Prevalence of menopausal symptoms in different ethnic groups of Asian women and responsiveness to therapy with three doses of conjugated estrogens/medroxyprogesterone acetate: the Pan-Asia Menopause (PAM) study.

Objective: To survey the prevalence of 18 menopausal symptoms in nine ethnic groups of Asian women. To evaluate responsiveness of symptoms to three estrogen/progestin doses in Asian women.

Design: A prospective, randomized, double-blind multinational clinical trial in 1028 healthy postmenopausal women from 11 Asian countries/regions. Following 2 weeks of baseline observations, the women received one of three conjugated estrogens (CE)/medroxyprogesterone acetate (MPA) doses (in mg) daily for 24 weeks: 0.625/2.5; 0.45/1.5; or 0.3/1.5. At baseline and throughout the study period, the women were asked to record each symptom daily on diary cards translated into 10 languages.

Results: The number of women in the different ethnic groups ranged from 24 (Malay) to 248 (Chinese). The overall prevalence of symptoms differed among the groups, with Vietnamese women generally reporting the highest rates. Within each ethnic group, the prevalence of individual symptoms varied substantially. Only 5% of Indonesian women, for example, reported hot flushes but 93% complained of body or joint aches/pains. Overall, body or joint aches/pains was the most prevalent symptom, ranging from 76% in Korean women to 96% in Vietnamese women. Therapy resulted in a significant decline in all symptoms. The decline was observed with all three doses after 4 weeks of treatment and continued throughout the 6-month study period.

Conclusion: The prevalence of individual menopausal symptoms differed among ethnic groups of Asian women. Within each ethnic group the percentage of women reporting each symptom varied substantially. Symptoms declined after 4 weeks of hormone therapy and thereafter throughout the study. The effect of the lowest dose of CE/MPA (0.3/1.5 mg/day) was comparable to that of the higher doses.