141 / 2019-11-05 23:58:39

Prevalence, severity, and associated factors of perimenopausal syndrome in women aged 40 to 60 years: A community-based cross-sectional study

Perimenopausal syndrome; Associated factors; The modified Kupperman Menopausal Index(mKMI); Logistic regression model; Chi-square automatic interactive detection (CHAID) classification tree

Purpose: The aim of the study was to provide suggestion for establishing strategies by investigating associated factors of women’s perimenopausal syndrome in Luzhou, China.
Methods: A cross-sectional, community-based study was performed on 502 women aged 40 to 60 years in Luzhou, Sichuan, China. Cluster sampling method was used to extract respondents. The modified Kupperman Menopausal Index(mKMI) score rank and self-administered questionnaire were used to evaluate perimenopausal syndrome symptoms of women. Chi-square test, multi-factor unconditional logistic regression model and chi-square automatic interactive detection (CHAID) classification tree were used to analyze the influencing factors of perimenopausal syndrome in 40-60 years old women.
Results: The mean (SD) age of menopause was 48.05(4.02) years old. The prevalence of perimenopausal syndrome was 87.1% and the total average mKMI score was (16.65±10.52). The mild, moderate, and severe prevalence rates of perimenopausal syndrome were 37.8%、46.6% and 15.6%, respectively. In descending order, the five most prevalent symptoms suffered by all participants were irritability (78.5%), insomnia(75.1%), fatigue(73.2%), hot flushes and sweating(72.0%) and dizziness(71.2%), respectively. The using rate of hormone replacement therapy (HRT) is 3.4% in patients with perimenopausal syndrome. Multivariate non-conditioned logistic regression showed that the poor quality of sleep(OR=2.000, P<0.001), high frequency of anxiety(OR=3.284, P<0.001), more times of pregnancies(P=0.049，0-1 time served as controls：2 times OR=1.386；3 to 4 times OR=2.309；5 times or more OR=0.929), asexual life (OR=2.924, P=0.003) were the main risk factors for perimenopausal syndrome. CHAID classification tree screened four influencing factors: anxiety, chronic disease, sexual life and quality of sleep, of which anxiety was the most important risk factor for perimenopausal syndrome. The AUC of logistic regression and CHAID classification tree were 0.771 and 0.775, respectively, and the model was reliable.
Conclusion: Perimenopausal syndrome in luzhou City has characteristics of high incidence (over than the national level 2/3), more serious degree, high prevalence of common perimenopausal syndrome symptoms, and the usage rate of HRT is relatively low. To help women spend a smooth perimenopausal periods, we should carry out peri-menopausal women's health care services, open relevant specialist outpatient clinics, timely conduct psychological counseling and psychological counseling for perimenopausal women, conduct mental health education, improve sexual health awareness, advocate healthy living habits, and expand the promotion of hormone replacement therapy.
Keywords: Perimenopausal syndrome; Associated factors; The modified Kupperman Menopausal Index(mKMI); Logistic regression model; Chi-square automatic interactive detection (CHAID) classification tree