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Vasomotor, psychological and somatic symptoms decrease after menopause in Australian women, with only sexual symptoms continuing. In Japanese women, somatic, psychological and sexual symptoms remain high after menopause. It is possible that westernization may be having a significant impact on the aging of women in Japan and it is, therefore important to capture through research just what this impact may be.

Objectives The International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE) project is a global research collaboration that aims to advance understanding of women’s reproductive health in relation to chronic disease risk by pooling individual participant data from several cohort and cross-sectional studies. The aim of this paper is to describe the characteristics of contributing studies and to present the distribution of demographic and reproductive factors and chronic disease outcomes in InterLACE. Study design InterLACE is an individual-level pooled study of 20 observational studies (12 of which are longitudinal) from ten countries. Variables were harmonized across studies to create a new and systematic synthesis of life-course data. Main outcome measures Harmonized data were derived in three domains: 1) socio-demographic and lifestyle factors, 2) female reproductive characteristics, and 3) chronic disease outcomes (cardiovascular disease (CVD) and diabetes). Results InterLACE pooled data from 229,054 mid-aged women. Overall, 76% of the women were Caucasian and 22% Japanese; other ethnicities (of 300 or more participants) included Hispanic/Latin American (0.2%), Chinese (0.2%), Middle Eastern (0.3%), African/black (0.5%), and Other (1.0%). The median age at baseline was 47 years (Inter-quartile range (IQR): 41–53), and that at the last follow-up was 56 years (IQR: 48–64). Regarding reproductive characteristics, half of the women (49.8%) had their first menstruation (menarche) at 12–13 years of age. The distribution of menopausal status and the prevalence of chronic disease varied considerably among studies. At baseline, most women (57%) were pre- or peri-menopausal, 20% reported a natural menopause (range 0.8–55.6%) and the remainder had surgery or were taking hormones. By the end of follow-up, the prevalence rates of CVD and diabetes were 7.2% (range 0.9–24.6%) and 5.1% (range 1.3–13.2%), respectively. Conclusions The scale and heterogeneity of InterLACE data provide an opportunity to strengthen evidence concerning the relationships between reproductive health through life and subsequent risks of chronic disease, including cross-cultural comparisons.

The main aim of the present study was to explore the midlife experience for women living in Australia and Japan. The specific objectives of the study included: (i) comparing menopausal symptoms between the two groups; and (ii) comparing the factor structure of symptoms and exploring their relationship to menopausal status. Postal questionnaires were distributed to two structured, random population based samples of midlife women aged 45-60 years; consisting of 712 women living in Australia and 1502 women living in Japan. Analysis showed significant differences in menopausal symptoms related to psychological symptoms (P < 0.001), including anxiety (P < 0.001) and depression (P < 0.001), somatic symptoms (P < 0.001), and vasomotor symptoms (P < 0.01). The analysis, which excluded hormone replacement therapy (HRT) users, found that there were significant differences seen across menopausal status in the following symptoms: difficulty in sleeping (P < 0.01), difficulty in concentrating (P < 0.01), feeling dizzy or faint (P < 0.001), loss of interest in most things (P < 0.01) and loss of feeling in hands or feet (P < 0.001). In the postmenopausal stage specifically, significant differences were seen in the areas of feeling tense or nervous (P < 0.01), feeling unhappy or depressed (P < 0.01), parts of body feeling numb or tingling (P < 0.05), headaches (P < 0.01), and sweating at night (P < 0.05). Our analysis revealed that the experience of menopause for women is different between Australian and Japanese women.

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Obesity and cigarette smoking substantially increased women's risk of frequent or severe vasomotor symptoms in a dose-response manner, and smoking intensified the effect of obesity. Short title: Obesity, smoking, and vasomotor symptoms AJOG at a Glance Why was this study conducted?  This pooled analysis provided precise estimates of the individual and joint associations between body mass index (BMI) and smoking with the risk of vasomotor menopausal symptoms (VMS). What are the key findings?  Higher BMI and greater smoking were associated with more frequent/severe VMS in the cross-sectional analysis, and smoking strengthened the effect of obesity. However, women who quit smoking before age 40 years had a similar level of risk as never smokers.  Prospective analyses showed similar results, but the individual and joint effects of BMI and smoking on subsequent VMS at three-year follow-up attenuated markedly after adjustment for baseline VMS.  The effect of BMI on VMS risk differed in pre-/perimenopause and postmenopause. What does this study add to what is already known?  Being both obese and smoking conferred a much higher risk of frequent/severe VMS than either alone.  Maintaining a normal weight before the menopausal transition and smoking cessation before age 40 years may mitigate the excess risk of frequent/severe VMS.

It is important that that consideration be given to incorporating the same tool within the cross-cultural design of studies so that comparisons between cultures and patterns of healthy aging can be made. The research suggests that there seems to be variations across Australian and Japanese midlife women in some areas of HRQOL and some factors that contribute to these areas.

This cross-sectional study explored the comfort and quality of life in hospitalized, preterm, pregnant women compared with pregnant outpatients, and identified the relationship between comfort, quality of life, and hospitalization. Two-hundred-and-twenty-one hospitalized pregnant women who met the inclusion criteria were recruited from obstetric units, and 1015 outpatient pregnant women were recruited from obstetric outpatient units in Japan. The women were questioned on six domains of the Japanese Short-Form-36 version 2 (bodily pain, general health, vitality, role emotional, social functioning, and mental health) and on their subjective comfort. A total of 189 hospitalized pregnant women and 503 low-risk pregnant women were analyzed. Subjective comfort and all six domains of health-related quality of life showed significantly lower scores for hospitalized women than outpatient women (P < 0.05-0.001). The mean differences in social functioning and role-emotional domains between the two groups were particularly marked. The result of this study suggests that these patients require positive psychological support to improve their comfort and quality of life.