Index (mKMI). A total of 316 women were enrolled in the study, with an average age of 50.5 years (SD: 5.1 y). The prevalence of menopausal syndrome (mKMI >6 points) was 80%, with 7% of the cases being severe. The top five reported symptoms were hot flushes/sweating (62%), fatigue (54%), sleep disturbance (51%), mood swings (40%), and joint/muscle pain (40%). The median interval between symptom occurrence and seeking perimenopausal health care was 5.0 months (IQR: 2.0-23.3 mo). Cox regression analysis revealed that older age, no health insurance, employment, multiple symptoms, sleep disturbance, urinary incontinence, and visits to nonspecialized departments were significantly associated with a longer delay in seeking perimenopausal health services (P < 0.05). The prevalence of menopausal syndrome was relatively high among 40- to 60-year-old women who initiated healthcare seeking in Shanghai. Months of delay occurred before they sought perimenopausal health services. The delay was related to age, the nature and number of symptoms, working status, and health insurance. Improvement of the menopausal health knowledge in Chinese middle-aged women may lead to more timely healthcare seeking. Professional and accessible perimenopausal health services are in high demand in Shanghai.

Assessment of sexual activity and menopausal symptoms in middle-aged Chinese women using the Menopause Rating Scale

Objectives: This study aimed to assess sexual activity and menopausal symptoms in middle-aged Chinese women and to correlate this with their vaginal maturation status (VMS).Methods: 120 women aged 45–60 years were assigned to four groups: premenopause (Pre-M), perimenopause (Peri-M), early postmenopause (Post-EM), and late postmenopause (Post-LM). The menopausal symptoms were assessed using the Menopause Rating Scale. VMS was determined using the vaginal maturation index (VMI) and pH value. Sexual activity including sexual frequency and distress was measured using self-administered questionnaires.Results: A high proportion (48.2%) of Post-LM women reported low sexual frequency, and a high proportion (24.2%) of Peri-M women reported sexual distress. Physical/mental exhaustion and sexual problems were the most prevalent symptoms, followed by sleeping problems and hot flushes/sweating rated as severe or very severe. Physical/mental exhaustion and sexual problems became more frequent as menopausal stages progressed (p < 0.05 and p < 0.01, respectively). Hot flushes/sweating was more prominent in women in the Peri-M and Post-EM groups. The Post-LM group exhibited lower VMI and higher pH values than the Pre-M and Peri-M groups (p < 0.017 and p < 0.001, respectively), and pH was positively correlated with sexual problems (r = 0.298, p < 0.01).Conclusions: Advancing menopausal status is associated with prevalent physical/mental exhaustion and sexual problems in middle-aged Chinese women. Hot flushes/sweating is among the most frequent menopausal symptoms rated as severe or very severe. In addition, urogenital symptoms are correlated with pH in these women.

A Convergence Study on the Relationship between Cereal Intake Level and Food and Nutrients Intake of Chinese Middle-aged Women

A Convergence Study on the Relationship between Cereal Intake Level and Food and Nutrients Intake of Chinese Middle-aged Women