Menarche, menopause, reproductive life span and menopause-specific quality of life: a cohort study

Abstract

Objective This study aimed to investigate the associations of menarche age, menopause age and reproductive life span with menopausal symptoms in Chinese women.Methods The prospective, longitudinal study included 557 midlife Chinese women. Menopausal symptoms were evaluated through the Menopause-Specific Quality of Life (MENQOL) questionnaire, covering vasomotor symptoms (VMS), psychosocial, physical and sexual domains. Generalized estimating equation models were used to estimate the crude and adjusted mean differences (β) and 95% confidence intervals (CI).Results Mean menarche and menopause ages were 13.92 ± 1.62 and 50.56 ± 3.20 years, with a mean reproductive life span of 36.64 ± 3.56 years. Age at menarche was not associated with MENQOL domain scores. Earlier menopause and shorter reproductive life span were associated with higher adjusted sexual-domain scores, with significant differences for menopause before age 45 years (β = 0.83, 95% CI: 0.21, 1.44) and reproductive life span <30 years (β = 0.98, 95% CI: 0.21, 1.74). These sexual-domain associations were attenuated after adjustment for time since menopause, whereas associations with higher VMS scores became apparent in postmenopausal analyses. No significant associations were observed for psychosocial or physical-domain scores.Conclusion Earlier menopause and shorter reproductive life span were associated with MENQOL-assessed sexual-domain discomfort, partly explained by time since menopause. Additional postmenopausal analyses also linked these factors to greater VMS burden.