The aim of the study was to specify prevalence and severity of menopausal symptoms among middle-aged women and to understand the factors associated with women's perimenopausal healthcare-seeking behavior in Shanghai, China. A community-based cross-sectional study was carried out involving 3147 participants aged 40-60 years. A combination of stratified sampling and quota sampling was used. Out of the total 16 districts in Shanghai, 7 were purposefully selected in consideration of covering both central and suburban areas, population distribution, and willingness to participate. Two communities were randomly selected in each of six districts. Four communities were randomly selected in the 7th district considering the relatively low coverage of central population in the sampling frame. Eligible women were recruited continuously according to the house number and invited to participate in the study until 200 participants were recruited in each community. A structured questionnaire was designed to collect information including sociodemographic data, menopausal symptoms, and experiences in seeking perimenopausal healthcare. The severity of menopausal symptoms was assessed with the modified Kupperman menopausal index (mKMI). The mean age of all the participants was 51 years. 33.13% of the participants were premenopausal, 14.52% were perimenopausal, and 52.35% were postmenopausal. The total prevalence of menopausal symptoms was 73.8%, while among the perimenopausal women, the symptoms were the most common (81.70%). The top three reported symptoms were fatigue (38.08%), hot flushes and sweating (33.65%), and joint ache (28.81%). Perimenopausal and postmenopausal participants had a higher score of the mKMI than premenopausal women (p < 0.01). Of the women who had symptoms, 25.97% had sought healthcare. A logistic regression model revealed that employment, menstruation status, and the mKMI were significantly associated with healthcare-seeking behaviors (p < 0.01). We concluded that prevalence of menopausal symptoms was relatively high among middle-aged women, with perimenopausal women showing the highest level. However, only a small percentage of the participants sought healthcare. Carrying out health education may be a measure to improve the healthcare-seeking behavior.
Keywords: associated factors; menopausal symptoms; perimenopausal healthcare.