Obesity and Menopausal Symptom Burden in Postmenopausal Women: Cross-Sectional Evidence From Eastern China

Background: To examine the relationship between body mass index (BMI) and the prevalence and severity of menopausal symptoms in a clinically verified cohort of peri- and postmenopausal women in Eastern China. Measure(s): This cross-sectional study included 1,371 women aged 40–60 years attending the Perimenopausal Health Care Center, Hangzhou Women’s Hospital, Zhejiang University School of Medicine, from June 2022 to June 2025. Anthropometric measurements were obtained using standardized protocols, and menopausal symptoms were assessed using the modified Kupperman Menopausal Index (mKI). Participants were classified by BMI according to Chinese criteria. Group differences were evaluated with ANOVA or chi-square tests, and Pearson’s correlation was used to assess associations between anthropometric measures and symptom scores. Results: The most common symptoms were hot flashes/sweating (76.6%), sexual difficulties (72.4%), fatigue (72.0%), insomnia (71.8%), and mood swings (66.3%). Symptom prevalence did not differ significantly across BMI categories. However, BMI correlated positively, though modestly, with vasomotor complaints (r = 0.069, P = 0.011), mood swings (r= 0.066, P = 0.014), sexual difficulties (r = 0.074, P = 0.006), and urinary symptoms (r = 0.076, P = 0.005). Obese women had significantly higher mKI sub-scores for vasomotor, sexual, and urinary symptoms compared with normal-weight participants. Conclusion: BMI was not associated with the overall prevalence of menopausal symptoms but was positively related to the severity of vasomotor, sexual, urinary, and mood-related complaints.